Routine inspection·December 15, 2025

On 12/15/2025 at 10:20 a.m. Licensing Program Analyst (LPA), Evelin Rios, conducted an unannounced Annual Required visit at the facility mentioned above. LPA was greeted by Staff #1 (S1) who granted access. LPA observed appropriate postings on the walls. LPA observed Staff #2 (S2) sweeping. S1 contacted the Administrator, Richard Garcia. LPA met with the administrator and explained the purpose of the visit. At approximately, 10:30 a.m. LPA Rios initiated the physical plant tour of the facility inside and out. The following was observed: Bedrooms: LPA inspected six (6) resident bedrooms. LPA observed bedrooms to be properly furnished with a bed, mattress, night stand, drawers and have sufficient storage. The rooms were clean and free of foul odors. Bathrooms: LPA inspected three (3) bathrooms, one (1) of which is located in a resident's private bedroom. All bathrooms were clean and in good repair. Bathrooms were properly supplied with toilet paper, soap and paper towels. LPA observed appropriate grab bars, and non-skid mats. LPA measured hot water temperatures in two common bathrooms. At 2:08 p.m., the bathroom near bedroom #4 measured 115.9°F. At 2:09 p.m., the bathroom near bedroom #2 measured 117.0°F. Laundry Room: By bedroom labeled #1, LPA observed a locked door to the laundry room. LPA observed a washer and dryer and cleaning supplies such as chemicals and detergents. (Continued on LIC809-C) (Continued from LIC809) Facility is equipped with two fire doors, fire sprinklers, and smoke detectors throughout. At 11:04 a.m., the administrator tested the smoke detectors and they were observed operational. LPA also observed more than one functioning carbon monoxide detector. Common Areas : The common areas such as the dining areas and living room were clean and clear of clutter. Tables and chairs appeared to be in good repair and sit the capacity of the facility. In the living room the couches and recliners were observed to be clean and in good repair. No tripping hazards observed. Doors in bedrooms and common areas leading to the outside have auditory alarms that were on and working properly. Kitchen: LPA inspected the kitchen and observed a 7 day non-perishable and 2 day perishable supply of food. All knives and sharps were observed locked in a kitchen cabinet and inaccessible to residents. LPA observed a fire extinguisher fully charged with service date 11/10/2025. LPA observed telephones through out the facility accessible to residents. Outdoor Area: LPA toured the outside area of the facility and observed appropriate outdoor furniture, with a covered shaded area for residents. The backyard is fully fenced in with enough outdoor space for activities. Passageways to entrances and exits were clear of obstructions. Resident and Staff Files : Resident and staff files are maintained locked in a hallway walk-in closet. From 11:43 a.m. to 1:10 p.m., LPA conducted a file review of five (5) out of five (5) resident records to insure compliance of licensing forms. The first aid kit, residents medication and medication records are stored in a locked hallway walk-in closet. Medications were reviewed for proper storage and documentation. Facility also uses a Medication Administration Record (MAR). LPA conducted a file review of three (3) staff records to ensure forms and training are up to date. One (1) out of the three (3) staff records reviewed did not have the annual 20 hours of training. LPA obtained a copy of the facilities updated liability insurance, and LIC500. LPA reviewed with the administrator the facility's emergency and disaster plan, infection control plan. LPA was not provided documentation of emergency type quarterly drills conducted for each shift in 2025. Deficiencies observed during todays visit, refer to LIC809-D. A copy of this report was provided. Appeal rights provided. Exit interview conducted.