Routine inspection·March 17, 2026

Licensing Program Analyst (LPA) Blanca Gonzalez conducted an unannounced required annual inspection visit. LPA was greeted by staff and explained the purpose of the visit. The facility is licensed to serve six (6) residents age range 60 and over of which five (5) can be non-ambulatory and one (1) bedridden. Hospice waiver in place for six (6) residents. There are currently five (5) residents in care, of which two (2) are receiving hospice services and one (1) resident is bedridden. The facility in operating within the limitations of there license. The facility is a single-story home located in a residential area of San Dimas. The home consists of a living room, kitchen, dining area, family room, four (4) resident bedrooms, two (2) bathrooms, attached garage with laundry, front and back yards. LPA utilized the Compliance and Regulatory Enforcement (CARE) tool for the today’s visit and observed the following: Physical Plant and Environment safety: Disinfectants, cleaning solutions, poisons and other items that could pose a danger if readily available to residents, were observed to be inaccessible to residents. LPA Gonzalez observed combination carbon monoxide/smoke detectors in hallways. Four (4) resident rooms were observed to contain required furniture, linens and lighting, all in good repair. LPA observed grab bars near toilets and inside shower as well as no-slip coating on shower floors. Passageways and exits are clear of obstructions. Continued on LIC809C Food Service: LPA observed sufficient supply of non-perishables for one week and perishable foods for a minimum of two days in the facility kitchen area. Soaps, detergents, and cleaning compounds were observed to be stored away from food supplies. Freezers and refrigerators were observed to be clean and operable at time of visit. Planned Activities: LPA observed magazines, and other activities for residents. At the time of visit, the staff and residents were celebrating St. Patrick’s Day. Disaster Preparedness: The facility has the Emergency Disaster Plan (LIC610D/9 pages) in place. Emergency drills are conducted quarterly, last drill was conducted 03/03/26. Residents with Special Needs : No pools or large bodies of water were observed. Knives, sharps or other items that could pose a danger to residents with dementia, were observed to be inaccessible. Auditory devices were observed to be in working order. Health Related Services/Incidental Medical Services: Centrally stored medication are secured in a locked kitchen cabinet. LPA observed Centrally Stored Medication and Destruction Record. LPA observed morning medications were not dispensed for R1 for March 17, 2026. Deficiency cited for missed medication. Personnel Records Training: LPA reviewed three (3) staff files and observed required annual training, CPR and First Aid for two (2) out of the three (3) personnel records reviewed, Health screening with TB testing results, fingerprint clearance and job applications. Resident Records/Incident Reports: LPA reviewed resident records for five (5) residents in care. Resident records are maintained at the facility and contained required documentation. Per California Code of Regulations, Title 22, and California Health and Safety Code, the deficiencies observed during today’s visit are documented on the LIC809D. Exit interview held and a copy of this report along with appeal rights were provided to Caregiver Maria “Josie” Alberto