Routine inspection·July 8, 2025

Licensing Program Analyst (LPA) Quoc Huynh arrived at the facility unannounced to conduct a required annual visit at 10:37AM. The LPA met with the Licensee Izhak Illouz and Administrator Arlene Ceballos. Entrance interview conducted. Beginning at 10:42AM, the LPA and Licensee toured the physical plant areas inside and outside to ensure there are no health and safety hazards, and facility is in compliance with Title 22 Regulations. The facility is a single story residential home. The following was observed: BEDROOMS/RESTROOMS: There were seven (7) total bedrooms; six (6) private resident bedrooms and one (1) locked staff bedroom. Bedrooms #3, #5, and #6 have direct exits to the outside, and Bedroom #5 is cleared for one (1) bedridden resident. Bedrooms were furnished appropriately with clean linens, appropriate furnishings and sufficient lighting. Extra linens were stored in a dresser located in the hallway. There were six (6) total restrooms in the facility: five (5) attached private resident restrooms and one (1) common restroom located in the common area. Restrooms were clean, sanitary, and in operating condition with grab bars and non-slip surfaces. All restrooms were sufficiently stocked with soap, paper products, and displayed hand washing signs. Sink cabinets were locked and contained hygiene products. Hot water was tested and measured between 114.4 degrees F and 118.4 degrees F, which is within the required range per regulation. Report Continued on LIC 809-C COMMON AREAS: At the time of the visit, living room and dining room furniture was observed to be in good condition. Required postings were located on the entryway wall. The facility maintained a comfortable temperature throughout the visit. During the visit, LPA observed residents participating in their weekly Music Class and the facility stored extra activities in the entertainment center. Night lights and exit signs were observed throughout the facility. Fire extinguishers were observed throughout the facility and was last serviced on 01/03/2025. OUTDOOR AREA: The surrounding grounds had multiple shaded patio areas equipped with furniture in good condition for resident and visitor use. There was one (1) emergency exit located on one side of the facility with a self-latching mechanism. The opposite side of the property had an Additional Dwelling Unit (ADU) that was occupied by residents unrelated to the facility. The side gate that led to the ADU was locked. All exits and passageways were free of obstructions. The LPA observed one (1) locked shed in the backyard that contained general storage, facility supplies, and emergency water. KITCHEN: The LPA observed knives stored inaccessible in a locked drawer. Cleaning supplies were stored inaccessible and locked under the sink. Kitchen appliances were clean and in operable condition. The facility had a supply of perishable and non-perishable food, as well as emergency food. Food in the refrigerator and freezer were observed to be properly stored with labels and dates. Medications were stored in a locked cabinet. The kitchen had laundry machines that were in good condition. RECORDS: Record review began at 11:03AM. Resident records were reviewed for, but not limited to care plans, physician's report, admissions agreement, and consent forms. All records were in order. Personnel records were reviewed for, but not limited to health assessments, criminal record clearances, first aid/CPR training, and the appropriate training. All records were in order. Report Continued on LIC 809-C INFECTION CONTROL/EMERGENCY DISASTER PLAN: During today's visit, LPA reviewed the facility's infection control plan and emergency disaster plan. Both documents were observed to be complete and reviewed annually as required. Emergency disaster drills are conducted quarterly, with the last documented drill on 04/25/2025. Smoke and carbon monoxide detectors were tested at 12:13PM and were operational. Additionally, the facility does monthly smoke/fire alarm checks and replaces batteries if necessary. MEDICATIONS: Medication review began at 12:16PM. Medications were centrally stored and kept inaccessible in the kitchen. Medications were observed for two (2) residents. Medications were labeled and checked for expiration dates and were properly documented on the centrally stored medications and destruction record. No errors observed during the medication review. No deficiency cited. Exit interview conducted. A copy of the report was reviewed and provided.