Routine inspection·September 29, 2025

Licensing Program Analyst (LPA) Tena Herrera conducted the required annual inspection. LPA arrived unannounced and met with Rachel Duque and explained the purpose for today’s visit, shortly after Administrator Robert arrived to assist with visit. The facility is licensed to serve 6 Non-Ambulatory Residents ages 60 and above. The facility is a single-story home located in Bellflower, Ca. A tour of the facility includes: 4 bedrooms, 2 full bathrooms, living room, kitchen, dining area, laundry area, den, detached garage with office and tool shed used as storage. LPA utilized the Compliance and Regulatory Enforcement (CARE) tools for the visit todays visit and the initial visit and observed the following: Infection Control: Facility maintains the required Infection Control Plan. Operational Requirements: The facility has an approved fire clearance and maintains the required liability insurance. Physical Plant & Environment Safety: LPA toured facility, residents’ bedrooms were checked and closet/drawer space to accommodate each resident comfortably was available. The front yard is free of debris/hazards and the outdoor and passageways are free of obstruction. No bodies of water were observed at the facility. There are no security bars or weapons on the premises. Hygiene products are readily available for clients. The hot water temperature was tested and measured within the required range of 105-120 degrees F. All storage areas for cleaning solutions, toxins, knives, and hazardous items are kept in a locked and are inaccessible to residents. Smoke detectors and carbon monoxide detectors are operable and in compliance. There fire extinguisher was observed and is fully charged. (Continued on LIC809-C) Staffing & Personnel Records-Training : There appears to be sufficient staffing at all times in the facility. Staff has criminal record clearance, current First-Aid/CPR/AED training along with other ongoing training are documented in personnel files. LPA reviewed 5 staff files and observed 2 staff missing their valid First-Aid certificates missing from file, citation will be issued and detailed on the LIC809-D . Administrator Teresa Santos certificate expires on 8/20/2027. Resident Records-Incident Reports: Resident files are kept in a secure location and have the following documents in their files - Pre-admission appraisal/Appraisal Needs & Services Plan, Admission Agreements, Identification & Emergency Information and current Physician's Report. LPA reviewed 3 Resident Files and observed that Resident #1 was missing their Physician's Report, citation will be issued and detailed on the LIC809-D . Residents Rights-Information: Residents are provided with telephone and internet at the facility. The facility has the following posters posted: Residents Rights, Complaint Poster, and Ombudsman. Planned Activities: Facility provides scheduled activities and have a variety of activities to choose from within the facility. There is an outdoor activity area available for the residents. Food Service: The kitchen was observed for the ability to prepare and serve food. LPA observed an appropriate food supply of two (2) days of perishables and one week (7 days) of non-perishables. Incidental Medical & Dental: Medication is properly labeled and are centrally stored in a closet and are in their original containers. LPA reviewed 2 residents’ medications and there were no issues observed. Disaster Preparedness: The facility has an Emergency Disaster Plan with contact numbers and at least 2 relocation sites. Last fire/disaster/earthquake drill was conducted on 9/2/25. Residents with Special Health Needs: There are no bedridden or residents with postural supports at this facility. Per California Code of Regulations, Title 22, and California Health and Safety Code, there deficiencies observed during the visit will be documented on the LIC809-D page. Exit interview held, a copy of the report and appeal rights were emailed to Robert Francisco.