Routine inspection·June 9, 2025

On 06/09/25, Licensing Program Analyst (LPA) Elvira Gonzalez conducted an unannounced annual required visit using the CARE Inspection Tool. LPA met with staff, Jimbo Paug and explained the purpose of today’s visit. LPA was granted access to the facility. Administrator Lodervine Alipio joined LPA for the inspection shortly after. The facility is licensed to serve two (2) ambulatory and (4) non-ambulatory residents aged 60 and above. Hospice waiver approved for one (1) resident. Currently there are four (4) residents in the facility. The facility is a single-story home located in a residential neighborhood. It consists of the following: four (4) resident bedrooms, three (3) bathrooms, of which two (2) are private, and one (1) is shared, a living room with workspace for staff, kitchen, dining area, laundry area, an outside shaded seating area, and a detached garage. LPA Gonzalez and Lodervine Alipio toured the entire physical plant. There were no bodies of water or obstructions on the premises. Exits/ Walkways around the home were free of debris and hazards. All residents’ bedrooms were inspected. The bedrooms had the required furniture, beds, mattresses, box springs and bedding were in good condition, adequate lighting was provided, and storage for resident’s personal belongings was observed. LPA observed the walls and floors were in good repair. Bathrooms were clean and operational and found to be within Title 22 regulations. The hot water temperature measured between 105.F and 120.F degrees. A comfortable temperature is maintained in the facility. LPA observed the facility to be sanitary and appropriately furnished at the time of visit. The storage area for personal hygiene, cleaning supplies, toxins, and sharp objects were stored and inaccessible to residents. Continued on LIC 809-C The kitchen was inspected, and sufficient perishable and non-perishable food was available and maintained properly. Fire extinguishers were charged, and smoke detectors and carbon monoxide were tested and operable. A working landline phone is available. A first aid kit along with manual was fully stocked and available. LPA noted that all required postings were on the walls. LPA conducted a review of four (4) resident records, and two (2) staff files, and observed them to be in order and complete. The Medication Administration Records (MAR) were reviewed and found to be maintained in order. Centrally stored medications are kept locked and inaccessible to residents. The Medication Administration Records (MAR) were reviewed and found to be maintained in order. Centrally stored medications are kept locked and inaccessible to residents. The facility is current with Community Care Licensing (CCL) annual fees. Liability insurance is active with expiration date of 07/01/25. No deficiencies were cited during this inspection visit. An exit interview was conducted with Administrator Lodervine Alipio, and a copy of the report was provided.