Post-licensing visit·November 13, 2025

Licensing Program Analyst (LPA) Quoc Huynh arrived at the facility to conduct an unannounced Post-Licensing visit at 9:37AM. The LPA was greeted by staff and met with the Administrator Arlene Ceballos. The Licensee Izhak Illouz arrived shortly thereafter. Entrance interview conducted. Beginning at 9:42AM, the LPA and the Administrator toured the physical plant areas inside and outside to ensure there are no health and safety hazards, and the facility is in compliance with Title 22 Regulations. The following was observed: COMMON AREAS: At the time of the visit, the living room and dining room furniture was observed to be in good condition. The facility maintained a comfortable temperature throughout the visit. LPA Huynh noted required signage and postings in the facility’s entryway. KITCHEN: Knives were stored inaccessible in a locked drawer. Cleaning supplies were inaccessible under the sink. Kitchen appliances were clean and in operable condition. The facility had a sufficient supply of perishable and non-perishable food, as well as emergency food. Food in the refrigerator was observed to be of good quality with dates. Files and medications were stored in a locked cabinet. Laundry machines were observed and were in good condition. Report Continued on LIC 809-C OUTDOOR AREA: The backyard had several areas equipped with furniture for resident and visitor use. There was a detached garage that contained emergency water and general storage. There was two (2) self-latching side gates for emergency use. No bodies of water noted, and exits were free of obstructions. BEDROOMS/RESTROOMS: There were six (6) total private resident bedrooms. Bedrooms #4, #5, and #6 had direct exits to the outside with Bedroom #6 approved for one (1) bedridden resident. Bedrooms were furnished appropriately with clean linens, appropriate furnishings and sufficient lighting. A dresser with extra linens was observed in the hallway. There were six (6) total restrooms in the facility: five (5) private resident restrooms and one (1) common area restroom in the hallway. Restrooms were clean, sanitary, and in operating condition with grab bars and non-slip surfaces. All restrooms were sufficiently stocked with soap and paper products. Hot water was tested and measured between 102.6 degrees F and 119.1 degrees F. RECORDS: Record review began at 10:04AM. 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 files were in order. 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 recently. Emergency disaster drills are conducted quarterly, with the last documented drill on 10/25/2025. Combination smoke and carbon monoxide alarms were tested at 10:38AM and were operational. Fire extinguishers were observed throughout the facility and were last serviced 1/3/2025. Report Continued on LIC 809-C MEDICATIONS: Medication review began at 10:45AM. 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. Medications 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 today's report was reviewed and provided.