Routine inspection·March 4, 2026

At 10:00am, Licensing Program Analyst (LPA), Angela Panushkina conducted an unannounced annual inspection at the facility mentioned above. LPA was greeted by Staff #1 (S1), who granted access to the facility. Administrator arrived shortly after, and LPA explained the reason for the visit. Facility is licensed for capacity of six (6) residents of which five (5) are non-ambulatory and (1) bedridden, in room #1. LPA observed that currently there are five (5) residents in care, two (2) of which are under hospice care. At approximately 10:00am, LPA toured the kitchen area and observed enough supplies of staple non-perishable for minimum 1 week and perishable for 2 days at the facility. All knives and sharps are observed to be locked in a kitchen drawer and inaccessible to residents. There is a fire extinguisher in the kitchen, and it was last serviced on 08/11/2026. At approximately 10:20am, LPA observed medications are centrally stored and locked in six (6) drawer double cabinet, located by the kitchen area and inaccessible to residents in care. LPA also observed a First Aid Kit complete with the required items as per Title 22 Regulations. There are four (4) bedrooms designated for residents’ use and have sufficient lighting. All bedrooms are properly furnished, clean and have appropriate bedding and linens. Auditory alarms were tested and observed to be operational. LPA observed that R5 (in room #4) had a hospital bed with ½ bed rail . LPA reviewed R5's facility file and did not observe a written doctor’s order. Continue on LIC809-C At 10:30am LPA observed all bathrooms are clean and in good repair. Properly supplied with toilet paper, soap and paper towels. The hot water temperature measured at 116.2°F. LPA observed appropriate grab bar and non-skid mat. All trash cans in bathrooms had fitted lids to protect them from cross contamination. Laundry area is located in an attached garage and kept locked and inaccessible to residents. The facility maintains a comfortable temperature at 70°F. The living room and dining area appeared clean and were properly furnished. Smoke detectors located throughout the facility and the carbon monoxide was observed in a hallway, and at 10:45am they were tested and observed to be operational. At approximately 11:00am, LPA toured the outside area of the facility. LPA observed a clean covered patio and backyard furniture to accommodate the six (6) residents. LPA discussed the importance of maintaining care and supervision to meet the needs of residents. At 11:30am, LPA reviewed records of five (5) residents and two (2) staff. Resident and staff records appeared to be complete and updated. LPA collected Certificate of Liability Insurance and LIC500. Moreover, during today’s visit LPA checked the California Secretary of State website and observed that the facility's licensee “AM3 Corporation” had been suspended. LPA conducted an interview with the Administrator and was informed that they will have it in good standing by the end of March 2026. Deficiencies issued on LIC809-D. Failure to correct the deficiencies may result in civil penalties. Exit interview conducted, appeal rights explained and copy of this report signed and delivered.