Routine inspection·March 13, 2026

On 03/13/2026 at 9:00 AM, Licensing Program Analyst (LPA) P. Manalo arrived unannounced to conduct 1-Year Annual Required inspection. LPA met with Administrator, Cristina Concepcion and explained the purpose of the visit. Administrator certificate is current. LPA toured the facility inside and out 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 and 2 bedroom is occupied by staff. There are no bodies of water observed. A comfortable temperature is maintained at 72 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 120 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 detector were in operating condition during visit. Fire extinguisher was last serviced on 03/31/2025. First aid kit was observed to be complete. Emergency disaster drill was last conducted on 09/15/2025. At 9:53 AM, LPA reviewed 4 residents records. At 10:21 AM, LPA reviewed 3 staff records and 2 of 3 have current first aid training and 2 of 3 are associated with the facility. At 12:00 PM, LPA reviewed a sample of resident’s 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 CCL by 03/27/2026: LIC 308 Designation of Administrative Responsibility LIC 500 Personnel Report LIC 610E Emergency Disaster Plan Liability Insurance THE FOLLOWING DEFICIENCIES WERE OBSERVED DURING VISIT: At 9:15 AM, LPA observed knife and scissors unlocked in the kitchen. At 9:22 AM, LPA observed Tylenol, Robitussin, Hydrocortisone Cream, Scissors, etc in R3's room. At 9:30 AM, LPA observed the garage unlocked with disinfectants. At 9:36 AM, LPA observed that one of the side gates is locked with a screw and the other side gate is locked with a screwdriver. At 9:45 AM, record review and observation revealed that the physical plant does not match the approved sketch on file. At 10:59 AM, LPA observed that the residents' files are incomplete such as their Appraisal Needs and Services Plan (LIC625, Identification and Emergency Information (LIC601), and Physician Report (LIC602A) for R3. At 11:13 AM, LPA observed that S2 is not associated with the facility. At 11:19 AM, LPA observed that the staff records are incomplete. S1 is missing First Aid Certification, S2 and S3 are missing Health Screening and TB Test. Continue to LIC809-C... Continued from LIC809-C... At 11:44 AM, LPA observed that R1, R2, and R4 have half bed rails without a doctor's order. At 12:05 PM, record review revealed that for R1 there is no discontinued order for the Melatonin and doctor’s order for sodium, docusate sodium, smartrx, blood sugar monitoring, etc. At 12:26 PM, record review revealed that the facility has not conducted a fire drill since September 15, 2025. 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.