Routine inspection·May 1, 2025

On 5/1/25, at 9:00am, Licensing Program Analyst (LPA) Perry Scott conducted an unannounced annual required visit using the new CARE Inspection Tool. LPA was met by Eden Cabebe, staff, and the purpose of the visit was explained. The facility is licensed to serve residents aged 60 and over, of which six (6) may be non-ambulatory, one (1) may be bedridden, and hospice waiver for 3. Currently, the facility has (5) residents. The facilities’ annual fees are current. The facility is a two-story residential home located in a residential neighborhood. The facility is located on the first floor, and consists of (3) resident bedrooms, (2) bathrooms, living room, dining room, kitchen, activity room, garage/ storage and backyard with patio cover and tables and chairs. LPA conducted a records review of (5) resident records, (5) staff records, and reviewed the facility disaster plan. All resident & staff records were complete. The facility disaster plan was current and in compliance with Title 22 at the time of visit. LPA reviewed (5) resident Medication Administration Records and did not observe any discrepancies at the time of visit. At 9:30am, LPA toured the physical plant. There are no bodies of water or firearm/ammunition on the premises. All resident rooms were checked. Beds and bedding were in good condition, adequate lighting provided, adequate storage for resident personal belongings was observed. Walls and floors were in good repair. Bed linens, comforters, and bath towels were adequately stocked at the time of visit. Bathrooms were found to be within Title 22 regulations. Report Continued On LIC809-C Toilets and water faucets worked properly. The shower was free of mold/mildew, there is adequate lighting, and sufficient toiletries accessible to clients. The water temperature measured 119.7F. A comfortable temperature is maintained in the facility. LPA observed the facility to be clean and appropriately furnished at the time of visit. Storage areas for personal hygiene, cleaning agents, toxins, and sharps were inaccessible to residents. The kitchen was inspected and there is enough perishable and non-perishable food available, which is stored properly. Medications were centrally stored and properly locked, first aid kit was checked and fully stocked . The fire extinguishers were fully charged. Smoke/ Carbon Monoxide detectors were operable. The facilities administrator’s certificate was current and expires on 10/24/2026. During the visit, LPA observed the facility infection control practices. LPA observed screening protocols for visitors, staff, and residents. LPA observed that sanitizing stations were in common areas and restrooms. LPA observed that the facility had the required postings, posted throughout the facility. LPA advised the staff to continuously monitor the Centers for Disease Control (CDC) website and Community Care Licensing ( www.cdss.ca.gov ) for Provider Informational Notices (PIN) and for any updates relating to COVID-19 guidance and other related issues. During today’s visit there were no deficiencies observed. An exit interview was conducted, and a copy of this Facility Evaluation Report was provided to Eden Cabebe, staff.