Routine inspection·June 3, 2026

On 6/3/2026, Licensing Program Analyst (LPA) L. Hall conducted an unannounced required annual inspection. LPA met with Caregiver, Loida Tamayo and explained the purpose of the visit. The Administrator currently holds a certificate (#7034377735) that expires on 5/31/2028. The facility’s fire clearance was approved for six (6) 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. One (1) bedroom is occupied by staff. All outdoor and indoor passageways are kept free of obstruction. A comfortable temperature is maintained at 69 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 111.1 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 12/09/2025. Emergency Disaster Plan was last reviewed on 4/29/2025. First aid kit was observed to be complete. Fire drill was last conducted on 4/26/2026. Continued on LIC809. Continued from LIC809. Three (3) staff records were reviewed, current and complete. All five (5) resident records were reviewed, current, and complete. LPA reviewed P & I. LPAs requested the following documents to be submitted to CCLD by 6/10/2026 . LIC308 Designation of Administrative Responsibility LIC500 Personnel Report LIC610E Emergency Disaster Plan (last page) Liability Insurance Surety Bond A copy of the Administrator certificate. LPA observed the following deficiency: At 2:50pm, LPA observed there was only one (1) staff member present with five (5) residents. 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 appeal rights and this report provided.