Routine inspection·October 27, 2025

LPA Licensing Program Analyst (LPA) Blanca Gonzalez conducted an unannounced required annual inspection visit and was greeted by Administrator Jasaiel De Leon. LPA Gonzalez explained the purpose of the visit. The facility is located on a main street in the city of San Dimas and is licensed to serve the elderly 60 and above, fire clearance for six (6) non- ambulatory, facility main retain one (1) hospice resident and has a dementia program. The facility is a single story home consisting of a kitchen, dining area, living room, four (4) resident bedrooms and two (2) bathrooms, laundry room, a front yard and a backyard. LPA utilized the Compliance and Regulatory Enforcement (CARE) tools for the visit today and observed the following: Physical Plant and Environment safety: Disinfectants, cleaning solutions, poisons and other items that could pose a danger if readily available to residents, were observed to be inaccessible to residents, secured in the locked laundry room. LPA observed carbon monoxide detector in the hallway, was tested and is operable. Smoke detectors observed in the hallway and resident bedrooms, were tested and are operable. LPA inspected four (4) resident rooms. All resident bedrooms contained required furniture, linens and lighting. Water temperatures in all grooming and bathing areas were measured to be with 105 – 120 degrees F. LPA observed grab bars near toilets and inside showers. LPA observed no-slip flooring in showers. Showers were observed to be wheelchair accessible. continued on LIC 809C Food Service: LPA observed sufficient supply of nonperishables for one (1) week and perishable foods for a minimum of two (2) days in the facility kitchen area. Soaps, detergents, and cleaning compounds were observed to be stored away from food supplies. Freezers and refrigerators were observed to be clean Residents Rights-Information: LPA observed the following postings in common areas throughout the facility: Complaint Poster (PUB 475), personal rights, and nondiscrimination notice. LPA observed facility land line was operable. Disaster Preparedness: The facility has the Emergency Disaster Plan (LIC610D/9 pages) in place. Fire drills are conducted monthly, last drill 10/01/25. LPA observed facility sketches with exits and emergency exits routes throughout various locations of the facility. Residents with Special Needs: No large bodies of water were observed. LPA observed signs posted indicating “No smoking - Oxygen in Use.” LPA observed an oxygen tank in resident room secured in stands. Knives, sharps or other items that could pose a danger to residents with dementia, were observed to be inaccessible. Health Related Services/Incidental Medical Services: The medications are centrally stored, secured in ta kitchen cabinet inaccessible to residents in care. The facility uses the Medication Administration Record (MAR) log to document medications given. The facility provides incidental medical services. Staffing: Administrator Certificate for Jasaiel De Leon expires 04/03/2026. Staff employed are over the age of 18 and are fingerprint cleared and associated to the facility. Personnel Records Training: Staff files are maintained at the facility. LPA observed required annual training, CPR and First Aid for two (2) personnel records reviewed. LPA observed TB testing results, Health screening, fingerprint clearance and job application for personnel records reviewed. Resident Records/Incident Reports: LPA reviewed files for four (4) residents in care. Resident files are maintained at the facility and contain the required documents. Per California Code of Regulations, Title 22, and California Health and Safety Code, no deficiencies were cited during today’s visit. Exit interview held and a copy of this report was provided to Administrator Jasaiel De Leon.