Routine inspection·December 4, 2025

Licensing Program Analyst (LPA) Gabriela Castro conducted an unannounced required annual inspection using the Compliance and Regulatory Enforcement (CARE) Tool. Upon arrival, LPA was greeted by Maria Macalino and explained the purpose of the visit. Administrator Michelle Aguirre arrived shortly thereafter. The facility is licensed to serve residents ages sixty (60) and older, with an approved capacity of six (6) residents, all of whom may be non-ambulatory. The facility is also approved to care for up to six (6) hospice residents. At the time of the inspection, six (6) resident were receiving hospice care. Facility Tour & Observations Required postings, including Personal Rights (LIC 613C), Ombudsman information, the Complaint Poster (PUB 475), and the nondiscrimination notice were observed in a common area. Residents had access to personal space, privacy, and adequate storage. No firearms or weapons were present. Physical Plant The facility is located in a residential area and is a one-story home consisting of four (4) resident bedrooms, two (2) restrooms one of which is a private restroom along with a living room, kitchen, dining area, laundry room, garage, and front and backyard areas.LPA observed that all four (4) resident bedrooms contained the required furnishings, including a bed, mattress, linens, dresser, chair, and appropriate lighting. Cleaning supplies and toxic substances were inaccessible to residents and locked in hallway closet.Bathrooms were clean and equipped with the required grab bars in the showers and near the toilets, as well as non-skid mats. Hot water temperatures measured 107.6°F in bathroom (1) and 109.2°F in bathroom (2), which are within the required range of 105–120°F. **Continued on LIC809C** Extra linens and towels were stored in a hallway cabinet. Smoke and carbon monoxide detectors were tested and found to be functional. Fire extinguishers were observed in the hallway by the garage entrance and inside the garage. No bodies of water were present on the premises. The backyard offered shaded seating. All indoor and outdoor passageways and exits were clear and unobstructed. Food Service Refrigerators/freezers were maintained at proper temperatures (refrigerators maximum of 40 degrees °F and freezer 0-degree °C) with sufficient supply of 2-day perishable and 7 days non-perishable food. Fresh produce, proteins, and dry goods were stocked. Knives and were observed in a locked kitchen drawer. Health-Related Services & Records Six (6) resident files were reviewed and contained current required documents, including Admission Agreements, Pre-Placement Appraisals, Consents, Physician’s Reports with TB results and ambulatory status, and Rights Acknowledgments. Six (6) residents’ medications were reviewed; medications were observed to be centrally stored and kept locked in the hallway closet. However, based on record review, all six (6) resident files did not contain updated re-appraisals as required by regulation 87463(a). Disaster Preparedness Last fire/earthquake drill was conducted on October 5, 2025, with logs available. LIC 610D Emergency Disaster Plan was posted on hallway bulletin board. Emergency supplies (water, food, flashlights, batteries, first aid) were observed in the garage. Infection Control Plan was updated. Personnel Records & Training Three (3) staff files were reviewed and included documentation of criminal record clearances, CPR/First Aid certification, and TB screenings. Administrator Certificate for Michelle Aguirre was verified and is valid through August 28, 2026. However, based on record review, staff were missing the required annual training as mandated by regulation. **Continued on LIC809C** Insurance Liability insurance was in compliance with an expiration date February 21, 2026. An exit interview was conducted with,Maria Macalino. During the inspection, deficiencies were observed and cited on the attached LIC 809D/809C in accordance with Title 22, Division 6 regulations. Michelle Aguirre, Administrator was advised of the nature of the deficiencies, the regulatory basis, and the required Plan of Correction (POC). Michelle Aguirre, Administrator agreed to submit proof of correction by the due dates specified. A copy of this report, LIC 809D/809C, and appeal rights will be provided via email.