Routine inspection·October 23, 2023

Licensing Program Analyst (LPA) Tao conducted an unannounced annual inspection visit. LPA met Ralph Estanislao, Administrator Assistant. LPA explained the purpose of the visit. The facility has a capacity of six (6) to serve residents from age 60 and above which may have six (6) non-ambulatory and three (3) hospice waivers. Three (3) residents are on hospice. Administrator certificate is current and expiration date is 03/17/25. Annual fees are current. During the visit, the CARE tool was used, facility tour was conducted, food supply was reviewed, staff/residents records were reviewed and medications were reviewed. The facility is a single story house located in a residential neighborhood in Covina consisted of three (3) bedrooms, two (2) bathrooms, open living room, dining room next to the kitchen, laundry room, outdoor patio and a storage shed in the backyard. Residents' bedrooms have dresser, chair and closet space available. Bathrooms, kitchen, common areas were inspected and in compliance. Two (2) days perishable and seven (7) days non-perishable were observed. Hot water temperature was in a range of 115.0 degrees Fahrenheit which was within Title 22 Regulation guidelines. Dual combo of smoke and carbon monoxide detectors are operable. Fire extinguishers are fully charged. Auditory devices are operable. Medication is centrally stored. Resident records are stored in a locked storage room and inaccessible to residents. No deficiency is cited per California Code of Regulations, Title 22. An exit interview was conducted and this report was provided to Administrator assistant, Ralph.