Routine inspection·August 20, 2025

On 08/20/2025, Licensing Program Analyst (LPA) Regina Cloyd conducted an unannounced required – annual inspection and met with the Administrator Virginia Asis and Administrator Assistant Rodolfo Lozada. The facility is licensed to serve six (6) non-ambulatory residents age 60 and over. The facility has a hospice waiver approved for six (6) residents. The facility currently has four residents with Assisted Living Waivers (one resident pending approval). Annual Fees are current. The facility is a single-story house located in a residential neighborhood and consists of three (3) bedrooms, two (2) bathrooms, family room/activity area, kitchen, dining area, and staff room. Administrator Assistant accompanied LPA inside and outside the facility during this inspection. Outside grounds were toured and no bodies of water were observed. Walkways around the home were clear of hazards. The facility is clean, sanitary, and in good repair. Resident bedrooms had the required furniture, bed linens and closet/drawer space to accommodate each resident comfortably. There are no security bars or weapons on the premises. Continue to LIC809-C. Resident bathrooms were checked. Toilets and water faucets worked properly, grab bars were secure, shower was free of mold/mildew and a non-skid mat was in place, and hot water temperature properly measured at 107.6 F. Resident bath towels, toiletries and personal hygiene supplies were adequately stocked. Common areas were clean and clear of hazards and doorways were free of obstructions. LPA toured the kitchen area and observed a two-day supply of perishable and a seven-day supply of non-perishable food. Knives and toxins were kept in locked storage cabinet. First Aid kit was available. Two fire extinguishers, last serviced February 13, 2025 was observed in the kitchen and in the laundry room. Staff tested the carbon monoxide detector and smoke detectors in the house. Both devices were functional. Five staff records were reviewed, five out of five staff records had current first aid certificates and required criminal record clearances or criminal record exemptions. Five resident records were reviewed and, five out of five resident records had medical assessments and pre-appraisal or reappraisals. Two residents’ medication was reviewed. Deficiencies are being cited based on California Code of Regulations, Title 22; see LIC809-D. During medication review, Resident #2 (R2) only had iron tablets in stock. However, R2’s medical assessment revealed R2 as diabetic. Interview with Staff indicated that R2’s insurance will not cover R2’s medication. The facility’s medication policy (medication refills) indicates medications are never allowed to run out unless directed to by the physician (obtain this direction in writing). Continue to LIC809-C. The plan of operation filed with Community Care Licensing Division (CCLD) does not match the plan of operation at the facility. An exit interview was conducted, plans of correction developed, technical assistance provided and a copy of this report with appeal rights was discussed and left with Administrator Assistant Rodolfo Lozada.