Routine inspection·September 25, 2025

Licensing Program Analyst (LPA) Daniel Konishi conducted an unannounced Required- 1 year visit using the full Care Compliance and Regulatory Enforcement (CARE) Tools. LPA was met by Sister Magdelene Grace and Administrator and Miguel Angel Gonzalez, Maintenance Technician/Supervisor and explained the purpose of the visit. Sister Magdelene Grace and Administrator and Miguel Angel Gonzalez, Maintenance Technician/Supervisor helped assist with the visit. The facility is licensed to care for 28 non-ambulatory, of which eight (8) may be bedridden. Approved hospice waiver for 12. LPA utilized the Compliance and Regulatory Enforcement (CARE) tools for the visit today and observed the following: Infection Control: Infection control practices and Personal Protective Equipment (PPEs) were observed. The facility has an Infection Control Plan in places. Staff are trained on the emergency infection control plan and following hand hygiene techniques. Emergency and disaster plan was completed and up to date. Operational Requirements: The Infection Control Plan has been added to the Plan. The facility does not have a Dementia Waiver in place. A Hospice Waiver for (12) is approved. A fire clearance is in place. The facility has valid Liability Insurance in place. Last fire drill was last conducted on 07/29/2025. Physical Plant/Environment Safety [Cont.]: The facility is a 2-story building located in a residential community. The facility consists of: First floor: lobby, dining room, living room, kitchen, office, den, activity room, medication room, laundry room, storage rooms, electrical room, boiler room and (10) resident rooms. Second floor : activity room, living room, office, medication room, laundry room, storage rooms, electrical room, staff break room and (11) resident rooms. LPA toured the facility with S1 and observed six (6) resident bedrooms, containing required furniture, lamps, dresser, chair, and closet space. Physical Plant/Environment Safety [Cont.]: The three bathrooms contain a working toilet, basin, and water faucet, walk in shower with grab bar, shower chair, and non-slip floor. The interior and exterior physical plant was inspected. Exit doors are free of any obstruction and there are no pools or large bodies of water. Cleaning supplies and toxic substances are inaccessible to residents. LPA tested hot water temperature in (6) random resident rooms (Rooms #D3, #D7, #D10, #D20, #D27 and #D29) in the first & second floors. Water temperature readings measured within the required 105 - 120 degrees Fahrenheit. The facility has ten (10) fully charged fire extinguishers, last serviced on 05/23/2025. Carbon Monoxide detectors were tested and operable. Resident Rights-Information: Resident personal rights, complaint hotline information and visitors’ policy posters are posted. Facility provides internet services and access to the facility telephone for all residents. Planned Activities: There is sufficient space to accommodate both indoor and outdoor activities. LPA observed sufficient equipment and supplies to accommodate residents with special needs to meet the requirements of the activity program. Monthly activity calendar is posted. The facility has a Resident Council and meet on a monthly basis. Food Service: Kitchen, food preparation area, and storage areas were observed to be clean and sanitary. Sufficient food supply is stored in the kitchen consisting of 2-day perishables, 7-day non-perishables, and emergency food supplies. Sanitation practices and kitchen cleanliness was observed. Kitchen has utensils for residents to use and to store their meals. Pesticides and cleaning supplies are kept away from the food preparation areas. Disaster Preparedness: The facility has an Emergency Disaster Plan posted with contact numbers and at least two (2) relocation sites. LPA observed the evacuation chair mounted by the stairway. ***Due to time constraints, LPA was not able to complete the annual inspection for this facility. LPA will do a continuation of this inspection at a later date.*** Per California Code of Regulations, Title 22, and California Health and Safety Code, there were no deficiencies observed during the visit. Exit interview and a copy of this report were provided to Administrator, Sister Magdelene Grace.