Routine inspection·February 5, 2026

On 2/5/2026 at 8:30 AM, Licensing Program Analyst (LPA) K. Nguyen arrived unannounced to conduct 1-Year Annual Required inspection. LPA met with Administrator, Grace Reano- Aquino and explained the purpose of the visit. The administrator certificate number: 7000015740. LPA toured the facility including but not limited to bedrooms, bathrooms, kitchen, common area and backyard. The facility consists of 19 bedrooms in total bedrooms which 18 bedrooms are occupied by the residents, and 0 bedroom is occupied by staff. All outdoor and indoor passageways are kept free of obstruction. There are no bodies of water. A comfortable temperature for residents is maintained at 75-degree Fahrenheit. LPA observed lighting in all rooms is adequate for the comfort and safety of the residents. Hot water temperature in the shared resident’s bathroom was measured at 110.7-degree Fahrenheit. All toilets, hand washing and bathing are safe, sanitary and in operating condition. The supply of extra hygiene was available for clients. There is a minimum of one week supply of nonperishables and 2-day perishables food supply. Report Continued on LIC 809c... Smoke detectors and carbon monoxide were in operating condition during visit. Fire extinguisher was last serviced on 03/18/2025. Emergency Disaster Drill was last posted on 2/3/25. First aid kit was observed to be complete. Fire drill was last conducted on 2/3/26. Liability Insurance effective on 11/28/25 to 11/28/26. At 9:30am, 6 resident records were reviewed. At 11am, 5 staff records were reviewed and 5 of 5 have current first aid training and are associated with the facility. A sample of 4 client’s medications were reviewed. Updated copies of the following documents were requested for facility file and are to be submitted to CCL by 2/13/2026: LIC 500 Personnel Report LIC 308 Designation of Administrative Responsibility LIC 309 Administrative Organization LIC 400 Affidavit Regarding Client/Resident Cash Resources LIC 402 Surety Bond LIC 610E Emergency Disaster Plan No deficiencies cited during visit. Exit interview conducted and a copy of this report provided.