Routine inspection·February 6, 2026

Licensing Program Analysts (LPA) J. Duarte arrived at the facility unannounced to conduct the Required Annual Inspection. LPA met with Administrator Jethronel Lazaga. LPA disclosed the purpose of the inspection and was granted entry into the facility.A tour of the facility was conducted with the Administrator. The facility was observed to be at a temperature of 72 degrees F, clean and no passageway obstructions were observed. The living room has sufficient seating for residents. Living room has a fireplace with a cover. The kitchen was toured and LPA observed an adequate supply of perishable and non-perishable food. The facility stores kitchen knives in a locked cabinet. All bedrooms were toured and observed to have the required furniture and adequate lighting. Bathrooms were observed operational, with non-skid strips and grabbed bars observed for the showers and toilets. The hallway restroom hot water measured at 109 degrees F and the hot water to the restroom connected to the room measured at 108 degrees F. The garage and outside of the facility was toured. The facility has a dryer and washer in the garage. The facility has an additional refrigerator and freezer in the garage with an additional food supply. LPA observed disinfectants, chemicals, tools, and paint unlocked. The facility has a pool that is gated and locked. The facility has seating and tables under the patio. The carbon monoxide/smoke detector was observed operational during inspection. Medications observed kept locked in hallway closet. Medications were reviewed along with MARS and observed medication for a resident was not logged on the centrally stored log to indicate a start date or how many pills were received to verify if the resident was receiving medication as prescribed. A first aid kit is stored with the medication and was complete. A sample of resident files and staff files were also reviewed and observed to have required documentation. Two fire extinguishers were observed with a service date of 01/19/26. Continued in LIC 809C. Continued from LIC 809. A repeat deficiency is being cited on the attached LIC 809D in accordance to California Code of Regulations, Title 22,Division 6. An exit Interview was conducted. A copy of this report and appeal rights were provided to AD, whose signature on this form confirms receipt of this report. LPA requested the following updated forms be faxed to CCL Department: Designation of Facility Responsibility (LIC308), Administrative Organization (LIC309), Personnel Report (LIC 500), Proof of current Liability Coverage. Please submit these documents by 02/13/26 .