Routine inspection·September 24, 2025

On 09/24/25, Licensing Program Analyst (LPA) Regina Cloyd conducted an unannounced required – annual inspection and met with Staff . The Assistant Irina Fried arrived later. The facility is licensed to serve six (6) non-ambulatory residents aged 60 and over. It also has an approved hospice waiver for two (2) residents. Annual Fees are current. The facility is a single-story structure located in a residential neighborhood. It consists of the following: 6 bedrooms, 3 bathrooms, family room, dining room, kitchen, living room, outside shaded area, indoor and outdoor activity area, laundry room and a detached garage. LPA did not observe any bodies of water on the premises. All walkways around the home were observed to be clean, clear, and free of debris, obstructions, and hazards. Staff accompanied LPA inside and outside the facility during this inspection. Outside grounds were toured and no bodies of water were observed. Walkways around the home were clear of hazards. The facility is clean, sanitary, and in good repair. Continue to LIC809-C. Resident bedrooms had the required furniture, bed linens and closet/drawer space to accommodate each resident comfortably. There are no security bars or weapons on the premises. Resident bathrooms were checked. Toilets and water faucets worked properly, grab bars were secure, shower was free of mold/mildew, a non-skid mat was in place, and hot water temperature properly measured at 120 degrees F. Resident bath towels, toiletries and personal hygiene supplies were adequately stocked. Common areas were clean, clear of hazards, and doorways were free of obstructions. LPA toured the kitchen area and observed a two-day supply of perishable and a seven-day supply of non-perishable food. Knives and toxics were kept in locked storage cabinet. First Aid kit was available. Two fire extinguisher, last serviced April 8, 2025 was observed in the kitchen/laundry area and front door exit. LPA tested the carbon monoxide detector and smoke detectors in the house. Both devices were functional. Five (5) staff records were reviewed and 5 out of 5 staff records had current first aid certificates and required criminal record clearances or criminal record exemptions. Five (5) resident records were reviewed, and two (2) residents’ medication was reviewed. Continue to LIC809-C. Deficiencies are being cited according to California Code of Regulations, Title 22. See LIC809-D. During record review, LPA did not observe an annual medical assessment for Resident #1 - #3. An exit interview was conducted, plans of correction developed, technical assistance provided and a copy of this report with appeal rights was discussed and left with Assistant Irina Fried.