Routine inspection·April 17, 2025

On 04/17/2025 at 11:00am, Licensing Program Analyst (LPA) Zina Brown conducted an unannounced visit to the above facility. The purpose of today’s visit was to conduct the one-year inspection. LPA met with Alvin Banzuela, Administrator and the purpose of the visit was discussed. Facility is licensed to serve 6 non- ambulatory residents of which two (2) may be bedridden and a waiver granted for an approved hospice care for six (6) residents. Three (3) of the residents are diagnosed with dementia, zero (0) receiving home health, and three (3) of the residents are receiving hospice care services. The facility does not handle any of the residents’ money. The facility fees are a balance of $495 due on 06.24.2025. LPA provided pin #386307 with the option for the facility to make an payment online.The facility has liability insurance with Perlas Insurance effective date as 10/28/2024. The home is a single story home consisting of: (4) resident bedrooms, (2) full bathroom, living room, kitchen with dining area, a attached garage and an outdoor shaded patio area in the backyard. Between the hours 11:06am - 11:28am, LPA toured the resident bedrooms had the required furniture, bed linens and closet/drawer space to accommodate each resident comfortably. 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, water temperature measured at 106.5F (in kitchen), 118.2 F (in bathroom #1), 118.0F (bathroom #2). Resident bath towels, toiletries and personal hygiene supplies were adequately stocked. Common areas were clean and clear of hazards; doorways were free of obstructions. Report continues on LIC 809-C Between the hours of 11:29am - 3:15 pm, LPA conducted a records review of (5) residents records, (5) staff records and (5) Client Medication Administration Records and the facility disaster plan. All client & staff records were complete. The facility disaster plan was current (last conducted on 04.10.2025) and in compliance with Title 22 at the time of visit. LPA did not observed any discrepancies at the time of visit. Kitchen was checked and observed to be within Title 22 regulations. Perishable and non-perishable food supply was checked. All cleaning solutions, hazardous items, and medications were securely locked and inaccessible to residents. Smoke detectors were working properly, and fire extinguisher was fully charged. Carbon monoxide detector was operational. First Aid kit was available. Outside grounds were toured and no bodies of water were observed. Walkways around the home were clear of hazards. There are no security bars or weapons on the premises. During todays visit LPA did not observe any deficiencies. An exit interview was conducted Alvin Banzuela, and a copy of this report was provided.