Inspection Report Summary
Most inspections found no deficiencies, with the facility consistently clean, sanitary, and in good repair. The most recent report from January 13, 2025, showed no deficiencies despite a self-reported resident elopement incident in December 2024, which resulted in no trauma and appropriate follow-up care. Earlier reports also confirmed compliance with infection control and safety regulations, and no complaints were filed or substantiated. There were no fines, enforcement actions, or severe issues noted in any report. The facility’s record appears stable and well-maintained over time.
Deficiencies per Year
4
3
2
1
0
Census Over Time
Census
Capacity
Inspection Report
Annual Inspection
Census: 6
Capacity: 6
Deficiencies: 0
Jan 13, 2025
Visit Reason
The inspection was an unannounced required annual inspection combined with a case management visit triggered by a self-reported incident involving a resident elopement.
Findings
No deficiencies were cited during the visit. The facility reported a resident elopement incident that occurred on December 19, 2024, with no signs of trauma found. The resident was admitted to home health upon return. The Licensee was provided technical assistance regarding the absentee notification plan.
Report Facts
Facility capacity: 6
Resident census: 6
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Carmen Lopez | Licensing Program Analyst | Conducted the inspection and case management visit |
| Frederick Locsin | Administrator/Director | Facility Administrator present during the visit |
| Donnah Locsin | Licensee | Licensee present during the visit and involved in incident reporting |
Inspection Report
Annual Inspection
Census: 6
Capacity: 6
Deficiencies: 0
Jan 13, 2025
Visit Reason
An unannounced required annual inspection was conducted to evaluate the facility's compliance with licensing regulations.
Findings
The facility was found to be clean, sanitary, and in good repair with no deficiencies observed or cited. All safety measures, medication storage, and resident accommodations were compliant with regulations.
Report Facts
Fire extinguishers present: 2
Residents interviewed: 3
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Carmen Lopez | Licensing Program Analyst | Conducted the inspection and reviewed facility compliance |
| Donnah Locsin | Licensee | Facility representative present during inspection and exit interview |
| Frederick Locsin | Administrator/Director | Discussed the purpose of the visit with the Licensing Program Analyst |
Inspection Report
Annual Inspection
Census: 2
Capacity: 6
Deficiencies: 0
Jan 9, 2024
Visit Reason
An unannounced required annual inspection was conducted to evaluate compliance with licensing requirements at the facility.
Findings
The facility was found to be clean, sanitary, and in good repair with no deficiencies observed or cited. All safety equipment and required documents were in place and compliant.
Report Facts
Fire extinguishers present: 2
Days of perishable food: 2
Days of non-perishable food: 7
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Carmen Lopez | Licensing Program Analyst | Conducted the annual inspection and authored the report |
| Frederick Locsin | Administrator | Facility administrator present during the inspection |
| Donnah Locsin | Licensee | Licensee present during the inspection |
Inspection Report
Annual Inspection
Census: 4
Capacity: 6
Deficiencies: 0
Dec 23, 2022
Visit Reason
Licensing Program Analyst Tammer de los Santos visited the facility to conduct an annual required licensing inspection.
Findings
The inspection verified compliance with infection control practices including universal entry screening, temperature checks, visitor sign-in, hand hygiene promotion, face coverings, and availability of PPE. No deficiencies were cited during the visit.
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Alyssa Collins | Lead Caregiver | Met with Licensing Program Analyst during the inspection and participated in exit interview. |
| Tammer de los Santos | Licensing Program Analyst | Conducted the annual required licensing inspection. |
| Denise Powell | Licensing Program Manager | Named as Licensing Program Manager on the report. |
Inspection Report
Census: 4
Capacity: 6
Deficiencies: 0
Oct 12, 2022
Visit Reason
An unannounced case management visit was conducted following a self-reported incident involving a resident who was sent to the hospital for an injury.
Findings
No deficiencies were cited during the visit. The case management requires further follow-up and may involve additional visits or phone calls.
Report Facts
Capacity: 6
Census: 4
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Frederick Locsin | Administrator | Met with Licensing Program Analyst during the visit |
| Donnah Locsin | Licensee | Contacted via telephone during the visit |
| Carmen Lopez | Licensing Program Analyst | Conducted the unannounced case management visit |
| Rebecca Hedgecock | Licensing Program Manager | Named in the report header |
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