Routine inspection·March 23, 2026

At 10:30a.m., Licensing Program Analyst (LPA) Antonia Alvizar-Ettima conducted an unannounced Required One (1) year inspection to the facility. LPA met the Administrator who granted entry to the facility and explained the reason for the visit. At approximately 10:45a.m., LPA and Administrator conducted a physical plant tour inside and out. During the tour, LPA observed that the facility is a home located in a residential community. Required postings were observed in the entry area and hallway. The dual smoke/carbon monoxide detectors are functioning properly located in each bedroom, dining area and hallways. The fire extinguisher is in the dining room and laundry area with purchased date of 05/03/2025. During the visit the facility is set at 75 degrees Fahrenheit. The facility is fire cleared for six (6) non-ambulatory residents; of which one (1) may be bedridden; six (6) hospice waiver. Fire Emergency drill was last conducted on 01/06/2026. The facility is currently occupying six (6) residents. 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 gas 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 under kitchen sink. Medications: are in a centrally stored and locked medication cabinet in kitchen 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 entry area and an extra one in the locked cabinet. Laundry Area: the washer and dryer located in the staff room/office. LPA observed the staff room/office to be inaccessible to residents where the laundry detergents and some cleaning solutions are stored. Bedrooms: LPA observed five (5) bedrooms designated for residents' and staff use. Bedrooms #3 - #4 are for private use, bedrooms #1 - #2 are shared and a staff room. All the resident’s bedrooms were properly furnished with appropriate dresser, bedding, and linens with sufficient lighting. Hallways are well lit. Linens are stored in hallway closet and observed to have ample supply of clean linen, comforters, and towels in facility. Bathrooms: LPA observed two (2) 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 110.3°F to 113.2°F and 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. The common areas were properly furnished and observed to be in good repair. 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. 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 six (6) 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.