Routine inspection·September 17, 2025

On 09/22/2025 at 10:30AM, Licensing Program Analyst (LPA) T. Syess-Gibson conducted an unannounced 1-Year Required inspection. LPA met with Mark Taylor and explained the purpose of the visit. Licensee asked Jadah Rougely, Caregiver to assist LPA during visit. The Administrator currently holds a certificate (#7016298740) Expires 08/05/2026. The facility’s fire clearance was approved for three (3) ambulatory and four (4) non ambulatory residents. LPA toured the facility with Caregiver, Jadah Rougely including but not limited to bedrooms, bathrooms, kitchen, common area and back yard. The facility consists of seven (7) bedrooms, one (1) occupied by staff and four (4) bathrooms. All outdoor and indoor passageways are kept free of obstruction. LPA observed a pool behind a properly secured locked gate in the backyard. A comfortable temperature is maintained at 81 degrees Fahrenheit. LPA observed lighting in all rooms is adequate for the comfort and safety of the residents. The hot water temperature in the resident’s shared bathroom was measured at 114.2 degrees Fahrenheit. Residents' bathrooms are equipped with grab bars and nonskid mats. There is a minimum of 7-day supply of non-perishable and 2-day of perishable foods. Continued LIC809C. Continued from LIC809 Smoke detectors and carbon monoxide were in operating condition during visit. Fire extinguisher was last purchased on 11/21/2024. Emergency Disaster Plan was last updated on 09/02/2025. First aid kit was observed to be complete. Fire drill conducted with residents on 09/03/2025. LPA reviewed six (6) resident records and five (5) staff records during visit The following forms are to be updated and submitted to CCLD by 09/29/2025: LIC 500 Personnel Report LIC 400 Affidavit Regarding Client/Resident Cash Resources LIC 402 Surety Bond LIC610E Emergency Disaster Plan LIC308 Designation of facility responsibility LPA observed the following deficiency: At 11:13AM LPA observed 2 knives in a kitchen drawer. At 11:21AM, LPA observed two (2) out of the three (3) residents’ shared bathroom did not have nonskid mats. 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 and a copy of this report and appeal rights provided.