Routine inspection·January 7, 2026

On 01/07/2026 at 12:40 PM, Licensing Program Analyst (LPA) L. Hall conducted an unannounced required annual inspection. LPA met with Caregiver, Liezyl Ajos and explained the purpose of the visit. The facility’s fire clearance was approved for six (6) non-ambulatory residents. LPA toured the facility including but not limited to bedrooms, bathrooms, kitchen, common area and back yard. The facility consists of four (4) bedrooms and two (2) bathrooms. All outdoor and indoor passageways are kept free of obstruction. No bodies of water observed. A comfortable temperature is maintained at 70 degrees F. 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 123.8 degrees Fahrenheit. Residents’ bathrooms are equipped with grab bars and non-skid mats. There is a minimum of 7-day supply of non-perishable and 2-day of perishable foods. Smoke detectors/ carbon monoxide were in operating condition during visit. Fire extinguisher was last serviced on 12/08/2025. Emergency Disaster Plan was last reviewed on 12/28/2025. First aid kit was observed to be complete. Fire drill was last conducted on 10/17/2025. Continued on LIC809. Continued from LIC809. Four (4) staff records were reviewed, current, and complete. LPA reviewed three (3) resident records were reviewed. LPA requested the following documents to be submitted to CCLD by 01/14/2026 . LIC308 Designation of Administrative Responsibility LIC610E Emergency Disaster Plan (last page) Liability Insurance LIC500 (Personnel Report) LPA observed the following deficiencies: At 1:37pm, LPA observed kitchen drawers had insects. At 1:39pm, LPA observed refrigerator to be unsanitary.] At 1:44pm, LPA observed shed in backyard unlocked. LPA also observed small Rubbermaid shed in backyard unlocked. At 1:50pm, LPA observed during record review R1 did not have an order for half bed rails. At 2:15pm, LPA observed facility did not have a qualified administrator. 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. A copy of the appeal rights and this report provided.