Routine inspection·September 23, 2025

Licensing Program Analyst (LPA) Daniel Konishi conducted an unannounced Required-1 year visit and met with House Manager, Wendy Vasquez. LPA explained the purpose of the visit. The facility is licensed to care for (6) non ambulatory residents age 60 and over. LPA utilized the Compliance and Regulatory Enforcement (CARE) tools for the visit today and observed the following: Infection Control: Infection control practices and Personal Protective Equipment (PPEs) were maintained. Bathroom has hygiene items such as paper towel, hand soap and toilet paper. LPA reviewed the Infection Control Plan in place. Operational Requirements: The fire clearance is in place. LPA observed a valid Liability Insurance policy and a valid Surety Bond Insurance in place. Last Fire/Disaster Drill was conducted on 07/09/2025. Physical Plant/Environment Safety: The facility is a single-story home located in a residential neighborhood which consists of (3) resident bedrooms, (3) bathrooms, living room with fireplace, kitchen, dining area, laundry/storage area, side yard and backyard. The interior and exterior physical plant was inspected. Resident bedrooms were toured. Each bedroom has a smoke detector, linen, light, chair and sufficient closet space. Resident beds have the required linen, and the linen is in good condition. The bathrooms were observed to be clean and operational. Extra linens and towels are located in the hallway closet. Side yard and backyard were inspected and have a shaded and sitting area. There are (2) fire extinguishers in the facility which was last serviced on 04/15/2025. Carbon monoxide detectors were tested and operable. There are no firearms or weapons stored at the facility. No open bodies of water. Cleaning supplies are locked and inaccessible to residents. Fireplace is covered and inaccessible to residents. Physical Plant/Environment Safety [Cont.]: LPA tested hot water temperature and measured readings were 106.1 deg. F in bathroom #1, 123.6 deg F in bathroom #2 and 125.03 deg F in bathroom #3 which are not within Title 22 Regulations. Resident Rights-Information: Resident personal rights, complaint hotline information and visitors’ policy posters are posted. Facility provides internet services to all residents and they have access to the facility phone. Planned Activities: Sufficient space to accommodate both indoor and outdoor activities was observed. Food Service: Kitchen, food preparation area, and storage areas were observed to be clean and sanitary. There is sufficient food supplies of 2-day perishable and 7-day supplies of non-perishable items. The food is properly stored in the refrigerator. There are no residents with special diets residing at this facility. Pesticides and cleaning supplies are kept away from the food preparation areas. Health Related Services: The medications are centrally stored and in their original containers and bubble packed. LPA reviewed medication for (6) residents. The facility uses the Medication Administration Record (MAR) log to document medications given. Medications are administered as prescribed by the Physician. First-aid kit has been reviewed and has all required items. Incidental Medical Services: There are no residents in the facility with incidental medical services nor have a restricted health condition. Disaster Preparedness: The facility has a complete Emergency Disaster and Mass Casualty Plan. Residents with Special Health Needs: Per House Manager, there is one (1) resident that receives home health services and no residents that receive hospice services. No residents have prohibited health conditions. ***Due to time constraints, LPA was not able to complete the annual inspection for this facility. LPA will do a continuation of this inspection at a later date.*** Per California Code of Regulations, Title 22, and California Health and Safety Code, the deficiencies observed during the visit are documented on the LIC809-D. Exit interview, appeals rights and a copy of this report were provided to the House Manager, Wendy Vasquez.