Routine inspection·February 19, 2026

On 2/19/2026 at 12:10pm, Licensing Program Analyst (LPA) L. Hall conducted an unannounced annual required inspection. LPA met with Yodit Gebreyohannes, Caregiver . Administrator, Filmon Woldemariam, arrived at 1:05pm, and LPA explained the purpose of the visit. Administrator holds a certificate #6070561740 expires 5/9/2026. The facility’s fire clearance was approved for five (5) non-ambulatory and 1 (one) bedridden resident. Facility has a hospice waiver for one (1). LPA toured the facility with Caregiver including but not limited to bedrooms, bathrooms, kitchen, common area, garage and backyard. The facility consists of six (6) bedrooms and three (3) bathrooms. No bodies of water observed. A comfortable temperature is maintained at 71 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 106.2 degrees Fahrenheit. Residents’ bathrooms are equipped with grab bars and non-skid mats. Smoke detectors and carbon monoxide were in operating condition during visit. Fire extinguisher was last serviced 3/15/2025. Fire drill last conducted on 1/25/2026. Emergency Disaster Plan was last reviewed on 5/1/2025. First aid kit was observed to be complete. Continued on LIC809. Continued from LIC809C. LPA reviewed both resident and staff records, all were current and complete. LPA also reviewed medications. LPA requested the following documents to be submitted to CCLD by 2/26/2026. LIC308 Designation of Administrative Responsibility Liability insurance. LIC 500 Personnel Report LIC 610E Emergency Disaster Plan. (9 pages) Administrator certificate LPA observed the following deficiencies: At 12:30pm, LPA observed the facility did not have a 7-day supply or non-perishables and 2-day perishable foods. At 12:47pm, LPA observed laundry room turned into staff room. At 12:55pm, LPA observed R1 and R2 having half bed rails with no doctor orders. 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