Routine inspection·June 24, 2025

On 06/24/2025 at 1:30 PM, Licensing Program Analyst (LPA) P. Manalo arrived unannounced to conduct 1-Year Annual Required inspection. LPA met with Co-Administrator, Camille Abolencia 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 which all 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 72 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 110.5 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 04/03/2025. Emergency Disaster Plan was last posted on 06/24/2025. First aid kit was observed to be complete. Emergency disaster drill was last conducted on 04/29/2025. At 2:14 PM, LPA reviewed 3 residents records. At 2:35 PM, LPA reviewed 4 staff records and 4 of 4 have current first aid training and associated to the facility. At 3:31 PM, LPA reviewed two samples of residents' medications. Continue to LIC809-C... Continue from LIC809... THE FOLLOWING DEFICIENCIES WERE OBSERVED DURING VISIT: At 2:09 PM, LPA observed a u-shaped metal piece used to lock the side gate. Civil Penalty of $500 is assessed. At 3:02 PM, record review revealed that all residents did not have an updated Appraisal Needs and Services Plan (LIC625). 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 Co-Administrator. Appeal Rights, Civil Penalty, and a copy of this report provided.