Routine inspection·April 6, 2026

At 11:45a.m., Licensing Program Analyst (LPA) Antonia Alvizar-Ettima conducted an unannounced Required One (1) year inspection to the facility. LPA met with the staff who granted entry to the facility and explained the reason for the visit. At about 11:55a.m., Administrator joined today’s visit. At approximately 12:30p.m., LPA and Administrator conducted a physical plant tour inside and out. During the tour, LPA observed that the facility is a single-story home located in a residential community with six (6) bedrooms and three (3) bathrooms. Fire Clearance was approved on 12/15/2017 (6) non-ambulatory and (6) bedridden residents. Approved hospice for two (2). Fire Emergency drill was last conducted on 03/01/2026. The facility is currently occupying five (5) residents. Facility maintains a telephone land line and it was observed to be operational. Required postings were observed in the dining area. The dual fire sprinkler/smoke detector appeared to function properly located in each bedroom and dining area. The carbon monoxide detector is located in the dining room. The fire extinguishers are throughout the facility with service date of 01/21/2026. During the visit the facility is set at 73 degrees Fahrenheit. LPA utilized the Compliance and Regulatory Enforcement (CARE) tools for the visit today and observed the following: Kitchen: LPA observed kitchen appliances and fixtures were functional. The kitchen has a working stove, freezer, refrigerator, microwave and dish washer. LPA found at least two (2) days perishable and seven (7) days non-perishable food at the facility that is properly stored. Frozen foods are wrapped and stored properly as well. Knives were stored in a locked drawer in the kitchen. Food storage and preparation areas are clean Cont. on LIC 809-C Cont. from LIC 809 and inaccessible to pests. Garbage cans have tight fitting covers. Toxic cleaning supplies were stored and locked away next to stove. Laundry Area: the washer and dryer located next to kitchen. LPA observed the staff office/room to be inaccessible to residents where the facility files and medication are kept. Medications: are in a centrally stored and locked medication cabinet in staff office/room cabinet, including over-the-counter medicines; medications are properly labeled and checked for expiration dates. Each centrally stored prescription and PRN medication has been logged in the medications logged with proper documentation from the resident’s doctor. First-aid has all proper items and were observed to be stored in dining area and an extra one in the medication locked cabinet. Bedrooms: LPA observed six (6) bedrooms designated for residents' and staff use. Bedrooms #3 - #4 are for private use, bedrooms #1 - #2 are shared and two (2) staff rooms. All the resident’s bedrooms were properly furnished with appropriate dresser, bedding, and linens with sufficient lighting. Facility is well lit. Linens are stored in bedrooms and observed to have ample supply of clean linen, comforters, and towels in facility. Bathrooms: LPA observed three (3) bathrooms to be clean, sanitary and with necessary supplies. The appropriate grab bars and mats in the shower. Hot water temperature measured at a range of 117.9°F to 114.9°F within the required range. Resident’s personal hygiene supplies are kept separate in plastic containers. Towels and washcloths are not shared. Common Areas: These included the dining area and living room for residents. Residents dining table fits six (6) residents. No obstructions and/or tripping hazards throughout the facility. There are no issues with Fire Clearance. Surrounding Grounds : Entry and exits were free of obstruction. The facility has appropriate outdoor furniture with a shaded covered area for residents and visitors. There is a ramp access with sturdy hand railings. There is a locked detached garage. The detached garage is used for storage supplies such laundry detergents, toiletries, PPE and incontinent supplies. The outdoor area was enclosed, and no bodies of water were observed. Staff Files : they have criminal record clearances and are associated to facility. Staff have current first aid and training documentation showing training completed. Administrator's certificate was observed to be current. Resident Records : All five (5) resident records were reviewed. Residents’ records are complete and current at this time. Residents were also interviewed. Facility is within CA code of Regulations Title 22 or Health and Safety Code. No deficiencies cited during today’s visit. Exit interview conducted. Copy of this report was provided to the administrator.