Routine inspection·March 9, 2026

License Program Analysts (LPA) Luis De Leon conducted an unannounced annual required visit. LPA met with Supervisor Roxana Aparicio. Administrator Gregory Restum was informed via phone about today’s visit; Administrator joined visit some time after. The purpose of today’s visit was explained to supervisor Roxana Aparicio. The facility is licensed to serve 22 residents over the age of 60, of which (12) may be non-ambulatory of which 12 can be bedridden on the 1st floor only, with a hospice waiver approved for 12 residents. The LPA use the Compliance & Regulatory Enforcement Tool (CARE) during today’s inspection. The visit consisted of the following: FACILITY PHYSICAL PLANT The facility is in a commercial area and is made up of a two-story building. The facility consists of the following: first floor has 10 bedrooms, 3 bathrooms, 2 closets, office space, and the kitchen; second floor has 6 bedrooms and 2 bathrooms, a front yard, a back yard, parking, and a laundry in the basement. The facility has a shaded area for residents to enjoy. There is not body of water on property. REVIEW OF FILES Client record review consisted of Admission Agreements, Identification and Emergency Info, Physicians Report, Consent Report, Needs and Service Plan, Personal Rights, Hospice care plan, and Centrally Store Medication. Staff record review consisted of Personnel Report, Health Screening, Criminal Record Statements, Fingerprint Clearance, Training, First Aid and CPR. Operation plan, disaster and emergency plan, and infection control plan. (Report continues on page LIC-809C...) Observations during facility tour: Bedrooms were furnished with a bedframe, dresser, lamps, and chairs. LPA observed that there was clean linen, bath towels, and personal hygiene with reasonable closet space available for residents. Wall and floors are in good repair. Hallways were clean and free of obstructions. Kitchen appliances were in working order and clean. There is sufficient two (2) days of perishables and seven (7) day supply of non-perishable food. Dining room has sufficient seating area. Weekly food menu is posted at facility. Toilets, showers, and water faucets are found in compliance with Title 22 regulations for temperature and function. Restrooms were stocked and clean. The water temperature was tested and measured. The temperature in five (5) bathrooms were not in compliance with Title 22 regulations between 105º and 120º F degrees. The bathrooms measure in the range of 129-153 degrees F. A deficiency is noted. Sharps are locked inside the kitchen room and inaccessible to residents. Also, disinfectants and cleaning supplies are locked and secured inaccessible to residents. Smoke detectors were observed in all bedrooms and carbon monoxide detectors were observed in hallway area. Five (5) fire extinguishers were observed and were fully charged with last inspection on March 2025. Last fire drill and earthquake drill were conducted on 01/19/2026. The medications are centrally stored and locked in the staff room. The facility uses the Medication Administration Record (MAR) log to document medications given. LPA reviewed medications for all five (5) residents. LPA observed that four (4) out of five (5) resident medication was not properly recorded for residents R1-R3, and R5. Medication was observed that appear that had not been administered or pills on packages did not match the MAR records. Interviews with staff were not able to provide proof of destruction of missing pills or extra pills were missed or refused by residents. Staff stated that medication was distributed, but not properly documented. A deficiency is noted. LPA conducted interviews with three staff and three residents. Per California Code of Regulations, Title 22, and California Health and Safety Code, the deficiencies observed during the visit are documented on the LIC-809D page. Exit interview was held and copies of reports LIC-809, LIC-809C, LIC 809D, and Appeal Rights were discussed and provided to Administrator Gregory Restum.