Routine inspection·March 7, 2026

Licensing Program Analyst (LPA) Jose Tan conducted an unannounced visit and was greeted by the staff Samantha Baltazar who called the Administrator. Administrator Sona Galstyan arrived about an hour later. LPA explained the reason for the visit. The facility is fire cleared for six (6) non-ambulatory residents, five (5) of which may be bedridden in Rooms 2 to 4. Hospice waiver for six (6) residents. At 9:21 AM, LPA conducted the physical plant tour with the staff and observed the following: The facility is a single storey with six ()6 bedrooms and four (4) bathrooms. Two (2) bedrooms and one (1) bathroom is designated for staff use. Dual smoke and carbon monoxide alarms were tested and observed to be operable. The facility is equipped with sprinkler system. Common Areas – The family room, dining room, and kitchen are combined. The family room was furnished with comfortable seating and a television. The dining room contained a dining room table and chairs. Fire extinguishers were located near the kitchen and the main door upon entry and last inspected on 11/14/25. Medications: LPA observed the resident medications and first aid kit were safely locked in a kitchen cabinet. Kitchen: LPA observed a two day supply of perishable food and a seven day supply of non-perishable food items. Dishwashing liquid and other cleaning agents were observed locked underneath the kitchen sink. Laundry Room is located adjacent to the kitchen and was observed to be locked during visit. Laundry detergent and other toxins were locked in the garage. (continued on LIC 809-C) (continued from LIC 809) Garage - The garage was attached to the house and was observed to be locked during visit. The garage is also being used as frozen and emergency food, PPE, cleaning agents, laundry detergents and other toxins and old equipment storage. Resident Rooms: There are four resident rooms which were furnished with a bed, linens, night stand, lamp and chair. The rooms were properly furnished and observed to be neat and clean. Staff Rooms are furnished, neat and organized. No medications were observed at the staff room. Bathrooms: There are three bathrooms in the facility. The bathrooms contained hand soap, paper towels, grab bars, and slip resistant mats. LPA observed the clean linens were located in a cabinet within the staff bathroom. Water Temperature: was tested and measured at a range of 115.2°F to 115.8°F. Surrounding Grounds : There were no visible hazards, and passageways were free from obstruction. There is a shaded area with comfortable seating in backyard. Client records : Client records are reviewed. Client records appeared to be complete and updated. Staff records : LPA conducted a complete file review of staff record. Staff records appeared to be complete and updated. Disaster drill was last conducted on 01/05/26 . Required posting are observed to be complete and current and displayed properly at the facility. Exit interview conducted. Copy of this report issued