Routine inspection·March 13, 2026

On 03/13/2026 at 10:45 AM, Licensing Program Analyst (LPA) L. Alexander arrived unannounced to conduct 1-Year Annual Required inspection. LPA met with Caregiver, Christopher Mendoza and explained the purpose of the visit. Christopher phoned, Administrator/Licensee, Victoria Lingbanan, to inform. Johnny and Victoria Lingbanan arrived shortly after. The facility’s fire clearance was approved for capacity of twenty-two (22) residents. Where all can be non-ambulatory . Hospice waiver approved for five (5) residents. Administrator certificate #7001801740 expires 11/25/2027. LPA toured the facility with Licensees Johnny & Victoria Lingbanan including but not limited to the residents’ apartments, bathrooms, multiple activity rooms, kitchen, common area and courtyard. There are no bodies of water observed. LPA observe lighting in all rooms are adequate for the comfort and safety of the residents. Hallway temperature was maintained at 76 degrees F. LPA observed lighting in all rooms are adequate for the comfort and safety of the residents. The hot water temperature in a sample of residents’ shared bathroom were measured at 106.7 and 109 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 medications, sharps and toxic are locked and inaccessible to residents in care. LIC809-C Continued... LIC809-C (Page 2) Smoke and carbon monoxide detectors were in operating condition during visit. Fire extinguisher was last serviced on 02/18/2026. Emergency Disaster Plan was last posted on 01/07/2026. First aid kit was observed to be complete. Emergency disaster drill was last conducted on 01/15/2026. LPA reviewed residents records. LPA reviewed ten (10) staff records and 10 of 10 have current first aid training and associated to the facility. Updated copies of the following documents were requested for facility file and are to be submitted to CCL by 03/20/2026: LIC 308 Designation of Administrative Responsibility - Reviewed LIC 309 Administrative Organization - Reviewed Updated LIC 500 Personnel Report LIC 610E Emergency Disaster Plan - Reviewed Copy of Liability Insurance Certificate Current Administrator’s Certificate - Reviewed 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.