Routine inspection·September 11, 2025

Licensing Program Analysts (LPAs) Daniel Konishi and Gabriela Castro conducted an unannounced Annual/Required inspection and met with Caregiver, Connie Duldulao and explained the purpose of the visit. Staff #1 (S1) helped assist with the visit. Administrator, Maria Tangonan arrived shortly after and LPAs explained the purpose of the visit. The facility is licensed for the age range 60 and over to serve six (6) non-ambulatory, of which one (1) may be bedridden. Bedridden in bedroom #2. Hospice Waiver for six (6). LPAs utilized the Compliance and Regulatory Enforcement (CARE) tools for the visit, today’s visit and the initial visit and observed the following: Infection Control: Infection control practices and Personal Protective Equipment (PPEs) were observed. LPAs observed that the facility has an infection control plan in place. Operational Requirements: Fire clearance was approved by LA County Fire Department for the age range 60 and over to serve six (6) non-ambulatory, of which one (1) may be bedridden. Bedridden in bedroom #2. Hospice Waiver for six (6).. Liability Insurance is valid and currently on file. Physical Plant/Environment Safety: This home contains 5 resident bedrooms, 1 staff bedroom, 2 bathrooms, 1 staff bathroom, living room, kitchen, dining room and an attached garage with a storge room inside of the garage. LPAs toured the facility with S1 and observed all (5) resident bedrooms, containing required furniture, lamps, dresser, chair, and closet space. The three bathrooms contain a working toilet, basin, and water faucet, walk in shower with grab bar, shower chair, and bathmat. Cleaning Supplies are secured and inaccessible to residents and locked underneath the kitchen sink. Sharps are secure and locked in a kitchen drawer. LPAs measured the water temperature at 109.4*F in bathroom #1, 112.6 degrees F in bathroom #2-, and 113.5-degrees F in bathroom #3 which are within Title 22 regulations. The carbon monoxide detector was located throughout the facility, tested, and functioning properly. There were three (3) fire extinguishers located in the kitchen, hallway and garage fully charged and up to date. The outdoor grounds were toured and inspected, and the patio was well maintained with a shaded seating area accessible for client use. The garage contained a working washer and dryer, with cabinetry that contained emergency supply kits, bottled water, toiletries, personal care supplies, and toxins and cleaning agents stored locked and inaccessible to the clients. There are no bodies of water. Staffing: A total of four (4) full-time staff members provide care and supervision to the residents. Personnel Records/Staff Training: LPAs reviewed Four (4) staff files that include personnel records, health/TB screenings, employee rights, criminal background clearance, 1st Aid/CPR/AED training, and staff training. Administrator’s Certificate is valid and expires on 10/30/2025. Resident Rights/Information: Residential Care Facility for the Elderly Complaint Poster (PUB 475) posted on the wall. Residents’ Personal Rights posted on the wall. Facility provides internet access for residents. Planned Activities: The facility has planned activities with monthly activity calendar and activity log. Facility has sufficient space to accommodate indoor and outdoor activities that are easily accessible. Food Service: The kitchen was inspected and has sufficient supply of 2-day perishable & 7-day non-perishable food. Kitchen, food preparation area, and storage areas were observed to be clean and sanitary. Incidental Medical and Dental: Residents are assisted with self-administration of prescription and non-prescription medications. LPAs reviewed five (5) centrally stored resident medication records. Centrally stored medications are kept in a safe and locked place not accessible to residents in care. Medications are given according to Physician directions. The first Aid kit had all the required items. Resident Records/Incident Reports: LPAs reviewed five (5) resident files containing Admission Agreements, Physician's Report, Ambulatory Status, TB clearance, Pre-Placement Appraisal, Appraisal/Needs and Services Plan, personal rights. Disaster Preparedness: A posted Emergency Disaster Plan LIC 610D containing emergency evacuation information was observed. An emergency drill was conducted in 09/11/2025. No manual restraints or seclusions are used in residents in care. Residents with Special Health Needs: There are two (2) residents that are provided hospice care services and LPAs reviewed a hospice care plan for one (1) resident. There are residents with postural support at this facility and LPAs reviewed staff training on postural supports. Full and Half bed rails for mobility assistance were observed in some resident rooms and LPA reviewed resident files with full and half bed rail orders. The facility is free from odors of incontinence. Per the California Code of Regulations, Title 22, and California Health and Safety Code, there were no deficiencies observed during today’s visit. An exit interview was held and a copy of the report was provided to the Administrator, Maria Tangonan.