Routine inspection·April 17, 2025

On 04/17/2025 at 11:15 AM/PM, Licensing Program Analyst (LPA) L. Alexander arrived unannounced to conduct 1-Year Annual Required inspection. LPA met with Caregiver, Catalina Atienza and explained the purpose of the visit. Catalina phoned, Licensee/Administrator, Conchita Gozun to inform. Conchita wasn't available to come to the facility but gave authorization for Catalina to sign report. The facility’s fire clearance was approved for capacity six (6) residents in which all may be non-ambulatory. Administrator's certificate# 7032863740 expires 11/23/2025. LPA toured facility with Catalina including but not limited to bedrooms, bathrooms, kitchen, common area and backyard. The facility consists of seven (7) total bedrooms which six (6) 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 70 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 123.5 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. LIC809-C Continued... LIC809-D Continued... Smoke and carbon monoxide detectors were in operating condition during visit. Fire extinguisher was last serviced on 09/04/2024. Emergency Disaster Plan was last posted on 01/04/2025. First aid kit was observed to be complete. Emergency disaster drill was last conducted on 10/07/2024 (Earthquake). LPA reviewed four (4) residents records. LPA reviewed five (5) staff records and four (4) of five (5) have current first aid training and associated to the facility. 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.