Routine inspection·October 31, 2025

On 10/31/25, Licensing Program Analyst (LPA) Mario Leon conducted an unannounced annual inspection. LPA was met by staff one, Jerald Padunan - Assistant Administrator Designee (S1), and later by staff two, Rachel Tuazon - Administrator Designee (S2) and the purpose of the visit was explained. The facility is licensed to serve six (6) non-ambulatory residents, of which one (1) may be bedridden. The facility has a hospice waiver approved for six (6) residents. The facility is a single-story structure located in a residential neighborhood. It has a ramp that goes along the west side of the facility. It consists of (5) bedrooms, (3) full bathrooms, shaded back yard, front yard, laundry room and attached garage. Protective devices are in place, including non-slip mats and grab bars in all showers and the average water temperature is 113.6°F (degrees Fahrenheit) and all water sources provide water within title 22 regulations. S1 accompanied LPA's tour of the inside and outside the facility during today's inspection. Outside grounds were toured and no bodies of water were observed. Resident bedrooms had the required furniture, bed linens, and closet/drawer space to accommodate each resident comfortably. There are no security bars or weapons on the premises. Resident bathrooms were checked. Toilets and water faucets worked properly, grab bars were secure, shower was free of mold/mildew, and a non-skid mat was in place. Resident bath towels, toiletries and personal hygiene supplies were adequately stocked. Common areas were clean and clear of hazards. Doorways were free of obstructions. During LPA's tour, LPA observed the windows and screens to be in minor disrepair. Please see LIC809-D. Report continues, please see 809-C. LPA toured the kitchen area and observed a two-day supply of perishable and a seven-day supply of non-perishable food. Knives and toxic cleaning agents were kept in locked storage cabinet. LPA observed the stove in disrepair, please see LIC809-D. First Aid kit was available, along with first aid manual. One fire extinguisher, last serviced September 25, 2025 was observed in the kitchen area. All drills have been conducted, last conducted on 10/02/25. S1 tested the carbon monoxide detector and smoke detectors in the house. Both devices were functional and operated within title 22 regulation. . There have been two deficiencies cited during today's visit, please see 809-D. An exit interview was held with staff two, Rachel Tuazon (S2) and a copy of this report, deficiencies cited and appeal rights were provided to S2.