Routine inspection·February 19, 2026

Licensing Program Analyst (LPA) Daniel Konishi conducted an unannounced Required-1 year visit. LPA were met by Leonisa Agnasin, Caregiver and LPA explained the p Marebeth Mallare, Administrator and Leonardo Mallare, Caregiver and explained the purpose of the visit. The facility cares for residents age range 60 and over and licensed for (5) non ambulatory, (1) bedridden resident (shall be in bedroom #3), and approved for (6) hospice residents only. There are currently (3) residents on hospice. 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. 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 reviewed and updated. A Hospice Waiver for six (6) is approved. Valid liability insurance policy is in place. The facility does not handle cash resources for the residents. Latest fire/earthquake drill was conducted on 02/05/2026. Physical Plant/Environment Safety: The facility is a single-story home located in a residential community. The home consists of living room, dining area, kitchen, four (4) resident bedrooms, one of the bedrooms has a fireplace that is adequately screened, four (4) bathrooms, back yard with swimming pool that is fenced and inaccessible to residents, and laundry area in the attached garage. The interior and exterior physical plant was inspected. Resident bedrooms were toured. Each bedroom has a smoke detector, bed, linen, dresser, light, and sufficient closet space. Hallway closet had extra linens and towels. Bathrooms have the required grabs bars and non-skid materials. The laundry room is clean and has cleaning supplies inaccessible to residents. Hot water temperature were measured between 109.5 degrees F to 110.8 degrees F which are within the required 105 - 120 degrees F. Physical Plant/Environment Safety [Cont.]: Carbon Monoxide detectors were tested and operable. All the appliances are clean and are working properly. The common areas such as activity room and dining room are clean and have the required furniture. The backyard has a shaded area and sitting area. Exit doors have auditory devices that were operating at the time of the visit. There are cameras in the front door, backyard, living room, dining area and kitchen. Exit doors are free of any obstruction. Cleaning supplies and toxic substances are inaccessible to residents. Sharps are locked, secure, and inaccessible to residents. The facility has (3) fully charged fire extinguishers, last serviced on 01/15/2025. Staffing: A total of three (3) caregivers including the Administrator provide care and supervision to the residents. Staff employed are over the age of 18 and have criminal background clearance, fingerprint cleared, have the required training and are associated to the facility. Personnel Records-Training: LPA reviewed three (3) staff files which include Personnel Record, Criminal Background Clearance, First Aid/CPR, Health Screening, TB Clearance, Employee Rights, and Staff Training. LPA reviewed that the Administrator did not provide a current Administrator Certificate in file and LPA checked pending Administrator Certificate Renewal Status CDSS (California Department of Social Services) website which did not show the Administrator’s name on the list. LPA reviewed Staff #1 (S1’s) file did not have a Valid First Aid Training. Resident Rights-Information: Resident personal rights are posted. Visiting policy is posted at a location that is visible and accessible to residents and families. LPA observed that the RCFE (Residential Care for the Elderly) “Let Us No” Complaint (PUB 475) Poster was not posted at the facility. Planned Activities: Information regarding Dementia is part of training for direct care staff and is included in the Plan of Operation. The facility has an activity calendar, activity supplies, and provides sufficient space to accommodate both indoor and outdoor activities. Food Service: The kitchen was inspected and has sufficient supply of 2 (two) day perishable & 7 (seven) day non-perishable food. Kitchen, food preparation area, and storage areas were observed to be clean and sanitary. The food is properly stored in the refrigerator (clean and well maintained). Pesticides and cleaning supplies are kept away from the food preparation areas. Plates, cups and utensils are kept cleaned and stored properly. Incident Medical and Dental: All residents have Restricted Health Care Plan and Needs and Services Plan on file. Home Health personnel services the residents in the facility. Hospice and Home Health Nurses conduct visits on a regular basis. LPA reviewed five (5) residents' medications. Based on record review, LPA observed Resident #1 (R1’s) Medication Administration Record (MAR) for the month of February 2026 was not up to date as initials for three (3) medications were missing initials and was last initialed on 02/02/2026. LPA also observed for Resident #2 (R2’s) MAR for the month of February 2026 was not up to date and not accurate since one medication was initialed from 02/01/2026 to 02/31/2026. LPA observed that Resident #3 (R3) did not have a current MAR in file. Resident Records-Incident Reports: LPA reviewed five (5) resident files which included face sheet, admission agreements, Physician's Report, Ambulatory Status, TB Clearance, Medical/Functional assessments, Needs and Services Plans, and Personal rights. Based on record review, Resident #6 (R6’s) file did not have documentation of determination for ambulatory status. Disaster Preparedness: The facility has a complete Emergency Disaster Plan in place and at least two (2) relocation sites. Last Fire and Earthquake Drill was conducted on 02/05/2026. Residents with Special Health Needs: Three (3) Residents are hospice and palliative care. Based on record review, LPA observed that Resident #1 (R1), Resident #2 (R2), and Resident#4 (R4) to Resident #6 (R6) had half bed rails and R1, R2, and R4 to R6’s file did not have physician's order for bed rails. Based on observation and record review, LPA observed that Resident #3 (R3) had full bed rails and R3’s file did not have a hospice care plan specifying a need for a full bed rail. Per California Code of Regulations, Title 22, and California Health and Safety Code, the deficiencies observed during the visit are documented on the LIC809-D. Exit interview, appeals rights and a copy of this report were provided to the Administrator, Marebeth Mallare.