At approximately 2pm The LPA and staff toured the physical plant areas inside and outside to ensure there are no health and safety hazards and facility is in compliance with Title 22 Regulations. The following was observed:

KITCHEN: The LPA inspected the kitchen/food service area. Knives and sharps were observed in a locked drawer at the time of the visit. Kitchen appliances were in operable condition. The facility has a sufficient supply of perishable and non-perishable food. Refrigerator and food pantry were checked for proper labels and expiration dates. Cleaning supplies were observed locked and inaccessible under the kitchen sink. The LPA observed an adequate amount of emergency food and water.

COMMON AREAS: At the time of the visit, furniture in the common areas was observed to be in good condition. The facility maintained a comfortable temperature. Fire extinguisher was observed to be new with a purchase date of 04/17/2026. The LPA observed a fireplace adequately covered at the time of the visit. Night-lights observed throughout the common areas and bathrooms. The LPA observed required postings throughout the common space. Auditory alarms observed functioning at the time of the visit. Facility smoke/carbon monoxide detectors and fire alarm are all wired and connected with the local fire station. The system was confirmed operable via the phone system. (Continued on LIC 809c)

BACKYARD: The backyard has a shaded patio area with adequate furniture for resident use. All passageways were observed to be clear and free of obstructions. The LPA observed three (3) sheds used for storage which were locked at the time of the visit. There is one (1) self-latching gate for emergency use. No bodies of water noted at the time of the visit. No obstructions or hazards observed inside or out.

RECORDS: LPA reviewed resident records and staff records starting at approximately 2:45 p.m. -3:30 p.m. Six (6) resident files were reviewed for, but not limited to, the following: signed admission agreements, current medical assessments with negative TB results, preplacement appraisal, and appraisal / current needs and services plan. All files were complete. Three (3) personnel files including the Administrator’s file were reviewed for, but not limited to: personnel records, health assessments with negative TB results, criminal record clearances, first aid/CPR training, and the appropriate yearly training. All records were in order. The facility's infection control plan was also reviewed; The facility’s policies and procedures as it pertains to infection control are adequate. An adequate amount of Personal Protection Equipment (PPE) was observed. In addition, the facility's emergency disaster plan was reviewed, which was observed to be complete and reviewed/updated annually. Emergency disaster drills are conducted quarterly as per regulation; with the last drill conducted on 06/10/2026.

MEDICATIONS: The LPA conducted a medications review at approximately 3:45 p.m. -4:30 p.m.. Medications are centrally stored in a locked cabinet by the kitchen. Medications observed documented properly and appear to be administered as prescribed at the time of the visit.

Exit interview conducted. A copy of the report and appeal rights were provided.

• Type A deficiencies are violations of licensing requirements that, if not corrected, have a direct and immediate risk to the health, safety, or personal rights of persons in care.

• Type B deficiencies are violations of licensing requirements that, without correction, could become a risk to the health, safety, or personal rights of persons in care, a recordkeeping violation that could impact the care of said persons and/or protection of their resources, or a violation that could impact those services required to meet the needs of persons in care.