Routine inspection·August 13, 2025

On 08/13/25, at 9:30am, Licensing Program Analyst (LPA) Perry Scott conducted an unannounced annual required inspection visit to Kingspine Senior Care Home. LPA met with Alyssa Gutierrez, Administrator, and explained the purpose of today’s visit. The facility is licensed to serve residents 60 years and above. The capacity is for six (6) residents which consist of the following: four (4) ambulatory, one (1) non-ambulatory, and one (1) bedridden resident. The facility has a hospice waiver for six (6) residents. Currently, the home has (6) residents. The facilities annual fees are current. The facility is a single-story residential home located in a residential neighborhood. The home consists of the following: 4 bedrooms, 2 bathrooms, kitchen, living room, dining area, laundry area, attached garage, and a backyard. LPA conducted a records review of (6) resident records, (5) staff records, and reviewed the facilities emergency disaster plan. All resident and staff records were complete. The facility emergency disaster plan was current and in compliance with Title 22 regulations at the time of visit. LPA reviewed (6) resident medication administration records and medication, and did not observe any discrepancies at the time of visit. At 10:00am, LPA and staff 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’s 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 are accessible to residents. The water temperature measured 108.9F degrees; 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 cleaning agents, toxins, and sharps were inaccessible to residents. The kitchen was inspected and there is enough perishable and non-perishable food available for the residents. All food items were stored properly. Medications were centrally stored and properly locked, first aid kit was checked and fully stocked with manual . The fire extinguishers were charged and last inspected on 03/06/2024, and the smoke/carbon monoxide detectors were operable. The last fire/emergency drill was conducted on 06/05/2025. The facilities administrator’s certificate was valid from 04/18/2024 through 04/17/2026. The facilities liability insurance was valid from 07/11/2025 through 7/11/2026. 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 facility 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. No deficiencies were cited during this inspection visit. An exit interview was conducted, and a copy of this Facility Evaluation Report was provided to Alyssa Gutierrez, Administrator.