Routine inspection·November 7, 2025

Licensing Program Analyst (LPA) Blanca Gonzalez conducted an unannounced required annual visit. LPA was met by caregiver Evelyn Valera and the purpose of the visit was explained. Administrator Teresita Maralit was advised telephonically. The facility is licensed to serve residents age range 60 and over, approved for six (6) non-ambulatory of which one (1) may be bedridden. Approved hospice waiver for two (2). The facility is a single-story home located in a residential area of San Dimas. The home consists of four (4) resident bedrooms, one (1) staff room, two (2) resident bathrooms, one (1) staff bathroom, living room, dining area, TV room, laundry room, front and backyards. LPA utilized the Compliance and Regulatory Enforcement (CARE) tools for the visit today and observed the following: The front and backyard are well maintained and there are no pools or large bodies of water. Passageways and exits are free of obstructions. Smoke detectors were observed throughout the facility and are operable. There is a carbon monoxide detector located in the hallway of the home, tested and not operable. Deficiency cited. There is a fire extinguisher located in the kitchen which was observed to be charged. Emergency drills conducted quarterly, last drill was August 2025. continued on LIC 809C continued from LIC 809 Kitchen appliances are clean and were operating at the time of the visit. Sharps are secured in a kitchen drawer and are inaccessible to residents. Kitchen was clean but there was evidence of pests in the form of a pest trap containing dead bugs on the kitchen countertop. Deficiency cited. There was not a sufficient supply of two (2) days perishable food, LPA observed not enough fresh fruit or bread for residents in care. Deficiency cited. Sufficient supply for seven (7) days non-perishable foods were observed. Fireplace located in the living room was inaccessible with a covered screen. Games and puzzles observed in living room for resident use. Dining room and living room are clean and free of obstructions and have sufficient seating for residents in care. Resident bedrooms have the required furniture and have sufficient closet and storage space. Resident beds have the required linen and the linen is in good repair. Washing machine and dryer were clean and operable at the time of visit. There is a locked cabinet in the laundry room with detergent, cleaning supplies and disinfectants, secured and inaccessible to residents in care. Cleaning solutions were observed unsecured on a countertop in the hallway accessible to residents in care. Caregiver secured cleaning solutions at time of visit, locking them in the laundry room. Deficiency cited. Medications are centrally stored in a locked cabinet in the TV room. Medications are documented properly and given as prescribed. First Aid kit was fully stocked with current manual. Three (3) resident and three (3) staff files were reviewed and were observed to contain required documentation. Facility file for resident #4 was mistakenly taken by EMS. Staff are awaiting resident’s family to retrieve file. Per California Code of Regulations, Title 22, and California Health and Safety Code, the deficiencies observed during the visit are documented on the LIC809D. Exit interview held and a copy of the report along with appeal rights were provided to the Caregiver Evelyn Valera.