Routine inspection·December 23, 2025

Licensing Program Analyst (LPA) Gabriela Castro conducted an unannounced required annual visit utilizing the Compliance and Regulatory Enforcement (CARE) Tool. LPA was greeted by Justine Trinidad, Caregiver, and informed him of the purpose of the visit. Administrator Deborah Davis and Lead Caregiver Lorraine Yee arrived shortly thereafter and participated in the inspection. The facility is licensed to serve six (6) residents, ages 60 and over. The license permits five (5) non-ambulatory residents, of which one (1) may be bedridden. The facility also holds a hospice waiver for six (6) residents. At the time of the inspection, three (3) residents were receiving hospice services. Facility Tour & Observations: Personal Rights postings (LIC 613C and Ombudsman), Complaint Poster (PUB 475), and nondiscrimination notice were observed in a common area. Residents had access to personal space, privacy, and adequate storage. No firearms/weapons were present. “No smoking - Oxygen in Use signs” in various locations of the facility. Physical Plant The facility is located in a residential neighborhood and is a one-story home consisting of five (5) resident bedrooms, three (3) bathrooms, a living room, kitchen, dining area, attached garage, front yard, and backyard. Each resident bedroom was observed to contain the required furnishings, including a bed, mattress, linens, dresser, chair, and adequate lighting. (Continued on LIC809C) Cleaning supplies and other toxic substances were observed to be inaccessible to residents and secured in locked kitchen and bathroom cabinets. Bathrooms were clean and equipped with required grab bars in showers and near toilets, as well as non-skid mats. Hot water temperatures were measured observed to be slightly below the required range of 105°F to 120°F. Extra linens and towels were available and stored in hallway cabinets and hallway closet. Smoke and carbon monoxide detectors were observed to be functional. A fire extinguisher was observed in the laundry room and hallway near the front entrance. No bodies of water were observed on the premises. The backyard was observed to provide shaded seating. Passageways and exits were observed to be clear and unobstructed. Health-Related Services & Records Three (3) residents’ medications were reviewed. Medications were observed to be centrally stored in a locked closet by the front door entrance. Medication Administration Records (MARs) were reviewed and observed to be current. Due to time constraints, LPA will return at a later date to complete annual inspection. No deficiencies are being cited at this time. Exit interview was conducted with Lorraine Yee, Lead Caregiver. A copy of this report will be emailed due to printer problems.