Routine inspection·April 14, 2026

On 04/14/2026 at 10:10 AM, Licensing Program Analyst (LPA) Ardalan Gharachorloo arrived unannounced to conduct 1-Year Annual Required inspection. LPA met with Administrator, Jezrael Pascual and explained the purpose of the visit. LPA toured facility including but not limited to bedrooms, bathrooms, kitchen, common area and backyard. 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 a t116.2 degrees Fahrenheit. Residents’ bathrooms are equipped with grab bars and non-skid mats. There is a minimum of one week supply of non-perishable and 2 day of perishable foods. Centrally stored medication and sharps were locked and inaccessible to residents. Smoke detectors and carbon monoxide detectors were in operating condition during visit. Fire extinguisher was last serviced on 01/19/2026. Emergency Disaster Plan was last posted on 04/14/2026. First aid kit was observed to be complete. Emergency disaster drill was last conducted on 03/01/2026. LPA reviewed 5 residents records and 5 staff records. LPA also reviewed a sample of resident’s medications. The following documents were reviewed during the visit: LIC 500 Personnel Report LIC 610E Emergency Disaster Plan, Liability Insurance, and Current Administrator’s Certificate. ***CONTINUE ON 809C*** ***CONTINUE FROM 809*** THE FOLLOWING DEFICIENCY WAS OBSERVED: · At 12:05 PM, LPA checked five resident records (S1-S5). Resident 2 (S2), Resident 3 (S3) and Resident 4 (R4) did not have a signed and completed admission agreement on file. The above deficiency was observed (see LIC 809D) and cited from the California Code of Regulations. Failure to correct deficiency by POC date may result in additional Civil Penalties. Exit interview conducted with Administrator. LIC809D, Appeal Rights and a copy of this report provided.