Routine inspection·July 18, 2025

On 07/18/25, Licensing Program Analyst (LPA) Mario Leon conducted an unannounced, annual, required visit using the CARE Inspection Tool. LPA was met by staff two, Jeno Benosa - House Manager (S2) and LPA explained the purpose of today’s visit. LPA was later met by staff one, Tina Cinco - Licensee (S1) and staff three, Tiny Layug - Administrator (S3). The facility is licensed to serve (6) elderly adults ages 60 and above of which (6) can be non-ambulatory, of which (1) may be bedridden in bedroom #1 or #2. Facility has an approved hospice waiver for three (3). The facility is a single-story structure located in a residential neighborhood. It has a ramp that goes along the west side of the facility. It consists of six (6) bedrooms (four (4) for resident use, two (2) for staff use), two (2) bathrooms, shaded back yard with seating, shaded front yard with seating, Kitchen, living room, family room ("Sun room"), laundry room and a two-car (2) detached garage. LPA and S1 toured the physical plant. There were no bodies of water or obstructions on the premises. LPA observed two (2) window screens in disrepair, please see LIC809-D. A total of four (4) resident bedrooms and (2) bathrooms were inspected. Beds and bedding supplies were in good condition, adequate lighting was provided, and storage for the residents’ personal belongings was observed. Bathrooms were found to be within Title 22 regulations and were operational. The facility presents a comfortable indoor temperature at 73.4゜F (degrees Fahrenheit) and hosts two (2) fire extinguishers, which showed the last annual maintenance having been performed on 10/08/24. Smoke and carbon monoxide detectors are all in operable condition. LPA observed the facility to be clean, sanitary, and appropriately furnished at the time of the visit. Storage areas for personal hygiene were observed. Cleaning supplies, toxins, and sharps objects were observed under the sink, unlocked, in bathroom one (#1). Please see LIC809-D. The kitchen was inspected and there is, at least, two (2) days of perishable and seven (7) days of non-perishable food is available and has been maintained properly. Report continues, please see LIC809-C. LPA reviewed (3) Medication Administration Records (MARs), no discrepancies were found. LPA observed the facility remains under infection control practices, as the facility appears to be in a clean and working condition. Staff have documented all six (6) residents AM and PM body temperatures. All mandated inspection control posters were posted throughout the facility and a copy of liability insurance, valid through 09/04/25, was provided to LPA during today's visit. LPA also verified this facilities' Annual Fee(s) as being current. According to the California Code of Regulations (Title 22, Division 6, Chapter 8), LPA observed two (2) deficiencies. Please see LIC809-D. An exit interview was held with staff one, Tina Cinco - Licensee (S1), and a copy of two (2) deficiencies cited, facilities' appeal rights and this Facility Evaluation Report was provided to staff one, Tina Cinco (S1) - Licensee.