Routine inspection·October 13, 2025

On 10/13/2025 at 8:30AM, Licensing Program Analysts (LPAs) James Sampair and Andrew Christy arrived unannounced to conduct the Required Annual Inspection of the facility. Upon arrival, LPA stated the purpose of the visit to Caregiver Junnel Barrosa. Administrator Nenita Williams arrived at 10:00AM. The facility currently has five (5) residents. LPAs inspected the inside and outside of the facility. All indoor and outdoor passageways were free of obstruction. Outside, there were no bodies of water. Inside, the temperature in the dining room was 70.4 degrees Fahrenheit and the hot water in the resident's bathroom was 108.4 degrees Fahrenheit. The LPAs observed adequate lighting in all of the rooms for the comfort and safety of the individuals. The LPAs observed more than the minimum of 7 days of nonperishable and 2 days of perishable food on hand. Sharps and other dangerous items were stored inaccessibly to residents. Smoke and carbon monoxide detectors were in operating condition. Fire extinguishers observed to be fully charged and last serviced on 12/10/2024. At 10:00AM, the LPAs reviewed the records of 5 residents and 5 staff members. The Emergency Disaster Plan was last reviewed 10/13/2025. Continued on LIC809C..... Continued from LIC809..... The following deficiencies were cited during the inspection: During file review around 10:25AM, it was determined many resident files were missing required forms. This includes updated Appraisal Needs And Services forms, Consent for Emergency Medical Treatment, and the Admission Agreement. This is considered a repeat violation. During file review around 10:50AM, it was determined many staff files were missing required forms. This includes the LIC503 and updated CPR/1st Aid training. This is considered a repeat violation. At 11:00AM, it was found that the facility did not have any listed quarterly emergency drills. Deficiencies are cited per Title 22 California Code of Regulations and listed on LIC809D. Failure to submit proof of corrections (POC) by plan of correction due date and/or any repeat deficiencies within a 12-month period may result in civil penalties. Exit interview conducted, and a copy of this report, along with appeal rights, was provided to the administrator.