Routine inspection·January 22, 2026

On January 22, 2026, Licensing Program Analyst (LPAs) Ernand Dabuet, Lizeth Villegas, Sparkle Day and Alfonso Iniguez conducted an unannounced annual required visit using the CARE Inspection Tool. LPAs met with Executive Director Cavin Yoo. LPA explained the purpose of today’s visit. The facility is licensed to serve (111) non-ambulatory elderly adults ages 60 and above. The facility is approved for (25) hospice residents. Currently, the facility has (12) residents on hospice care. The facility is a two-story structure located in a commercial neighborhood. It consists of the following: (81) resident bedrooms. Each room has a bathroom in the unit. The facility houses an activity room, dining area, kitchen, administrative offices, and outside patio area. LPA Dabuet toured the physical plant. There were no bodies of water or obstructions on the premises. All rooms were inspected. Beds and bedding supplies were in good condition, adequate lighting was provided, and storage for the resident's personal belongings was observed. Bathrooms were found to be within Title 22 regulations and were operational. LPA inspected rooms: #18; #20; #22; #40; #48; #74; #86; #62, #65 and #49. The water temperature range from 95.0 - 121.5 degrees F. and room temperature range from 66 - 70 degrees F. and smoke and carbon monoxide are all in operating condition. LPA Dabuet observed the facility to be sanitary and appropriately furnished at the time of the visit. Storage areas for personal hygiene, cleaning supplies, toxins, and sharps objects were stored and not accessible to residents. The kitchen was inspected and there is sufficient perishable and non-perishable food available maintained properly. All fire extinguishers were charged. A review of Fire Drills were completed 12/19/25 . Several working landline phones are available on-site. A review of Medication Administration Records found to be in order and accurate. Evaluation Report continues on LIC 809C During the visit LPA observed the facility's infection control practices. LPA observed screening protocols for visitors, staff, and residents, and sanitizing stations in common areas and restrooms. All mandated inspection control posters, including the Activities Calendar and Food Menu, were posted. An audit of resident's service records for resident #1-#6 (R1-R6) and staff personnel records for staff #1-#6 (S1-S6). The facility is current on Community Care Licensing annual fees. The facility has a current administrator certificate on file for Cavin Yoo #6078367740 09/12/2025 through 09/11/2027 RCFE. The facility has a Liability Insurance Certificate valid with policy # HOO76K0023601 effective 11/26/25 through 11/26/26. Deficiencies: The emergency call button is non-operational in the following rooms: #49, #20, #22, and #86. There is no emergency call button available in rooms #62 and #18. The toilet seat cover is missing in room #22. Disinfectant and toxic chemical sprays were observed in rooms #17 and #65. Scissors and other hazardous objects were found in room #18. Staff members #2, #3, and #5 do not have CPR/First Aid certifications on file. There is no Appraisal/Needs Service Plan LIC 625 on record for residents #1, #2, #3, and #5. Staff members #4 and #6 do not have TB Test and Health Screening results on file. Residents in rooms #18 and #65 have prescribed medications stored in their rooms, but they are unable to handle medications according to LIC 602A guidelines. The hot water temperature measured between 95°F and 97°F in rooms #18, #20, and #2. An exit interview was conducted, and a copy of this report and appeal rights were provided to Cavin Yoo.