Routine inspection·December 23, 2025

On 12/23/25 Licensing Program Analyst (LPA) M. Garza arrived at the facility to complete an unannounced annual visit. LPA met with Direct Support Professional, Leonardo Yap, explained reason for visit and was permitted entry into the facility. Licensee, Nida Bonavente and Michael Troncalas was contacted and arrived a some time later. LPA completed a tour of the facility inside and out. A health and safety check was completed on residents in care. 5 residents present during visit. There are currently no residents receiving hospice or home health services. Pathways and doors were clear and free from obstruction. 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 last serviced 01/02/2025. Resident rooms observed to have the required furnishings and with adequate lighting. Sharps, chemicals and medications were located in locked cabinets/closets and cupboards. LPA observed sufficient seating under covered patio areas. The following issues were observed during today’s visit: S2 observed working at the facility with residents present without S2 being associated to the facility. Administrator on file does not have an active administrator certificate. R1 does not have a physicians report in file. Record review of facility shows facility owes past due licensing fees in the amount of $3,463. Deficiencies cited per California Code of Regulations, Title 22, deficiencies are being cited on the attached 809D. If not corrected, the violations with have a direct risk to the health, safety and/or personal rights of residents in care. ***A civil penalty in the amount of $500 was immediately assessed*** CONT... CONT... LPA requested the following documents to be submitted to CCL by 01/02/2025: current copy of Administrator Organization (LIC 309), Designation of Administrative Responsibility (LIC 308), Emergency Disaster Plan (LIC 610-D), Affidavit regarding Resident Cash Resources (LIC 400), Personnel Report (LIC 500), Register of Facility Clients/Residents (LIC 9020) in order to update the facility file. Exit interview was conducted with Licensee, Nida. A plan of correction was developed by Licensee and reviewed by LPA. A copy of this report, deficiencies, civil penalties and appeal rights were discussed and provided to Administrator. Due to time constraints LPA will return at a later time to complete inspection tool.