Magnolia Manor

Type of visit: Required - 1 Year

At 12:00pm, Licensing Program Analyst (LPA), Angela Panushkina conducted an unannounced annual inspection at the facility mentioned above. LPA met with the Administrator and explained the reason for the visit. Facility is licensed for capacity of six (6) Non-Ambulatory residents. LPA observed six (6) bedrooms, two (2) single and two (2) double occupancy for residents’ use. Two (2) staff rooms are located upstairs. All bedrooms have sufficient lighting, properly furnished, clean and have appropriate bedding and linens. Auditory alarms were tested and observed to be operational. Facility has three (3) full bathrooms. The staff bathroom is located upstairs, and both resident bathrooms are located downstairs. All bathrooms were observed to be clean and in good repair. Properly supplied with toilet paper, soap and paper towels. The hot water temperature measured at 106.4°F. LPA observed appropriate grab bar and non-skid mat. All trash cans in bathrooms had fitted lids to protect them from cross contamination. The facility maintains a comfortable temperature at 72°F. The Common areas are furnished with adequate furniture to accommodate a maximum capacity of six (6) residents. At approximately 12:15pm, LPA toured the kitchen area and observed enough supplies of staple non-perishable for minimum 1 week and perishable for 2 days at the facility. All knives and sharps are observed to be locked in a kitchen drawer and inaccessible to residents. There is a fire extinguisher in the kitchen, and it was last serviced on 03/20/2025. Continue on LIC809-C At approximately 12:20am, LPA observed medications are centrally stored and locked by the entry closet and inaccessible to residents in care. The first-aid kit has been inspected which has at least the following: tweezers, scissors, antiseptic, bandages, gauze, thermometer; including a current First Aid manual. The laundry room is located in the garage. The washer/dryer appears to be in good condition. Laundry supplies are kept inaccessible when not in use with supervision. At 12:30pm, smoke and carbon monoxide detectors were tested and observed to be operable. There were no visible immediate hazards. At 12:40pm, LPA toured the outside area of the facility. LPA observed appropriate outdoor furniture, with a covered shaded area for residents. The outdoor area was free of visible immediate hazards. There is a swimming pool that is fenced. The fence surrounding the swimming pool is approximately 5 feet high all around. You will need a key to gain entry to the swimming pool as it is kept locked at all times. LPA discussed the importance of maintaining care and supervision to meet the needs of residents. Between 12:50am to 1:10am, LPA reviewed records of two (2) residents and one (1) staff. Client and staff records appeared to be complete and updated. LPA observed Administrator certificated renewed on 07/26/2024 with an expiration date of 07/25/2026. LPA collected Certificate of Liability Insurance and LIC500. No citations were issued during this visit. Exit interview conducted and copy of this report signed and delivered.the state’s words, verbatim · CDSS document, Mar 5, 2026

