Routine inspection·August 25, 2025

Licensing Program Analysts (LPA) Nune Margaryan conducted an unannounced annual visit using the Care Tool. LPA met with staff Suhandra Suwitra. Shortly after Administrator Phuoc (Henry) Truong arrived and assisted with the visit. LPA explained the reason for the visit. The facility is licensed for residents age range 60 and over. Facility approved for 6 non-ambulatory, of which 1 may be bedridden. Facility approved for 6 hospice waiver. Currently 1 client on hospice. The facility is a single story structure located in a residential neighborhood. It consists of the following: (5) resident bedrooms, (1) staff bedroom, (2) resident bathrooms, kitchen, dining room, living room, laundry room, detached garage. The front and backyard are well maintained and there are no pools or large bodies of water. There is a shaded seating area for the residents located in the backyard. LPA toured the facility. All indoor and outdoor passageways were free of obstruction. The kitchen was inspected. LPA observed all kitchen equipment to be clean and in working condition. LPA observed sufficient supply of perishable and non-perishable foods. Sharps, cleaning supplies are locked and inaccessible to residents. Smoke / Carbon monoxide detectors were in compliance and operational. There are (2) fire extinguishers (one in the kitchen and 1 in the garage) which are fully charged. The common areas (dining room, living room) are clean and were properly furnished. Resident rooms were sanitary and had the required furniture and furnishings. Medications are centrally stored in a locked cabinet in the kitchen. LPA observed detached garage/ storage room. There is a second refrigerator in the garage. Garage/Storage door is locked. Auditory devices are operable. Continue 809C The resident bathrooms are clean and operational w/grab bars and non-skid surface/mats in place. The hot water temperature was tested and maintained within the required range of 105-120*F. The first aid kit was observed and found to be in compliance with the Title 22 Regulations. Last emergency/ fire drill was conducted on 08/09/25. LPA reviewed 3 residents and 3 staff files. Residents’ files were found to be complete and current. LPA observed staff maintained a criminal record clearance and are associated to the facility. LPA reviewed residents' medications. Medications are documented properly and stored appropriately. Based on California Code of Regulations, Title 22, there were no deficiencies observed during the visit. An exit interview was conducted with the Administrator and a copy of this report was provided.