Routine inspection·July 22, 2025

On 07/22/2025 , Licensing Program Analysts (LPA) J. Duarte arrived unannounced at the facility to conduct an Annual Inspection. LPA introduced self, stated the purpose of the visit and was allowed entry into the facility by staff Juliana Canonero. LPA J. Duarte contacted Administrator (AD), Susan Baal who stated she would arrive shortly. Administrator Ulysis Baal arrived shortly after LPA contacted Susan. Susan arrived shortly after Ulysis arrived. LPA toured the inside and outside of the facility with AD Ulysis. The facility was observed to be clean, odor free and at a temperature of 78 degrees F. The pathways and doors were clear and free from obstructions. Common areas were clean, adequately furnished, and adequately lit. . LPA observed sufficient seating in the living room. The Kitchen and dining areas were clean and had sufficient seating. LPA observed a seven-day supply of non-perishable foods and two-day supply of perishable foods. However, there were multiple food items in the refrigerator that were expired and/or spoiled and there were also food in containers in the refrigerator that were not labeled. LPA observed unlocked staff medication in a kitchen cabinet and in the entry office. Knives were also observed to be unlocked in a kitchen cabinet. LPA toured the residents’ rooms. Two rooms are single occupancy and two are shared. Resident rooms were observed to have the required furnishings. The bathroom hot water measured at 105.4 degrees F. Bathrooms were equipped with grab bars next to the toilet and in the shower, and the showers had non-skid mats. LPA observed bleach unlocked in a cabinet in the hallway bathroom. Medication and MARS were reviewed for two residents and logs were observed to be complete. Report Continued on LIC 809C. Continued from LIC 809 Laundry area toured in the garage. LPA observed a locked closet in the garage that has all chemicals. The backyard was observed to have sufficient seating in the back patio. LPA observed a fenced pool in the backyard with a locked gate. Outdoor side gate is self-closing and self-latching. Smoke detectors and carbon monoxide detectors were present and operational at the time of visit. The fire extinguisher located in the kitchen was last serviced on 06/05/2025. A fire drill was conducted on 06/25/25, per staff records. Deficiencies are being cited in accordance with the California Code of Regulations, Title 22, Division 6 on the attached LIC 809D. LPA requested the following documents to be submitted to CCL by 07/28/2025: current copy of Administrator’s Certificate, Administrator Organization (LIC 309), Designation of Administrative Responsibility (LIC 308), Emergency Disaster Plan (LIC 610E), Affidavit regarding Resident Cash Resources (LIC 400), Personnel Report (LIC 500), Register of Facility Clients/Residents (LIC 9020) to update the facility file. An exit interview was conducted, and a plan of correction was reviewed and developed with the administrators. A copy of this report and appeal rights were discussed and provided to the Administrator, whose signature on this form