Routine inspection·December 5, 2025

At 9:45a.m., Licensing Program Analyst (LPA) Antonia Alvizar-Ettima conducted an unannounced Required One (1) year inspection to the facility. Upon arrival, LPA met with Manager/Caregiver whom granted entry to the facility and explained the reason for the visit. Later Licensee joined today’s visit. At approximately 10:15a.m., LPA and Manager/Caregiver conducted a physical plant tour inside and out. During the tour, LPA observed that the facility is a one-story home located in a residential community. The home has four (4) bedrooms, two (2) full bathrooms, one (1) 1/2 bathroom; living room / dining area, and kitchen. There is a small office located next to front door. Required postings were observed in the entry area. The smoke alarms are operational, located in each bedroom and hallways. Front yard landscape is in good condition at time of this visit. There is a carbon monoxide detector that functions properly. The fire extinguisher is in the kitchen with purchased date of 12/10/2024. During the visit the facility is at 74 degrees Fahrenheit. The facility is licensed to serve 6 (six) non- ambulatory residents ages 60 and over of which 1 (one) may be bedridden and facility is approved to retain six (6) residents on hospice. The facility cares for elderly residents with dementia. Fire Emergency drill was last conducted on 11/10/2025. The facility is currently occupying five (05) residents. LPA utilized the Compliance and Regulatory Enforcement (CARE) tools for the visit today and observed the following: Kitchen: LPA observed kitchen appliances and fixtures were functional. The kitchen has a working gas stove, faucet, freezer, refrigerator, and microwave. LPA found at least two (02) days perishable and seven (07) Cont. on LIC 809-C Cont. from LIC 809 days non-perishable food at the facility that is properly stored. Frozen foods are wrapped and stored properly as well. Knives were stored in a locked drawer in the kitchen. Food storage and preparation areas are clean and inaccessible to pests. Garbage cans have tight fitting covers. Toxic cleaning supplies were stored and locked away in the kitchen cabinet and laundry room closet. Medications: Medications are in a centrally stored and locked medication cabinet in office area, including over-the-counter medicines; medications are properly labeled and checked for expiration dates. Each centrally stored prescription and PRN medication has been logged in the medications log with proper documentation from the resident’s doctor. First-aid has all proper items and were observed to be stored in a locked cabinet in the office area. Laundry Room: LPA observed washer and dryer machines located adjacent to the kitchen. Bedrooms: All residents bedrooms were properly furnished with appropriate dresser, beddings, and linens with sufficient lighting. Hallways are well lit. Linens are stored in resident room closet and observed to have ample supply of clean linen, comforters, and towels in facility. Bathrooms: LPA observed bathrooms to be clean, sanitary and with necessary supplies. The appropriate grab bars and mats in the showers. Hot water temperature measured at a range of 118.0°F to 118.4°F and within the required range. Resident’s personal hygiene supplies are kept separate in plastic containers. Towels and washcloths are not shared. Common Areas: These included the dining area and living room for residents. The common areas were properly furnished and observed to be in good repair. Residents dining table fits six (06) residents. No obstructions and/or tripping hazards throughout the facility. Surrounding Grounds : Entry and exits were free of obstruction. The facility has appropriate outdoor furniture with a shaded covered area for residents and visitors. The outdoor area was enclosed, and no bodies of water were observed. Two (2) storage sheds with extra supplies, observed to be locked and inaccessible to residents in care. Staff Files : Staff files all have criminal record clearances and are associated to facility. Staff have current first aid and training documentation showing training completed. Administrator's certificate was observed to be current. Resident Records : All five (05) resident records were reviewed. Residents’ records are complete and current at this time. Staff and residents files locked and inaccessible. Residents were also interviewed. Facility is within CA code of Regulations Title 22 or Health and Safety Code. No deficiencies were found, exit interview conducted, copy of report was provided.