Routine inspection·November 17, 2025

Licensing Program Analyst (LPA), Mayra Cota, conducted an unannounced annual visit today. LPA was greeted and was granted entry to the home by Luz Preza Mendoza, and the reason for the visit was explained. Ewa Nyczak, Administrator, arrived shortly after and continued to facilitate the visit. The facility is licensed to serve (3) ambulatory and (3) non-ambulatory residents age 60 and over, non-ambulatory in ground bedrooms only. Hospice waiver approved for (2) residents. The facility is operating within the scope of its license. The two-story home is in a residential area of Pasadena, and it consists of the following: First floor is made up of a receiving area, living room, dining room, kitchen, laundry room, (3) resident bedrooms, and (1.5) bathrooms. Second floor is made up of (3) resident bedrooms, (1) staff room, (2) full bathrooms, sunroom and attic. The facility also has a front and backyard with a patio area and detached garage. The following was observed during today’s visit: The facility is in good repair inside and out and walkways, passageways, ramps and exists are clear debris and obstructions. Furniture throughout the home is in good repair and there is enough seating for residents in care. Kitchen was observed clean. Appliances were also observed clean and operable. The facility has sufficient 2-day perishable and 7-day non-perishable supply of food. Sharps, cleaning supplies and other toxins are kept locked in a closet on the first floor of the home and inaccessible to residents. Resident bedrooms have the required lighting, furniture and bedding, and each room has sufficient closet space. Bathrooms were also inspected and have grab bars and non-slip mats in place. The water temperature was tested in the bathrooms and measures within the compliance range of 105 – 120 degrees F. ***Continues on LIC 809-C The facility has two fire extinguishers, one on each floor which were observed charged. Both fire extinguishers were last inspected on 10/22/25. Facility conducts safety drills quarterly. Last drill was conducted on 9/1/25. Exit doors are equipped with safety chimes which were tested and operating during today’s visit. LPA reviewed facility’s Emergency Disaster Plan and found it to be up to date. The facilily's Infection Control Plan was reviewed and also kept up to date. The home has a PPE station in the dining area which was observed stocked. Stairway evacuation chair was observed in good repair and readily available for use. The home is equipped with an electric chair lift which was also tested and observed operable during visit. Medication is kept centrally stored, locked and inaccessible to residents in care. The front and backyard are clean, and no pools or bodies of water were observed. The detached garage is kept locked. Shaded area for residents was observed and patio furniture is in good repair. Due to time constraints, LPA Cota will return at a later time to complete annual inspection. No deficiencies noted during today's visit. Exit interview was conducted with Ewa Nyczak, Administrator, and a copy of the report was provided.