Poet's Vista Residential Care

On 01/30/2026 at 12:00 PM, Licensing Program Analyst (LPA) L. Alexander arrived unannounced to conduct 1-Year Annual Required inspection. LPA met with Administrator, Haimanot Batha and explained the purpose of the visit. The facility’s fire clearance was approved for six (6) residents. In which all may be non-ambulatory, one (1) bedridden and there's an approved hospice waiver for three (3) resident. Administrator certificate # #7011929740 expires 05/18/2026 . Licensee, Girmay Gebremedhin, arrived shortly. LPA toured facility with Haimanot including but not limited to bedrooms, bathrooms, kitchen, common area and backyard. The facility consists of six (6) total bedrooms which six (6) bedrooms are occupied by the residents. All outdoor and indoor passageways are kept free of obstruction. There are no bodies of water observed. A comfortable temperature is maintained at 70 degrees Fahrenheit. LPA observed lighting in all rooms are adequate for the comfort and safety of the residents. The hot water temperature in the residents’ shared bathroom was measured at 100.7 degrees Fahrenheit. Residents’ bathrooms are equipped with grab bars and non-skid mats. There is a minimum of one-week supply of nonperishable and 2-day of perishable foods. Centrally stored medication and sharps were locked and inaccessible to residents. LIC809-C Continued... 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 LIC809-C (Page 2) Smoke detectors and carbon monoxide detector were in operating condition during visit. Fire extinguisher was last serviced on 01/27/2026. Emergency Disaster Plan was last posted on 01/06/2026. First aid kit was observed to be complete. Emergency disaster drill was last conducted on 01/02/2026. LPA reviewed six (6) residents records. LPA reviewed seven (7) staff records and all have current first aid training and associated to the facility. Updated copies of the following documents were requested for facility file and are to be submitted to CCL by 02/06/2026: LIC 308 Designation of Administrative Responsibility LIC 309 Administrative Organization Updated LIC 500 Personnel Report LIC 610E Emergency Disaster Plan - Reviewed Liability Insurance Current Administrator’s Certificate - Reviewed No deficiencies cited during visit. Exit interview conducted and a copy of this report provided.

On 02/19/2025 at 3:15 PM, Licensing Program Analysts (LPAs) L. Alexander and L. Holmes arrived unannounced to conduct 1-Year Annual Required inspection. LPAs met with Administrator, Haimanot Bahta and explained the purpose of the visit. The facility’s fire clearance was approved for six (6) non-ambulatory. In which one (1) resident may be bedridden. Hospice waiver approved for two (2) residents. Administrator Certificate #7011929740 expires 05/18/2026. LPAs toured facility with Haimanot including but not limited to bedrooms, bathrooms, kitchen, common area and backyard. The facility consists of six (6) total bedrooms which five (5) bedrooms are occupied by the residents and one (1) bedroom is occupied by staff. All outdoor and indoor passageways are kept free of obstruction. There are no bodies of water observed. A comfortable temperature is maintained at 71 degrees Fahrenheit. LPAs observed lighting in all rooms are adequate for the comfort and safety of the residents. The hot water temperature in the residents’ shared bathroom was measured at 111.2 degrees Fahrenheit. Residents’ bathrooms are equipped with grab bars and non-skid mats. There is a minimum of one week supply of nonperishable and 2-day of perishable foods. Centrally stored medication and sharps were locked and inaccessible to residents. Smoke and carbon monoxide detectors were in operating condition during visit. Fire extinguisher was last serviced on 01/20/2025. Emergency Disaster Plan was last posted on 03/19/2024. First aid kit was observed to be complete. Emergency disaster drill was last conducted on 01/20/2025. LIC809-C Continued.... 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 LIC809-C Continued LPAs reviewed five (5) residents records. LPAs reviewed four (4) staff records and 4 of 4 have current first aid training and associated to the facility. Updated copies of the following documents were requested for facility file and are to be submitted to CCL by 02/26/2025: LIC 308 Designation of Administrative Responsibility LIC 309 Administrative Organization LIC 500 Personnel Report LIC 610E Emergency Disaster Plan - Reviewed Liability Insurance No deficiencies cited during visit. Exit interview conducted and a copy of this report provided.

