Routine inspection·February 27, 2026

On 02/27/2026 at 8:00 AM, Licensing Program Analyst (LPA) L. Alexander arrived unannounced to conduct 1-Year Annual Required inspection. LPA met with Caregiver, Anabelle Mendoza, and explained the purpose of the visit. Ms. Mendoza phoned, Licensee/Administrator, Victoria Lingbanan, to inform. Ms. Lingbanan arrived shortly after. The facility’s fire clearance was approved for six (6) residents in which all may be non-ambulatory. Hospice waiver approved for one (1). Administrator Certificate #7001801740 expires 12/31/2027. LPA toured facility with Victoria including but not limited to bedrooms, bathrooms, kitchen, common area and backyard. The facility consists of five (5) total bedrooms which all five 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 75 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 116.5 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 04/15/2025. Emergency Disaster Plan was last posted on 01/16/2026. First aid kit was observed to be complete. Emergency disaster drill was last conducted on 01/22/2026. LPA reviewed four (4) residents records. LPA reviewed four (4) staff records and three (3) of 4 have current first aid training and associated to the facility. THE FOLLOWING DEFICIENCIES WERE OBSERVED DURING VISIT: LPA observed during record review that S1-S5 were missing annual 20hrs training. S5 was missing initial 40hrs training in their records. The following deficiencies were observed (see LIC 809D) and 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. Updated copies of the following documents were requested for facility file and are to be submitted to CCL by 03/06/2026: LIC 308 Designation of Administrative Responsibility LIC 309 Administrative Organization Updated LIC 500 Personnel Report LIC 610E Emergency Disaster Plan Liability Insurance Certificate Current Administrator’s Certificate - Reviewed Exit interview conducted. Appeal Rights and a copy of this report provided.