Routine inspection·January 8, 2026

Licensing Program Analyst (LPA) Quoc Huynh arrived unannounced for a required one-year visit. The LPA arrived at 9:16AM and met with Interim Executive Director (ED) Virginia Sumulong. Entrance interview conducted. At 9:28AM, the LPA and ED 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 two-story building. The following was observed: RESIDENT ROOMS: The LPA observed eight (8) randomly selected rooms on the first and second floors and no immediate health or safety hazards were observed. Appropriate furniture was observed in the units including clean linens and sufficient lighting. Restrooms were clean, with properly installed grab-bars in resident bathrooms and non-skid strips in shower tubs. Water temperature was tested throughout the units and measured between 108.1 degrees F and 120.7 degrees F. Resident pull cord was tested with a staff response of less than one (1) minute. COMMON AREAS: On the first floor there was a lobby/reception area, administrative offices, medication room, two (2) visitor restrooms, laundry room, beauty shop, shower room, and two (2) courtyards. On the second floor there was an activity room, library, two (2) visitor restrooms, staff lounge, and laundry room that contained extra linens. All required rooms were secured and inaccessible to residents. LPA Huynh observed all common areas to be clean, clear of obstructions, and furniture were in good condition. Required posting were observed on the first floor hallway and no bodies of water were observed. Report Continued on LIC 809-C KITCHEN/DINING ROOM: The main kitchen is located on the first floor and attached to the dining room. Facility dining room and kitchen were inspected and found to be in compliance with Title 22 regulations. Facility uses Sysco Foods for food deliveries which occur every Friday. There was a sufficient supply of perishable and non-perishable food. The LPA observed the refrigerators and freezers with food to be of good quality and labeled with expiration dates. An extra pantry was located in the rear of the building inside an unattached shed that contained non-perishable items and an extra freezer containing frozen meat. Emergency food and water were stored in supply closets near the kitchen. OUTSIDE: The facility had a rear patio with various tables and chairs for resident use. The furniture were in good condition. The perimeter of the facility was secured with two (2) remote driveway gates with built in doors. The rear of the facility also had parking spaces for staff and visitors. RECORDS: Resident records were reviewed at 10:17AM. LPA Huynh reviewed six (6) files for, but not limited to admissions agreements, medical assessment, appraisals, and consent forms. Resident records reviewed were in order at this time. The LPA reviewed six (6) personnel records for, but not limited to job application, health assessments, TB results, criminal record statements and clearances, first aid/CPR certification, and appropriate trainings. Staff files reviewed were in compliance with regulation at this time. The LPA discussed with the ED about ensuring all in-service staff training contains the duration of the training completed. INFECTION CONTROL/EMERGENCY DISASTER: The LPA reviewed the facility's Infection Control Plan and Emergency Disaster Plan. LPA noted that the facility is in compliance with regulation with both plans reviewed annually. The facility conducts emergency disaster drills monthly, with the last drill documented on 12/30/2025. Fire extinguishers were observed throughout the facility and last serviced on 10/10/2025. Fire systems are inspected annually with the last inspection on 10/10/2025 by Fox Fire Life and Safety Inc. Report Continued on LIC 809-C MEDICATION: Medication review began at 1:03PM. The LPA reviewed medications for five (5) residents. Medications were maintained locked inaccessible to residents on the first floor. Resident medications reviewed were documented and stored in compliance with regulation at this time. No deficiency cited. Exit interview conducted. A copy of the report was reviewed and provided.