Routine inspection·October 13, 2025

Licensing Program Analyst (LPA) Tena Herrera conducted the required annual inspection. LPA arrived unannounced and met with Administrator Lynn Hughes and explained the purpose for today’s visit. The facility is licensed to serve 36 Non-Ambulatory Adults ages 60 and above, with a hospice waiver of up to 3 residents. The facility currently has 3 residents utilizing hospice services. LPA utilized the Compliance and Regulatory Enforcement (CARE) tools for the visit today and observed the following: Infection Control: Facility has sufficient PPE supplies and maintain the required Infection Control Plan. Operational Requirements: Facility maintains the required liability insurance. Physical Plant & Environment Safety: LPA toured facility, residents’ bedrooms were checked and closet/drawer space to accommodate each resident comfortably was available. The backyard is free of debris/hazards and the outdoor and passageways are free of obstruction. No bodies of water were observed at the facility. There are no security bars or weapons on the premises. Hygiene products are readily available for clients. The hot water temperature was tested and was within the required range of 105-120 degrees F. All storage areas for cleaning solutions, toxins, knives, and hazardous items are kept in a locked cabinets and are inaccessible to residents. Smoke detectors and carbon monoxid e detectors are operable and in compliance. There fire extinguishers were observed and are fully charged. Facility has video surveillance inside c ommon areas and outside perimeter of the facility. Call buttons were tested and operable. Staffing : There appears to be sufficient staffing at all times in the facility. Personnel Records-Training : Staff files are maintained in a secure location. LPA reviewed 4 staff files during today’s visit, files reviewed contained the following: Criminal Background Clearance, First-Aid/CPR/AED and sufficient on-going training. Lynn Hughes maintains a valid Administrator Certificate that expires 11/2025 (and confirmed has submitted renewal). (Continued on LIC9099-C) Residents Rights-Information: Residents are provided with telephone and internet at the facility. The facility has the following posters displayed: Residents Rights, Complaint Poster, and Ombudsman. Planned Activities: Facility provides activities and there is sufficient space both indoor/outdoor for activities. Food Service: The kitchen was observed for the ability to prepare and serve food. LPA observed an appropriate food supply of two (2) days of perishables and one week (7 days) of non-perishables. Incidental Medical & Dental: Medication is properly labeled, are centrally stored in their original containers. Resident Records-Incident Reports: Resident files are maintained in a secured locked cabinet and have the following documents in their files - Admission Agreements, Identification & Emergency Information, current Physician's Report, Pre-admission appraisal/Appraisal Needs & Services Plan. LPA reviewed 5 resident files with no issues. Disaster Preparedness: The facility has an Emergency Disaster Plan with contact numbers and at least 2 relocation sites. The last drill was conducted on 9/10/25. Residents with Special Health Needs: There are currently 3 residents using hospice services, LPA reviewed 2 of the residents files and hospice records with no issues observed . LPA observed signs posted indicating “No smoking - Oxygen in Use” in various locations of the facility. Per California Code of Regulations, Title 22, and California Health and Safety Code, there were no deficiencies observed during the visit. Exit interview held and a copy of the report provided to Administrator Lynn Hughes.