Routine inspection·July 23, 2025

On 07/23/25 Licensing Program Analyst arrived at the facility to complete an unannounced annual visit. LPA met with Administrator, Leticia Rodriguez explained reason for visit and was permitted entry into the facility. LPA completed a tour of the facility inside and out. A health and safety check was completed on residents in care. 6 residents in care. There are no residents receiving hospice services and 1 resident receiving home health services. Facility was without odor. Common areas were adequately furnished, and adequately lit. Smoke detectors and carbon monoxide detectors were present and operational at time of visit. Fire extinguisher present and fully charged, last purchased on 6/18/25. Last fire drill on conducted on 7/1/25. Resident rooms observed to have the required furnishings. Sharp and medications were located in locked cabinets/closets. Pathways and doors were clear and free from obstruction inside house. LPA observed sufficient seating under covered patio areas. The following issues were observed during today’s visit: Front door observed with 2 locks located on the inside top of the door. Facility observed with debris/items throughout the house/garage in need of cleaning/removal. Exit door leading into garage unable to be opened completely. Small chest freezer in garage observed to be plugged in to an extension cord. Chemicals/supplements observed under kitchen sink/pantry unlocked and accessible to residents in care. Both side gates observed with sliding locks, pull string missing and inaccessible. Right side back fence observed leaning into neighbors yard, in need of repair. Deficiencies cited per California Code of Regulations, Title 22. Deficiencies are being cited on the attached 809D. If not corrected, the violation with have a direct risk to the health, safety and/or personal rights of residents in care. CONT... CONT... LPA requested the following documents to be submitted to CCL by 8/1/25: current copy of Administrator’s Certificate, Administrator Organization (LIC 309), Designation of Administrative Responsibility (LIC 308), Emergency Disaster Plan (LIC 610-D), Personnel Report (LIC 500), Register of Facility Clients/Residents (LIC 9020) in order to update the facility file. Exit interview was conducted with Administrator, Leticia. A plan of correction was developed by Administrator and reviewed by LPA. A copy of this report, deficiencies, and appeal rights were discussed and provided to Administrator via email due to technical issues.