Routine inspection·July 25, 2025

On 7/25/2025 at 9:00 am, Licensing Program Analyst (LPA) Y. Brown arrived unannounced to conduct the Annual Required inspection. LPA met with Administrator (AD) Beatriz "Tess" Padilla and explained the purpose of the visit. The facility’s fire clearance was approved for capacity of six (6) residents all non-ambulatory. Hospice waiver for two (2) residents. Administrator holds a certificate (#7005130740) that expires on 6/20/2026. LPA toured the facility with the AD including but not limited to bedrooms, bathrooms, kitchen, common area, backyard and garage. The facility consists of five (5) total bedrooms which four (4) bedrooms are occupied by the residents and one (1) bedroom is occupied by staff. All outdoor and indoor passageways are kept free of obstruction. There are no bodies of water observed. A comfortable temperature is maintained at 75.7 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 106.2 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 and carbon monoxide detectors were in operating condition during visit. Fire extinguisher was last serviced on 08/19/2024. Emergency Disaster Plan was last posted on 10/01/2024. First aid kit was observed to be complete. Emergency disaster drill was last conducted on 06/03/2025. Continue on LIC809C. Continued from LIC809. LPA reviewed four (4) resident files and five (5) staff files. LPA reviewed a sample of medication. LPA requested the following documents to be submitted to CCLD by 8/1/2025. LIC 308 Designation of Administrative Responsibility LIC 500 Personnel Report LIC 610E Emergency Disaster Plan (last page) No deficiencies cited during visit. Exit interview conducted and a copy of this report provided.