Routine inspection·December 18, 2025

On this day, December 18, 2025, Licensing Program Analyst (LPA) Delmundo arrived unannounced to conduct an annual required inspection. LPA was granted entry by staff, Nancy Amistad, and informed the reason for visit. LPA called and spoke over the phone with Olive 'Lyn' Neri, administrator (ADM) who authorized Nancy Amistad to with LPA in touring the facility. LPA also met with other staff, Myriel Danilo Espiritu. ADM arrived at around 11:55 am with other John Louie Neri. LPA toured the facility inside out. LPA inspected the kitchen, dining area, living room, bedrooms, common and ensuite bathrooms, side yard and backyard. Food supplies were observed good for 2 days of perishables and 7 days of non-perishables. Central storage for medications was observed locked. Smoke and carbon monoxide detectors were tested, and observed in operating condition during visit. Facility conducts disaster drills every quarter and records showed last conducted December 15, 2025 . Fire extinguisher checked, observed fully charge with tag showed serviced July 26, 2025. Hot water temperature in the ensuite bathroom was tested and measured at 111. 6 degrees Fahrenheit. LPA reviewed 5 staff and 5 residents records. Medications inspected and compared with LIC622 Centrally Stored Medication and Destruction Records and doctor's orders. Residents' P&I checked and compared with last recorded balance. ......continued on 809C On this same day, LPA received the updated/current copies of the following documents: 1. LIC308 Designation of Facility Responsibility. 2. LIC500 Personnel Report 3. LIC610E Emegency Disaster Plan (9 pages) 4. $3M liability insurance certificate 5. Proof of Surety Bond coverage The following deficiencies were observed and cited from Title 22 California Code of Regulations and listed on 809Ds. -at 10:22 am, CA-Rezz incontinent wash in the kitchen cabinet without lock. -at 10:23 and 10:25 am, peeler and can opener in other kitchen cabinets without lock. -at 10:26 am, heavily scratched kitchen island, dusty and soiled upright kitchen cabinets, and greasy and rusty cooking range. -at 10:28 am, unlocked screw driver in the laundry area. -at 10:32 am, CA-Rezz incontinent wash and wound cleanser in residents' room. -at 10:43 am, CA-Rezz incontinent wash and wound cleanser in another resident's room. -a resident has Oxygen and there's no signs posted. -at 10:47 am, inside of the refrigerator in the storage dirty. -at 10:50 am, rotten dining bench in the backyard. -at 2:00 pm, staff (S5) does not have the required 4 hours postural support, restricted health condition and hospice care training. Deficiencies and plan and proof of corrections were discussed with the ADM. Failure to submit proof of corrections by plan and correction of due dates and any repeat violation may result in civil penalty. Exit interview conducted. Appeal Rights, LIC9098 Proof of Correction form and copy of this report provided.