Follow-up·January 15, 2026

Licensing Program Analyst (LPA) Blanca Gonzalez conducted an unannounced case management visit. LPA met with On-Call Administrator Clemencia Bousheri and the reason for the visit was explained. The purpose of the visit was to follow up on items addressed during the Noncompliance Conference (NCC) meeting held on October 1, 2025. The facility is licensed to serve age range 60 and over. Six (6) non-ambulatory residents of which one (1) may be bedridden. Hospice waiver for two (2). The facility is operating within the scope of their license with six (6) residents, of which one (1) is receiving hospice care. The facility has dementia care for residents. The facility is a single-story home located in a residential area of Glendora. The front yard has secured perimeters in the form of a motorized gate to prevent residents from leaving the property. The home consists of five (5) resident bedrooms, 2 bathrooms, a kitchen, dining area, living room, office, shaded outdoor patio, and attached garage. LPA toured the facility and observed the following: The facility was observed to be clean and free of debris and obstructions. Water temperature was tested in the resident bathroom and measured at 117.1°F, which is within the required 105°F-120°F. Resident bedrooms were observed to contain the required furniture, linens and lighting. Linens were observed to be in good repair. continued on LIC 809C continued from LIC 809 The kitchen was observed to be clean and free of pests. Soaps, detergents, and cleaning supplies are stored separate from food supplies. Sufficient supply of 2 days perishable & 7 days non-perishable foods was observed in the kitchen. Combination smoke and carbon monoxide detectors were observed throughout facility. LPA reviewed six (6) resident files and four (4) staff files. Files were observed to be complete and contained the required documentation. LPA reviewed log for emergency drills. Last fire/earthquake drill was conducted October 2025. Per California Code of Regulations, Title 22, and California Health and Safety Code, there are no deficiencies observed during today’s visit. Exit interview held and a copy of this report was provided to Clemencia Bousheri