Routine inspection·March 26, 2026

Licensing Program Analyst (LPA) Nadia Shahbazian conducted an unannounced annual required visit and inspection of the facility. LPA met with Jorge Adle Mendoza - Administrator and explained the reason for the visit. The facility is licensed to serve six (6) residents ages 60 and above, of whom (6) may be non-ambulatory. Facility has an approved waiver for two (2) hospice residents. At 10:15am, with the assistance of Administrator, LPA took a tour of the physical plant and observed the following. Required postings were observed in the entry area. The smoke/carbon monoxide detectors are hardwired and interconnected. At 11:05 am smoke alarms/carbon monoxide detectors were tested and observed to be functional. The fire extinguisher is located in the kitchen and was purchased on 3/1/2026. The auditory alarms on all exit doors were functional at the time of the visit. Kitchen: Appliances consisted of stove, dishwasher and microwave. LPA found a sufficient supply of perishable (2 days) and non-perishable (7 days) foods at the facility. Knives were stored in a locked drawer in the kitchen. Chemicals and detergents were stored in a locked cabinet underneath the sink. LPA observed an exit door in the kitchen, leading to the front. Common Areas : The family room and the office are located by the entry. There is a living room and dining a room, furnished with tables, chairs and a television set. There is a double sided fireplace in the family and living rooms; both fireplaces were properly covered by a glass cover. LPA observed a karaoke machine and entertainment area in the living room. Facility offers a land-line telephone, cable and internet access for resident's use. Continued on 809-C Bedrooms: There were four (4) bedrooms, three (3) of which are designated for residents' use. Bedroom #4 is designated as staff room but there is awake staff at night. All bedrooms are were properly furnished with appropriate beddings, chairs, cabinets, linens and have sufficient lighting. Currently bedrooms #2 and #3 are vacant. Bathrooms: There are two (2) bathrooms, one near bedroom# 4 and one between bedrooms #2 and #3. LPA observed functional fixtures, grab bars and non-skid mats in each bathroom. Hot water temperature was measured at 108.9 and 109.7 degrees Fahrenheit. Surrounding Grounds : There were no bodies of water or obstructions on the premises. There is a covered patio with furniture appropriate for outdoor use. There is a locked shed in the backyard. Garage is detached and is currently being utilized as storage. The laundry machines and detergents are kept locked in the garage. There is a ramp leading from the living room to the backyard; there is also a side door in the kitchen and a door in bedroom# 4 leading to the backyard. Facility uses the main entry door as the emergency exit door. Facility conducts quarterly fire/emergency drills, the last drill was conducted on 01/01/2026. Resident Files/Medications : LPA reviewed the records for the one (1) resident. Medications are kept locked in the hallway closed. LPA observed a complete first aid kit and the manual in locked medication cabinet. LPA counted medication for the one (1) resident, for accuracy of administration. Staff Files : LPA also conducted a file review of staff records to insure forms and training are up to date and in compliance with licensing requirements. LPA reviewed the facility liability insurance with expiration dated of 09/07/2026. Administrator Certification expiration date is 12/03/2026. Pursuant to Title 22 Division 6 of the CA Code of Regulations, no deficiencies were observed during the visit. Exit Interview Conducted / A Copy of the Report Issued to the Administrator.