Routine inspection·May 1, 2025

Licensing Program Analyst (LPA) Abeye Duguma met with Jorge Aquino for a Required One (01) Year visit. LPA contacted the administrator Silica Bungabong who designated Jorge Aquino to sign and accept the report. LPA explained the reason for the visit. A tour of the physical plant was conducted at around 10:00 AM and the following was noted: There is one entrance being utilized at the facility. Facility has five (05) bedrooms and two (02) full bathrooms. One (01) out of five (05) bedrooms is semi-private and the remaining are all private single occupancy. The facility is fire cleared for six (06) non-ambulatory of which one (01) may be bedridden and has a hospice waiver for six (06). The facility is currently occupying four (04) residents. The facility has outdoor furniture with a covered shaded area for residents and visitors. The facility does not have a swimming pool/body of water. The garage is currently being used for storage. Laundry detergents, cleaning agents and other toxins are locked away. Kitchen is sufficiently stocked with at least two (02) days perishable and seven (07) days non-perishable food. Frozen foods are wrapped and stored appropriately. Food storage and preparation areas are clean and inaccessible to pests. Knives and sharps are observed to be locked and inaccessible to residents. (continued on LIC 809-C) The living and dining room are neat and clean. The facility maintains a comfortable temperature at 72°F. The smoke and carbon monoxide detectors are hardwired, interconnected and observed to be operational. Fire extinguisher is located near the living and dining area and observed to be fully charged and last purchased 04/21/2025. The residents' rooms are adequately furnished with appropriate lighting system. Hallways are well lit. Residents have enough personal hygiene product provided by the licensee. The bathroom was checked for cleanliness and proper operations. The hot water temperature was measured at 115.3°F. Towels and washcloths are not shared. There was enough clean linen available in the cabinets. LPA observed medication to be locked and inaccessible to residents. Facility maintains a complete first aid kit. During the tour LPA observed multiple half rail beds being used by residents but without a written order from a physician indicating the need for the postural support. During record review, LPA also observed missing documentation for one (01) out of four (04) residents. Pursuant to Title 22 Division 6 Chapter 8 of the CA Code of Regulations, the following deficiencies were cited (refer to LIC 809-D): No other health and safety hazards noted during the visit. Exit interview conducted. Copy of this report issued.