Routine inspection·November 14, 2025

On 11/14/2025 Licensing Program Analyst (LPA) Evelin Rios arrived at the facility to conduct an unannounced annual inspection. Upon entry, LPA was asked to sign in and had their temperature taken by staff. LPA was greeted by the Administrator Merlita Nepomuceno. LPA Rios explained the purpose of the visit. At 9:00 a.m., LPA and Administrator conducted a physical plant tour of the facility, both inside and outside. The following observations were made: LPA observed required postings were displayed on the walls leading to the common areas. A closet by the entrance was observed containing emergency food and water, a fully stocked first aid kit, flashlights, and an overflow supply of pantry food. The attached garage is through a staff room that is maintained locked . Inside the attached garage, LPA observed a washer and dryer, a locked cabinet containing cleaning products and chemicals, and a deep freezer with an overflow supply of food. In the kitchen , LPA observed the appliances and fixtures were in good working condition. LPA observed a sufficient supply of two days perishable food and seven days non-perishable food. Cookware, cutlery, and dishware were observed to be in good repair. Residents' medications were observed locked in a kitchen cabinet. On a kitchen wall LPA observed a fire extinguisher, fully charged with purchased date 09/01/2025. A carbon monoxide detector located by the kitchen was tested by staff and was observed operational. There are four (4) bedrooms designated for residents' use. One (1) room is shared. Resident bedrooms were furnished with beds, night stand, chairs, dressers, bedding and linens. The bedrooms have sufficient lighting and storage. Exit doors with auditory alarms were observed operational. There are two (2) bathrooms designated for residents. One (1) bathroom is located in the shared room and is for private use. Bathrooms were properly supplied and had functional fixtures. Hot water temperature was taken from one (1) of two (2) bathrooms at 10:58 a.m. and read 113 degrees Fahrenheit, within regulation. The common areas, include the living and dining rooms. They were clean, clear of clutter, and appropriately furnished. The furniture was observed to be in good repair. A fireplace in the living room was secured with a screen. A telephone was accessible to residents on the kitchen peninsula and a television along with games were readily available for resident use. No tripping hazards were observed. The outdoor area was free of hazards and has a covered patio with outdoor furniture. LPA observed a locked shed used for storage. Passageways to the emergency exit was free from obstructions. The smoke detectors are interconnected. LPA observed a staff test a smoke detector at 11:02 a.m. The smoke detector alarms went off through out the facility. LPA reviewed facility records, including but not limited to the Certificate of Liability Insurance, the Infection Control Plan (last reviewed by the licensee representative on 07/31/2025), the Emergency and Disaster Plan (LIC 610E, reviewed on 10/02/2025). From approximately 9:30 a.m. to 11:00 am., LPA reviewed staff files and resident records. LPA conducted a file review of three (3) staff records to insure forms and training are up to date and compliance with licensing forms. LPA conducted a file review of four (4) resident records to insure compliance of licensing forms. LPA and administrator reviewed centrally stored medication and medication records for proper documentation. Facility also keeps a Medication Administration Record (MAR). Pursuant to Title 22, Division 6, Chapter 8 of the CA Code of Regulations, there were no deficiencies observed during todays visit. Exit Interview Conducted. A copy of the report Issued.