Routine inspection·September 26, 2025

On September 26, 2025, Licensing Program Analyst (LPA) Ernand Dabuet conducted an unannounced annual required visit using the CARE Inspection Tool. LPA met with administrator Antonia Dionisio. LPA explained the purpose of today’s visit. The facility is licensed to operate for (6) non-ambulatory of which (2) maybe bedridden elderly adults ages 60 and above. Currently, the facility has (1) hospice resident in care. The facility is approved for (1) hospice resident. The facility is a single-story structure located in a residential neighborhood. It consists of the following: (5) residents' rooms, (2) bathrooms, (1) staff bedroom, (1) staff bathroom, a living area, a dining area, a kitchen, and a garage used for storage. LPA toured the physical plant. There were no bodies of water on the premises. All rooms were inspected. Beds and bedding supplies were in operational condition, lighting was provided, and storage for the resident's personal belongings was observed. Bed linens, comforters, and bath towels were available during the visit. Bathrooms were operational with water temperature measured at 105.0 degrees F. A comfortable temperature of 74 degrees F. was maintained in the facility. LPA observed the facility to be furnished at the time of the visit. Storage areas for personal hygiene and sharps objects were stored and not accessible to residents. The kitchen was inspected, and sufficient perishable and non-perishable food was maintained adequately. A fire extinguisher was charged. The facility has conducted emergency fire drills on a monthly basis. The last Fire Drill was on 09/05/25. A review of the Medication Administration Record (MAR) was observed to be maintained in order. (Evaluation Report continues LIC 809-C) LPA observed First Aid Kit was maintained. A working landline phone was operational. The facility had operational smoke and carbon monoxide in bedrooms and common areas. The facility has current liability insurance on file effective 09/23/25 through 09/23/26. The facility is current on CCL License dues with a zero balance. An audit of residents #1-#3 (R1-R3) service files and staff #1-#2 (S1-S2) personnel files. The facility has the current administrator's certification on file for Antonia Dionisio #7009828740 Expiration 12/11/2026. DEFICIENCIES: Resident #3 admitted without a Medical Assessment for Residential Care Facilities for the Elderly (LIC 602A) on file. Resident #1 diagnosed with NCD has a Physician Report LIC 602A from 2023. No current Medical Assessment for Residential Care Facilities for the Elderly LIC 602A on file. LPA observed staff prescription medications left unattended and accessible to residents in care in a vacant resident's room. LPA observed Resident #3 had full bed rails and is not on hospice nor had physician's orders for full bed rails. According to the California Code of Regulations (Title 22, Division 6, Chapter 8), the following deficiencies has been observed and citation issued (ref. LIC 9099-D). An exit interview conducted with Antonia Dionisio a copy of report and appeal rights provided. Note: *Citations not cleared by the due date will be a $100 fine assessed for each citation until it is cleared. Civil penalties will continue to accrue until Proof of Corrections (POC) are cleared. *