On 03/19/2024 at 10:45 AM, Licensing Program Analyst (LPA) Lori Alexander arrived unannounced to conduct 1-Year Annual Required inspection. LPA met with Caregiver, Lidya Hailu and explained the purpose of the visit. Lidya phoned Administrator, Haimanot Bahta, to inform. Administrator, Haimanot arrived approx. 11:50 AM. The facility’s fire clearance was approved for capacity of 6 (Six) residents in which 1 (One) can be Bedridden. Hospice waiver approved for 2 (Two) residents. Administrator Certificate #6040140740 Expires 05/18/2024. LPA toured facility with Haimanot including but not limited to bedrooms, bathrooms, kitchen, common area and backyard. The facility consists of 7 total bedrooms which 6 bedrooms are occupied by the residents and 1 bedroom is occupied by staff. All outdoor and indoor passageways are kept free of obstruction. There are no bodies of water observed. A comfortable temperature is maintained at 70 degrees Fahrenheit. LPA observed lighting in all rooms are adequate for the comfort and safety of the residents. The hot water temperature in the residents’ shared bathroom was measured at 108.3 degrees Fahrenheit. Residents’ bathrooms are equipped with grab bars and non-skid mats. There is a minimum of one week supply of nonperishable and 2-day of perishable foods. Centrally stored medication and sharps were locked and inaccessible to residents. 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 Smoke detectors and carbon monoxide detector were in operating condition during visit. Fire extinguisher was last serviced on 01/25/2024. Emergency Disaster Plan was last posted on 03/19/2024. First aid kit was observed to be complete. Emergency disaster drill was last conducted on 01/25/2024. LPA reviewed 3 residents records. LPA reviewed 6 staff records and 6 of 6 have current first aid training and associated to the facility. Updated copies of the following documents were requested for facility file and are to be submitted to CCL by 03/26/2024: LIC 308 Designation of Administrative Responsibility LIC 309 Administrative Organization LIC 500 Personnel Report - Reviewed Liability Insurance Current Administrator’s Certificate - Reviewed No deficiencies cited during visit. Exit interview conducted and a copy of this report provided.

On 02/09/23 at 12:39 PM, Licensing Program Analyst (LPA) L. Alexander arrived unannounced to conduct 1-Year Annual Required inspection. LPA met with Administrator, Haimanot Batha, and explained the purpose of the visit. The facility’s fire clearance was approved for 6. LPA toured facility with Haimanot including but not limited to bedrooms, bathrooms, kitchen, common area and backyard. The facility consists of 6 total bedrooms which 4 bedrooms are occupied by the residents. All outdoor and indoor passageways are kept free of obstruction. There are no bodies of water observed. A comfortable temperature is maintained at 70 degrees Fahrenheit. LPA observed lighting in all rooms are adequate for the comfort and safety of the residents. The hot water temperature in the residents’ shared bathroom was measured at 105.4 degrees Fahrenheit. Residents’ bathrooms are equipped with grab bars and non-skid mats. There is a minimum of one week supply of nonperishable and 2-day of perishable foods. Centrally stored medication and sharps were locked and inaccessible to residents. Smoke detectors and carbon monoxide detector were in operating condition during visit. Fire extinguisher was last serviced on 02/01/23. First aid kit was observed to be complete. 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 Updated copies of the following documents were requested for facility file and are to be submitted to CCL by 02/16/2023: LIC 308 Designation of Administrative Responsibility LIC 309 Administrative Organization LIC 500 Personnel Report LIC 610E Emergency Disaster Plan Liability Insurance Current Administrator’s Certificate Facility Sketch Covid-19 Mitigation Plan Monkeypox Addendum No deficiencies cited during visit. Exit interview conducted and a copy of this report provided.