Facility is licensed to serve elderly residents aged 60 and above. All residents may be non-ambulatory. Facility approved for Three residents on hospice. The facility a single-story home and consists of three (3) shared resident Bedrooms and two (2) Resident Bathrooms, dining room, living room, TV room, staff room, office, and patio/deck area.

LPA toured the facility and observed the following: Each resident’s bedroom has the required furniture and bedding. There is extra clean linen and towels in hallway closet. Smoke detectors were observed in each room and throughout the facility and are properly operating. There is 1 carbon monoxide in the dining room and is properly operating. The facility has one (1) fully charged fire extinguishers which is kept in the kitchen. Cleaning supplies and toxic substances are inaccessible to clients in a locked storage in garage. Freezers are maintained at a temperature of 0-degree F and the refrigerators at a maximum of 45 degrees F. Sufficient supply of 7 days non-perishable foods was observed in the kitchen. There was not enough 2-day perishable food deficiency cited. There is an extra refrigerator and freezer in garage that did not have much food. There are no firearms or weapons stored at the facility. The hot water temperature in the bathrooms were measured between the range of 128.6-129.7 degrees F that does not meet title 22 regulations deficiency cited. Bathrooms have the required grab bars and nonskid mats in bathrooms. The facility does not have a swimming pool or bodies of water on the premises There is a shaded seating area for the residents located in the backyard. Passageways and exits are free of obstruction.

Deficiencies have been noted on LIC 809D under Title 22 Regulations. Exit interview was conducted and a copy of this report, LIC 809D and appeal rights were provided to Maria Blanco.