Routine inspection·February 5, 2026

On 2/5/2026 at 9:50am, Licensing Program Analyst (LPA) L. Hall conducted an unannounced annual required inspection. LPA met with Caregiver, Josephine Ambagan, and explained the purpose of the visit. Licensee, Jennifer Rances, arrived at 10:27am. Administrator holds a certificate #7033979740 expires 3/6/2026. The fire clearance is approved for two (2) ambulatory and four (4) non-ambulatory residents. LPA toured the facility including but not limited to bedrooms, bathrooms, kitchen, common area and back yard. The facility consists of six (6) bedrooms and two (2) bathrooms. One (1) bedroom occupied by staff. No bodies of water observed. A comfortable temperature is maintained at 74 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 113.4 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. Emergency disaster plan last reviewed 12/23/2025. Fire extinguisher was last purchased 12/27/2025. First aid kit was observed to be complete. Fire drill was last conducted on 01/09/2026. Continued on LIC809. Continued from LIC809. LPA reviewed five (5) staff and five (5) resident records. LPA also reviewed a sample of the medications. LPA requested the following documents to be submitted to CCLD by 02/12/2026 . LIC308 Designation of Administrative Responsibility LIC610E Emergency Disaster Plan (last page) Liability Insurance LIC500 (Personnel report) Administrator certificate LPA observed the following deficiencies: At 10:03am, LPA observed a chair blocking the exit door in bedroom #3. At 10:05am, LPA observed a sink, 3 chairs, 2 trash cans, a mop bucket, and remnants of commodes in back yard. At 10:25am, LPA observed during record review R1 is bedridden and facility does not have a bedridden fire clearance. At 11:05am, LPA observed during record review there was not a hospice care plan for R3 and R4. At 11:15am, LPA observed S1, S3, S4, and S5 are not first aid certified. At 11:44am, LPA observed during record review the medication administrator record (MAR) was not filled out for R1 and R2. Continued on LIC809C. Continued from LIC809C. *An immediate one-time civil penalty for $500.00 will be assessed on today's date for 87202(a)* Deficiency is 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 LIC421M, appeal rights, and this report provided.