Routine inspection·October 29, 2025

On 10/29/2025 at 12:00pm, Licensing Program Analyst (LPA) L. Hall conducted an unannounced annual required inspection. LPA met with Merla Fernandez, Caregiver. LPA spoke with Administrator, Edwin Liwanag, via telephone and explained the purpose of the visit. The administrator holds a certificate #7006273740 expires 10/23/2026. The facility’s fire clearance was approved for eight (8) non-ambulatory and two (2) bedridden residents. LPA toured the facility including but not limited to bedrooms, bathrooms, kitchen, common area and back yard. The facility consists of seven (7) bedrooms and three (3) bathrooms. One (1) bedroom is occupied by staff. 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 117.0 degrees Fahrenheit. Residents’ bathrooms are equipped with grab bars. Fire extinguisher was last serviced on 11/05/2024. First aid kit was observed to be complete. Fire drill was last conducted on 10/3/2023. Continued on LIC809. Continued from LIC809. LPA reviewed three (3) staff and observed three (3) of four (4) files were current and complete. All five (5) resident files were reviewed and complete. LPA requested the following documents to be submitted to CCLD by 11/5/2025. LIC 308 Designation of Administrative Responsibility LIC 500 Personnel Report LIC 610E Emergency Disaster Plan (last page) Liability Insurance LPA observed the following deficiencies: At 12:15, LPA observed during record review R1, R2, R3, and R5, did not have an updated medical assessment and appraisal needs and services plan. At 12:56pm, LPA observed facility did not have a supply of 7-day perishables and 2-day non-perishables foods for residents. At 12:57pm, LPA observed a recliner, 2 wheelchairs, chest of drawers, and 2 bedrails on left hand side of house in back yard. At 1:05pm, LPA observed smoke detectors and carbon monoxide alarms were not operable. At 2:05pm, LPA observed during record review S2 and S3 do not having annual training. At 2:05pm, LPA observed during record reviews S2 and S3 is not first aid or CPR certified. Continued on LIC809C. Continued from LIC809C. The deficiencies were observed (see LIC809D) and cited from the California Code of Regulation, 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 and appeal rights provided.