Routine inspection·June 30, 2025

Licensing Program Analyst (LPA) Quoc Huynh arrived at the facility unannounced to conduct a required annual visit at 9:56AM. The LPA was greeted by Staff, informed them of the reason for the visit, and Staff proceeded to notify the Administrator. The Administrator arrived at 10:50AM. Entrance interview conducted. Beginning at 10:26AM, the LPA and the Staff 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 following was observed: KITCHEN: There was a laundry closet in the Kitchen that was observed to be operational with locked cabinets which stored detergent, cleaning supplies, and a first aid kit. Knives were stored inaccessible in a locked drawer near the sink. Kitchen appliances were clean and in operable condition. LPA observed the kitchen sink to have mold in the grout and the surrounding counter space. The Staff stated they informed the Licensee about the mold a couple days prior to the visit. The Licensee contacted a plumber over the weekend, who arrived at the facility towards the end of the visit. Food in the refrigerator was observed to be properly stored with labels and dates. Report Continued on LIC 809-C COMMON AREAS: At the time of the visit, the living room and dining room furniture was observed to be in good condition. There was a fireplace in the living room, which was observed to be screened and inaccessible. Also located in the dining room was the facility’s office space which had a desk and three (3) locked cabinets that contained files and medications. LPA observed nightlights throughout the facility. The facility maintained a comfortable temperature throughout the visit. One (1) fire extinguisher was observed and was purchased on 06/27/2025. BEDROOMS/RESTROOMS: There were four (4) total bedrooms: Bedrooms #1 and #2 are private, Bedroom #4 is shared, and Bedroom #3 can be utilized as a private or shared room. Each Bedroom had a direct exit to the outside, except for Bedroom #1. Bedrooms were furnished appropriately with clean linens, appropriate furnishings and sufficient lighting. LPA observed Bedrooms #1 and #2 had mounted cameras. The Administrator and Staff stated they were unplugged and not being utilized. LPA advised the Administrator to completely remove them from the walls, to which they agreed. Extra linens were stored in the hallway cabinets. There were three (3) total restrooms in the facility: two (2) were shared and located in the hallways, and one (1) was a private restroom located in Bedroom #3. Restrooms were clean and 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. The restroom in Bedroom #3 had two (2) sinks, one of which was observed to be leaking. The plumber stated they would need to replace both sinks in the restroom. Hot water was tested and measured between 106.9 degrees F and 109.6 degrees F. OUTDOOR AREA: The backyard had one (1) patio area equipped with furniture for residents and visitors to use. There is a driveway gate used as an emergency exits and is remote and manually operated. On the opposite side of the property was a gate with a ramp that only Bedroom #2 had direct access to. No bodies of water noted, and exits were free of obstructions. The LPA observed a detached garage connected to the driveway which contained general storage, extra facility supplies, extra food, and emergency food and water. Report Continued on LIC 809-C LPA observed an Additional Dwelling Unit (ADU) under construction in the rear of the property. The facility notified the Department, however, will need to also send an updated facility sketch, building permits, and a written plan of the intended use of the ADU. RECORDS: Record review began at 11:15AM. 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. LPA observed the Licensee Gigi Papazian did not have a current Administrative Certificate on file. The Administrator stated that they have missed the window for renewal and will need to restart the application process from the beginning. MEDICATIONS: Medication review began at 2:20PM. Medications are centrally stored and kept inaccessible in the office area. Medications were observed for two (2) residents. Medications are labeled and checked for expiration dates. Medications are properly documented on the centrally stored medications and destruction record. No errors observed during the medication review. INFECTION CONTROL /EMERGENCY DISASTER PLAN: During today's visit, the LPA reviewed the facility's infection control plan and emergency disaster plan. Both documents were observed to be complete and updated annually as required. Emergency disaster drills are conducted quarterly, with the last documented drill on 06/01/2025. Smoke and Carbon Monoxide alarms were tested at 2:41PM and were operational. Pursuant to Title 22 CA Code of Regulations, the following deficiencies were cited (refer to LIC 809-D). Exit interview conducted. A copy of today's report and appeal rights were reviewed and provided.