Routine inspection·February 24, 2026

On 02/24/2026 at 9:40 AM, Licensing Program Analyst (LPA) P. Manalo arrived unannounced to conduct 1-Year Annual Required inspection. LPA met with Administrator, Irene Jenkins, and explained the purpose of the visit. Administrator certificate is current. LPA toured facility inside and out including but not limited to bedrooms, bathrooms, kitchen, common area and backyard. The facility consists of 5 total bedrooms of which 4 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 68 degrees Fahrenheit. LPA observed lighting in all rooms is adequate for the comfort and safety of the residents. The hot water temperature in the residents’ shared bathroom was measured at 107.2 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. Smoke detectors and carbon monoxide detectors were in operating condition during visit. Fire extinguisher was last purchased on 01/12/2026. First aid kit was observed to be complete. Fire drill was last conducted on 02/04/2026. Liability insurance is effective from 03/03/2025 to 03/03/2026. At 10:30 AM, LPA reviewed 5 residents records. At 10:47 AM, LPA reviewed 3 staff records and 3 of 3 have current first aid training and are associated with the facility. At 11:30 AM, LPA reviewed two samples of residents’ medications. Continue to LIC809-C... Continued from LIC809... Updated copies of the following documents were requested for facility file and are to be submitted to CCLD by 03/06/2026 LIC 500 Personnel Report LIC9020 Register of Facility Clients/ Residents Liability Insurance THE FOLLOWING DEFICIENCIES WERE OBSERVED DURING VISIT: At 10:04 AM, LPA observed scissors unlocked in the kitchen drawer. At 10:22 AM, LPA observed both showers soiled. At 11:51 AM, LPA observed that R4's file is incomplete and all the residents LIC625 (Appraisal Needs and Services Plan). At 12:00 PM, LPA observed R1 and R4’s PRN medication in the facility not available and R4’s doctor’s order for PRN medication missing. The Facility was cited from the California Code of Regulations, Title 22 and/or Health and Safety Code Failure to correct deficiencies by POC date may result in additional Civil Penalties. Exit interview conducted with Administrator. Appeal Rights and a copy of this report provided.