Routine inspection·October 10, 2025

At 11:55 am on this day, October 10, 2025, Licensing Program Analyst (LPA) Delmundo arrived unannounced to conduct an annual required inspection. LPA met with Emily Aliping, administrator (ADM), and informed the reason for visit. LPA toured the facility inside out with ADM. LPA inspected the kitchen, dining area, living room, bedrooms, bathrooms, garage, front, side and backyards. There's supplies of 2 days of perishables and 7 days of non-perishables food. Central storage for medications was observed locked. Cleaning supplies were also locked. Facility has smoke and carbon monoxide detectors that were tested and observed in working condition. Hot water temperature in the ensuite bathroom was tested, and measured at 106.1 degrees Fahrenheit. Facility conducts disaster drills every quarter, and records showed last conducted September 1, 2025. LPA reviewed 3 staff and 3 residents files, and interviewed 1 resident. Medications inspected and compared with doctor's orders and LIC622 Centrally Stored Medication and Destruction Record. Resident's P&I checked and compared with last recorded balance. ........continued on 809C (page 2) LPA observed the following: -at 12:10 pm, half bed rail in resident's bed. LPA verified, and ADM stated there's no doctor's order. -at 12:15 pm, staff medications in drawer without lock in unlocked staff bedroom. -at 2:50 pm, resident (R1) has 4 medications listed on After Visit Summary dated 6/24/25, but facility does have have these. Facility has 2 medications for R1 but not listed on the order. LPA received on this day copies of following updated/current documents: 1. LIC308 Designation of Facility Responsibility 2. LIC610E Emergency Disaster Plan (9 pages) 3. $3M Liability Insurance certificate Administrator to submit the following updated/current documents by October 24, 2025: 1.LIC500 Personnel Report 2. Surety Bond coverage Deficiencies are cited from Title 22 California Code of Regulations, and listed on 809Ds. Failure to submit proof of corrections by plan of correction due dates may result in civil penalty. Deficiencies and plan and proof of corrections were discussed with the administrator. Exit interview conducted. Appeal Rights, LIC9098 Proof of Correction form and copy of this report provided.