Routine inspection·January 21, 2026

Licensing Program Analysts (LPA) B. Miranda conducted an unannounced visit today (January 21, 2026) for the facility’s annual inspection. LPA introduced themselves and was allowed entrance into the facility. LPA met with Administrator Rajvinder Samra. Facility is licensed for 6 residents and has a current census of 5. Facility has 4 bedrooms and 2.5 bathrooms. One bedroom is for staff, and the other three bedrooms are for residents. Currently 2 bedrooms are shared, and one resident has their own room. Facility Water temperature was checked in the kitchen which read at 111.9 degrees Fahrenheit and in the common bathroom which read at 109.0 degrees Fahrenheit. Fire Extinguisher was serviced February 4, 2025, and has correct charge. Smoke and carbon monoxide detectors were tested and in working order. There is 1 resident currently on hospice. R1 is currently on oxygen. Facility did not obtain approval from the Dept to retain R1 who has a restricted health condition. The facility did not report to the local fire dept in writing regarding R1 being on oxygen. Rajvinder Samra Administrator's Certification expires August 9, 2026. Staff files were reviewed. Resident files were reviewed, complete, and current. Physician reports are current and do not indicate residents are at risk for elopement or hygiene products are a danger. Facility provided a log for disaster drills that are conducted quarterly. First aid kit is on site and complete. Toxins and cleaning supplies are locked and inaccessible. There is a locked storage for medications. LPA inspected the exterior and interior of the facility, including the common living spaces, resident bedrooms, bathrooms, medication storage, kitchen, garage and outdoor areas. Bedrooms were clean, properly furnished, with adequate lighting, and in good repair. Food supply is adequate for 2-day perishable and 7-day nonperishable. Observed deficiencies were cited during today's inspection per California Code of Regulations, Title 22. Exit interview was conducted and a copy of this report LIC809, LIC 809D, and appeal rights were provided to Administrator Rajvinder Samra.