Routine inspection·May 8, 2025

On 05/08/2025 at 8:50 AM, Licensing Program Analyst (LPA) P. Manalo arrived unannounced to conduct 1-Year Annual Required inspection. LPA met with Care Staff, Na Liu and explained the purpose of the visit. Administrator (ADM) Isabella Joe was contacted by the phone and arrived shortly after. The Administrator holds a certificate #7002486740 and expires on 11/28/2025. LPA toured facility inside and out including but not limited to bedrooms, bathrooms, kitchen, common area and backyard. The facility consists of 4 total bedrooms which 3 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 71 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 105.9 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 purchased on 05/08/2025. Emergency Disaster Plan was last posted on 03/15/2025. First aid kit was observed to be complete. Emergency disaster drill was last conducted on 04/01/2025. Continue to LIC809-C... Continue from LIC809... At 9:59 AM, LPA reviewed 3 residents records. At 10:44 AM, LPA reviewed 2 staff records and 2 of 2 have current first aid training and associated to the facility. At 11:11 AM, LPA reviewed two samples of resident’s medications. All records were observed to be complete and up to date. Updated copies of the following documents were requested for facility file and are to be submitted to CCL by 05/16/2025: LIC 308 Designation of Administrative Responsibility LIC 500 Personnel Report THE FOLLOWING DEFICIENCY WAS OBSERVED DURING VISIT: At 11:30 AM, LPA observed scissors, screwdrivers, and Lysol wipes unlocked and accessible to residents. The Facility was cited from the California Code of Regulations, Title 22 and/or Health and Safety Code Failure to correct deficiency by POC date may result in additional Civil Penalties. Exit interview conducted with Administrator. Appeal Rights and a copy of this report provided.