Routine inspection·May 13, 2026

On 05/13/2026 at 11:15am, Licensing Program Analyst LPA L. Hall conducted an unannounced annual required inspection. LPA met with Caregiver, Mary Grace Abaniel, Caregiver. House Manager, Bryan Bautista, arrived at 11:30am, and explained the reason for the visit. The administrator currently holds a certificate (#7031852740) that expires on 09/25/2027. The facility’s fire clearance was approved for six (6) Non-ambulatory residents. Hospice waiver for six (6). LPA toured the facility including but not limited to bedrooms, bathrooms, kitchen, common area, garage and backyard. The facility consists of seven (7) bedrooms and three and one-half (3-1/2) bathrooms. One (1) bedroom is occupied by staff. No bodies of water observed. LPA observed lighting in all rooms are adequate for the comfort and safety of the residents. 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 120.2 degrees Fahrenheit. Night lights are maintained in hallways and passages. Residents’ bathrooms are equipped with Continued on LIC809C. Continued from LIC809C. grab bars and non-slip mats. Smoke detectors and carbon monoxide were in operating condition during visit. Fire extinguisher was last serviced on 01/06/2026. Emergency Disaster Plan was last reviewed on 04/11/2025. Fire drill was last conducted on 05/07/2026. First aid kit was observed to be complete. The following forms to be updated and submitted to CCLD by 05/20/2026: LIC610E Emergency Disaster Plan (last page) Liability Insurance LIC308 Designation of facility responsibility LIC500 Personnel record A copy of the administrator certificate. LPAs observed the following deficiencies: At 11:20am, LPA observed pills sitting in a cup on top of the microwave in the kitchen. At 11:50am, LPA observed during record review no hospice care plan for R6. At 12:00pm, LPA observed S5 has not been fingerprinted and have been working and on the schedule since 5/3/2026. Continued on LIC809C. Continued from LIC809C. At 12:05pm, LPA observed S4 and S5, did not have a file available for review. At 12:20pm, LPA observed CCLD did not received a hospice initiation for R6. At 12:40pm, LPA observed a lock on outside of bedroom #3 (Staff stated it is used at night. At 12:44pm, LPA observed R4 had a full bedrail. At 12:57pm, LPA observed a lock on the outside of bedroom #5 (Staff stated it is used at night) At 12:50pm, LPA observed closet in bedroom #5 is used for a storage for facility items. *An immediate civil penalty for $500.00 will be assessed on today's date for fingerprints* 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, LIC421BG, and this report provided.