Type of visit: Required - 1 Year

At 11:15am, Licensing Program Analyst (LPA) Angela Panushkina arrived at the facility to conduct an unannounced annual inspection. Upon arrival, LPA met with the Administrator and LPA explained the reason for the visit. At 11:20am LPA conducted a tour of the physical plant and observed the following: Upon entry, LPA observed a locked closet and was informed that all residents medications and files are kept in there. Facility is licensed for capacity of six (6) Non-Ambulatory residents. There are four (4) bedrooms designated for clients’ use, of which two (2) bedrooms are private and two (2) bedrooms are shared. Bedrooms are appropriately furnished and have appropriate lighting. Facility has awake staff at night. Bathrooms have soap, paper towels and hand washing signs were observed. Extra towels and linens were readily available. The hot water temperature measured at 120.0°F. Facility maintains a temperature of 72°F. LPA observed there to be sufficient stock of one-week perishable foods and two-day non-perishable foods. Frozen foods are properly wrapped and stored appropriately. Food storage and preparation areas are clean and inaccessible to pests. The fire extinguisher is located in the kitchen and was last serviced on 03/18/2024. Laundry is located in the garage. The washer/dryer appear to be in good condition. Laundry supplies are kept inaccessible when not in use with supervision. All chemicals, detergents and medications are kept in the garage and inaccessible to residents in care. Smoke detectors and carbon monoxide monitors were tested at 11:40am and observed to be functional. At 11:50am, LPA observed appropriate outdoor furniture, with a covered shaded area for residents. There is a swimming pool that is fenced all around with a gate that will be kept locked at all times. The fence surrounding the swimming pool is approximately 5 feet high all around. You will need a key to gain entry to the swimming pool as it is kept locked at all times. Continue on LIC809-C LPA discussed the importance of maintaining the care and supervision to meet the needs of residents.. Between 11:50am to 12:30am, LPA reviewed records of two (2) residents and two (2) staff. Client and staff records appeared to be complete and updated. Annual fee is paid in full. LPA observed Administrator certificated renewed on 07/26/2024 with an expiration date of 07/25/2026. LPA collected Certificate of Liability Insurance and LIC500. No citations issued during this visit. Exit interview conducted and copy of this report signed and delivered.the state’s words, verbatim · CDSS document, Mar 4, 2025

Type of visit: Required - 1 Year

At 10:15 am Licensing Program Analyst (LPA), Lorena Casillas, conducted an unannounced annual inspection at the facility mentioned above. LPA was greeted by the Administrator Jeaneth Cristobal, who granted access to the facility and LPA explained the reason for the visit. At 10:45 am, LPA conducted a tour of the facility, and the following was observed: Infection control: The facility had submitted and approved Mitigation Plan and Infection Control Plan. Proper signs were observed along the hallway and in the restrooms. Kitchen: At 10:50 am LPA toured the kitchen area and observed enough supplies of staple non-perishable for minimum of seven days and perishable for two days at the facility. All knives and sharps are observed to be locked in a kitchen drawer and inaccessible to residents. There is a fire extinguisher in the kitchen that was last serviced on 03/20/23. Bedrooms: There are four (4) bedrooms designated for resident use and have sufficient lighting. All bedrooms are properly furnished, clean and have appropriate bedding and linens. Auditory alarms were tested and observed to be operational. Bathrooms: At 10:55 am LPA observed all bathrooms are clean and in good repair. Properly supplied with toilet paper, soap, and paper towels. The hot water temperature measured at 107.7 °F. LPA observed grab bar and non-skid mats. LPA also observed appropriate hand washing signs posted in each bathroom. All trash cans in bathrooms had fitted lids to protect from cross contamination. Continued on LIC809-C Common Areas: The facility maintains a comfortable temperature at 74°F. The living room and dining area appeared clean and were properly furnished. No obstructions or tripping hazards throughout the facility. Outside areas: At 11:00 am LPA toured the outside area of the facility. There is a swimming pool that is fenced all around with a gate and kept locked at all times. The fence surrounding the swimming pool is approximately 5 feet high all around its parameters. LPA also observed a clean covered patio and furniture to accommodate residents. Garage: Laundry area is in the attached garage and kept locked and inaccessible to residents. Extra PPE supplies and food storage were also observed. Smoke detectors/carbon monoxide. Dual smoke and carbon monoxide detectors were located throughout the facility, and at 11:00 am they were tested and observed to be operational. Administrative: LPA collected Resident Roster and LIC500. Certificate of Liability Insurance will be emailed to LPA. Annual fee is due by 03/30/2024 LPA gave Administrator PIN. Administrator will pay fee by due date. Resident Interviews: At 12:00 pm LPA interviewed residents. Staff Interviews: At 12:10 pm LPA interviewed staff. Medications: At 12:20 pm LPA and Administrator went over medications. No citations issued during this visit. Exit interview conducted. Copy of report given to Administrator.the state’s words, verbatim · CDSS document, Mar 13, 2024