Routine inspection·July 18, 2025

Licensing Program Analyst (LPA) Daniel Konishi conducted the required annual inspection. LPA arrived unannounced and was greeted by Jose Diaz (Caregiver) and the purpose for today’s visit was explained. Shortly after Administrator Thomas Trice assisted with the visit. The facility is licensed to serve 6 Non-Ambulatory residents ages 60 and above, with a hospice waiver for 5. The facility is a two-story home located in Cerritos, Ca (only the downstairs part of the home is licensed). A tour of the facility includes a living room, dining area, kitchen, 4 bedrooms, 2 bathrooms (1 bathroom is within a share resident room), an attached garage with laundry, front yard and back yard. LPA utilized the Compliance and Regulatory Enforcement (CARE) tools for the visit, today’s visit and the initial visit and observed the following: Infection Control: The facility staff are using appropriate hand hygiene and gloves while assisting residents’ medications. Staff are cleaning and disinfecting throughout the day. The facility has sufficient PPE supplies and has an Infection Control Plan maintained at the facility. Operational Requirements: The facility has an approved fire clearance, there is a plan of operation with required Infection Control Plan and facility maintains the required liability insurance in place. Physical Plant & Environment Safety: LPA toured facility, residents’ bedrooms were checked and closet/drawer space to accommodate each resident comfortably was available. The front yard is free of debris/hazards and the outdoor and passageways are free of obstruction. No bodies of water were observed at the facility. Hygiene products are readily available for clients. The hot water temperature was tested and measured 113.8 degrees and 114.2 degrees which is within the required range of 105-120 degrees F. Physical Plant & Environment Safety [Cont.]: All storage areas for cleaning solutions, toxins, knives, and hazardous items are kept in a locked and are inaccessible to residents. Smoke detectors and carbon monoxide detectors are operable and in compliance. The fireplace in the living room is secure and inaccessible to residents. There fire extinguisher was observed and is fully charged. The last fire/disaster/earthquake drill was conducted on 6/28/25. Staffing : There appears to be sufficient staffing at all times in the facility. With night staff that is trained and able to assist in the care and supervision of the residents in the case of an emergency. Personnel Records-Training : LPA observed four (4) staff files which include: health screening, TB test results, personnel records, criminal record clearance, current First-Aid/CPR/AED training along with training in postural supports, medication assistance, and other ongoing training are documented in personnel files. LPA reviewed four (4) staff files with no issues observed. Administrator Thomas Trice certificate expires on 12/1/26. Resident Records-Incident Reports: Resident files are kept in a secure location. LPA reviewed five (5) resident files which included the Face Sheet, Identification and Emergency Information, Physician’s Report, ambulatory status, TB test result, Pre-admission appraisal/Appraisal Needs & Services Plan, Preplacement appraisal, Admission Agreements, Personal Rights. LPA reviewed five (5) resident files with no issues observed. Residents Rights-Information: Residents are provided with telephone and internet at the facility. The facility has the following posters posted: Residents Rights, Complaint Poster, and Ombudsman. Planned Activities: Facility provides scheduled activities and have a variety of activities to choose from within the facility. There is an outdoor activity area available for the residents. Food Service: LPA toured the kitchen which appeared clean and the appliances and fixtures functional. The facility kitchen was observed to be clean at the time of inspection. There are sufficient food supplies of 2-day perishable and 7-day non-perishable items. The food is properly stored in the refrigerator. There are no clients with modified diets residing at this facility. Plates, cups and utensils are kept clean and stored properly. Incidental Medical & Dental: Medication is properly labeled and are centrally stored in a closet and are in their original containers. LPA reviewed six (6) residents’ medications and there were no issues observed. Disaster Preparedness: The facility has an Emergency Disaster Plan with contact numbers and at least 2 relocation sites. Residents with Special Health Needs: There are no bedridden or residents with postural support at this facility. Facility has the required "Oxygen in Use" signs posted. The facility currently has two (2) residents under hospice care and the facility has hospice care plans in place. Per California Code of Regulations, Title 22, and California Health and Safety Code, there were no deficiencies observed during the visit. An exit interview was held and a copy of the report will be emailed to Administrator Thomas Trice.