Routine inspection·July 10, 2025

On 07/10/2025 at 8:55 AM, Licensing Program Analyst (LPA) P. Manalo arrived unannounced to conduct 1-Year Annual Required inspection. LPA met with Administrator, Imelda Abolencia, and explained the purpose of the visit. Administrator certificate is current. The facility’s fire clearance was approved for 6 may be non-ambulatory and 4 hospice residents. LPA toured facility inside and out including but not limited to bedrooms, bathrooms, kitchen, common area and backyard. The facility consists of 4 bedrooms for all the residents in care. Outdoor and indoor passageways are kept free of obstruction. There are no bodies of water observed. LPA observed lighting in all rooms are adequate for the comfort and safety of the residents. 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. First aid kit was observed to be complete. Emergency disaster drill was last conducted on 06/01/2025. At 9:47 AM, LPA reviewed 3 residents records. At 10:16 AM, LPA reviewed 4 staff records and 3 of 4 have current first aid training. At 11:30 AM, LPA reviewed two samples of residents’ medications. Continue to LIC809-C... Continue from LIC809... Updated copies of the following documents were requested for facility file and are to be submitted to CCL by 07/18/2025: LIC 610E Emergency Disaster Plan THE FOLLOWING DEFICIENCIES WERE OBSERVED DURING VISIT: At 9:00 AM, LPA observed S3 at the facility and was not fingerprint cleared. At 9:45 AM, LPA observed the hot water temperature measured at 127.4 degrees Fahrenheit. 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 Administrator. Appeal Rights and a copy of this report provided.