Routine inspection·September 6, 2025

Licensing Program Analyst (LPA) Galarza conducted an unannounced annual inspection visit. The purpose of the visit was explained to Administrator Joy Villaflores. The facility serves elderly residents ages 60 and older. The following were observed/inspected: Infection Control: The Infection Control Plan was reviewed and includes environmental cleaning and disinfection activities. Facility has sufficient Personal Protective Equipment. Operational Requirements: A hospice waiver for 1 resident is in place. A fire clearance was granted for 4 non-ambulatory and 2 ambulatory residents. Facility does not handle resident P & I monies. Liability Insurance in the amount of at least ($1,000,000) per occurrence and ($3,000,000) in total annual aggregate is current with an expiration date of 7/13/2026. Physical Plant/Environment Safety: The facility is a single story home located off a major street. The facility is owner operated and consists of 5 resident bedrooms and 1 staff bedroom for Administrator, 3 bathrooms, living room, dining room, kitchen, outdoor covered patio area, outdoor laundry room, and a 2 car attached garage presently being used as a storage area. Smoke and carbon monoxide detectors were tested and are operational. The facility has one (1) fire extinguisher. Water temperature readings did not measure within the required 105 - 120 degrees Fahrenheit. The facility has a 1st Aid Kit and Manual. Cleaning supplies, knives, and toxic substances are inaccessible to residents. The last Emergency Disaster drill was conducted on 8/15/25. Exit door in room #3 was obstructed by R2's bed. Staffing: A total 4 staff members provide care and supervision to the clients. Personnel Records/Staff Training: Administrator certificate expires 8/2/2027. Staff have criminal background clearance and training. Four (4) staff files were reviewed. Proof of staff training, health clearance, and 1st Aid/CPR training is current. Resident Records/Incident Reports: A total two (2) resident files were reviewed. They contained admission agreements, Physician's Reports, Appraisals, TB clearance, Physician's Orders, medical consent. Medication Administration records are in place. Resident (R3) does not have a file. RCFE and Ombudsman complaint posters are posted in the main entryway of the facility. The RCFE poster is not the required size. A technical advisory was issued. Planned Activities: Sufficient space to accommodate both indoor and outdoor activities was observed. The facility does not have a Resident Council. Food Service: Sufficient food supply is stored in the kitchen and pantry areas consisting of: 2-day perishables, 7-day non-perishables, and emergency food supplies. Residents do not have modified diets. Incident Medical and Dental: Centrally stored resident medications were reviewed. 30-day supply of medications was observed. Medical and dental transportation is provided by family or medical transport. R3's medications were observed unlocked next to their bed, and S3's medication pill box was unlocked in the garage. Disaster Preparedness: Emergency and Disaster Plan LIC 610E was reviewed. Facility has a First Aid Kit and Manual. Residents with Special Health Needs: No residents receive hospice care or home health services. No residents have prohibited health conditions. Two residents have half bed rails for mobility assistance. Per Title 22, deficiencies were cited. An exit interview was conducted with Administrator Joy Villaflores. A copy of the report, appeal rights, and technical advisory was provided.