Routine inspection·September 18, 2025

On 9/18/2025 at 11:30 AM, Licensing Program Analyst (LPA) A. Gomez arrived unannounced to conduct 1-Year Annual Required inspection. LPA met with Backup Administrator, Marjorie Osia and explained the purpose of the visit. Administrator was out of town during inspection. The facility’s fire clearance was approved for all non-ambulatory of which one may be bedridden. LPA toured facility with Marjorie including but not limited to bedrooms, bathrooms, kitchen, common area and backyard. The facility consists of 6 total bedrooms which all 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 72 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 124.2 degrees Fahrenheit and 125.1 degrees Fahrenheit in room 4. 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 not locked and inaccessible to residents. Smoke detectors and carbon monoxide detector were in operating condition during visit. Fire extinguisher was last serviced on 12/18/2024. Emergency Disaster Plan was last posted on 9/3/2025. First aid kit was observed to be complete. Emergency disaster drill was last conducted on 9/15/2025. At 12:00pm, LPA reviewed 6 of 6 residents records. At 12:35 am, LPA reviewed 3 staff records and 3 of 3 have current first aid training and associated to the facility. Report continues on LIC809-C THE FOLLOWING DEFICIENCIES WERE OBSERVED DURING VISIT: LPA observed ADUs in the backyard being utilized by staff that are not fire cleared and are not listed on the facility sketch. LPA observed the hot water at 125.1 and 124.2 degrees F LPA observed unlocked prescription medications in medication cups in the kitchen drawer as well as used needles unlocked under the kitchen sink in a plastic container. 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. Exit interview conducted. Appeal Rights and a copy of this report provided.