Amber Street II

Type of visit: Required - 1 Year

On 5/12/2026 at 11:20 AM Licensing Program Analyst (LPA) Toni Nwala conducted an unannounced annual required visit. Upon entry, LPA was greeted by Joanne Pantuso, Administrator, and informed them of the purpose of the visit. At the time of the visit, there were two (2) staff members and five (5) residents present. Facility Overview: The facility is a one-story home with (6) bedrooms and () 7bathrooms, including an attached garage. There is a fenced swimming pool in compliance with building code. There are no known firearms on the premises. Infection Control: LPA observed that hygiene and cleaning supplies were available for regular facility maintenance. The facility’s infection control plan was reviewed and found to meet department requirements. Physical Plant: The physical plant, including floors, windows, and doors, was clean and well maintained. Fixtures and furniture were in good repair. The outdoor area was free of hazards. Laundry equipment was in good working condition. Sharp and dangerous objects were securely locked and inaccessible to residents. Both the smoke detector and carbon monoxide detector were operational, and the hot water temperature was 105.8°F. There were 3 fire extinguishers, and all had current inspection tags dated 02/15/2025. Continued on LIC809-C.... Food Service: The facility’s kitchen was clean and equipped to prepare food. The facility maintained the required two-day supply of perishable foods and a seven-day supply of non-perishable foods. Care & Supervision/Administration: Adequate staff were present to supervise clients during the visit. The administrator holds a current administrator’s certificate. Record Review and Resident/Staff Files: LPA reviewed files for (4) staff members, confirming criminal clearances, updated training, and CPR/First Aid certification. (3) resident files were reviewed and contained all required documentation. Health-Related Services/Incidental Medical Services: All resident medications were securely locked. LPA reviewed medications for (5) residents, confirming that all medications were listed and accounted for. Disaster Preparedness: LPA reviewed the facility’s emergency and disaster plan, including documentation of the last fire drill conducted on 3/19/26, which met department requirements. All facility exits were clear of obstructions. No deficiencies were cited during the visit. An exit interview was conducted, and a copy this report was reviewed and provided to Jamie Pantusothe state’s words, verbatim · CDSS document, May 12, 2026

Type of visit: Case Management - Incident

Licensing Program Analyst (LPA) Valerie Flores conducted an unannounced case management visit to the facility. LPA met with Licensee, Jamie Pantuso and explained the purpose of the visit. LPA conducted a health and safety check by touring the facility; LPA observed (3) three of the (3) three residents present. On 6/10/2025, the department received a 3-day eviction notice regarding Resident 1 (R1). According to the information received R1 was displaying aggressive and threatening behaviors towards other residents in care, including physical posturing and verbal hostility. R1 was admitted to the facility on 6/3/2025. LPA conducted interviews with staff and residents present. Information revealed R1 has not physically attacked or harmed other residents in care however R1s outburst consisting of grunting noises will often agitate other residents in care. In addition, R1 has shown inappropriate behaviors towards staff when staff assist R1. R1 will make inappropriate sexual gestures and sexual remarks towards the staff, R1 attempted to bite staff, and R1 dug their fingernails into a staff’s arm during a behavioral episode. LPA was unable to interview the staff who experienced the behaviors of R1, however LPA was able to corroborate R1s behaviors through record review of noted incidents regarding R1, observed by staff. All other staff on shift during LPA's time of visit did not have any firsthand knowledge of the above noted incident(s). According to the Licensee, the residents responsible party and Licensee both have come to an agreement that the facility is not a good fit for R1. LPA has confirmed with Licensee that the resident was relocated on 06/13/2025. There were no health and safety concerns during the visit. Exit interview was conducted, and a copy of this report was issued, to Licensee, Jamie Pantuso.the state’s words, verbatim · CDSS document, Jun 16, 2025

Type of visit: Prelicensing

On 05/14/2025, Licensing Program Analyst (LPA) Debbie Palacios conducted an announced visit to the pending facility to conduct a pre-licensing inspection. LPA met with Applicants Joanne Pantuso and Jamie Pantuso. Fire clearance has been granted for six (6) residents, four (4) of which may be Non-Ambulatory. Waiver/granted for Hospice Care for five (5) residents. Applicant Joanne's Administrator certificate expires on 04/25/2026. LPA conducted of a tour of the facility’s interior and exterior. LPA did not observe any residents residing in the home or evidence to suggest the home is currently occupied. The facility is made up of a one-story home with six (6) resident bedrooms, six (6) bathrooms, (1) staff bathroom, a kitchen, living/family room, laundry room and a backyard/patio. LPA observed a locked gated swimming pool. The physical plant is in good repair. Indoor and outdoor passageways are free of obstruction. An outdoor shaded seating area is available for future residents. LPA observed four (4) charged fire extinguishers mounted throughout the facility, last serviced on 02/15/2025. LPA tested the smoke alarms and carbon monoxide detectors and found them to be operational. LPA observed that the laundry room was locked and has a the washer and dryer area with detergents and cleaning solutions are stored in a locked cabinet. Resident bedrooms had the required bedding, furniture, closet storage, and functional lighting. LPA observed that each bedroom has an emergency exit door and floor plans posted on the walls. Continued from LIC809.. LPA toured the kitchen and observed that food was stored in a safe and healthful manner. The facility has a 7-day supply of nonperishable food items. Emergency food, water and essentials are stored in the kitchen closet. Medications, personnel and resident files will be stored in the additional kitchen cabinets. LPA observed an additional medium sized fridge in the kitchen to store medications. LPA toured the bathrooms and observed bathrooms to be in safe and sanitary conditions. The hot water temperature in the resident bathrooms measured at 113-degrees Fahrenheit. LPA observed multiple closets in the hallway to store hygiene supplies, linens and blankets. Living/family room has a working television and adequate seating in common areas. The facility has a central heating and air conditioning system installed with a central panel located in the hallway to control entire house. Emergency disaster plans, personal rights, and complaint procedures were posted in the hallway wall. LPA observed a complete first aid kit and manual. During today’s visit, LPA did not observe any issues or concerns. Applicants have completed COMP III and final approval of licensure will be granted by the Centralized Application Bureau analyst. An exit interview was conducted where a copy of this report was discussed and provided.the state’s words, verbatim · CDSS document, May 14, 2025

Type of visit: Office

Facility Type: RCFE Application Type: Initial Capacity: 6 Method: Telephone call with CAB COMP II Participants: Pantuso, Joanne On 4/15/25, the applicant/administrator participated in COMP II at CAB via telephone call with analyst at CAB. Identification of the applicant and administrator was verified by confirming driver’s license number. During COMP II, applicant and administrator confirmed the understanding of Title 22. Component II was successfully completed. Applicant and administrator were advised to email/fax signed LIC 809 with copy of photo ID to CAB. During COMP II, CAB analyst confirmed Applicant/Administrator’s understanding of following areas: 1. Facility operation: License type, client/resident populations, and program 2. Admission Policies 3. Staffing requirements & Training 4. Restrictive/Prohibited Health Conditions 5. General provisions 6. Emergency Preparedness 7. Complaints & Reporting 8. Pre-licensing readinessthe state’s words, verbatim · CDSS document, Apr 15, 2025