Routine inspection (multi-day)·December 4, 2025

Licensing Program Analyst (LPA) Daniel Konishi conducted the required unannounced annual inspection. LPA was allowed entry by Araceli Sanches Alvarez, Caregiver and LPA explained the purpose of today's visit. Co-Administrator, Natalia Arpentieva arrived shortly after and assisted LPA with the inspection. The facility is licensed to serve six (6) non-ambulatory residents ages 60 and over, of which one (1) may be bedridden. All bedrooms approved for bedridden. Waiver granted for two (2) hospice care. The initial annual visit was conducted on 12/02/2025. During the initial visit the following ten (10) Compliance and Regulatory Enforcement (CARE) tool Licensee, Natalia Arpentieva.domains were observed and reviewed: Infection Control, Operational Requirement, Physical Plant/ Environmental Safety, Resident Rights-Information, Staffing, Personnel Records-Training, Planned Activities, Food Service, Incidental Medical and Dental, Disaster Preparedness. During today’s annual visit, the following two (2) Compliance and Regulatory Enforcement (CARE) tool domains were observed and reviewed: Resident Records-Personnel Reports, Resident with Special Health Needs. Resident Records-Incident Reports: LPA reviewed five (5) resident files containing Information and Emergency Identification, Admission Agreements, Physician's Report, TB clearance, Ambulatory Status, Medical/Functional assessments, Pre-Placement Appraisal, Appraisal/Needs and Services Plans, Personal Rights, Restricted Health Care Plans and Hospice Notes/Records were reviewed. [Continue in LIC809-C] Resident with Special Health Needs: One (1) resident receive hospice care. Appraisals were observed in resident files. No residents have prohibited health conditions. LPA reviewed physician orders for use of full bed rails in (1) resident file who is under hospice care. LPA reviewed physician orders for three (3) residents that use bed rails. Per California Code of Regulations, Title 22, and California Health and Safety Code, there were no deficiencies observed during the visit. Exit interview and a copy of this report were provided to Co-Administrator, Natalia Arpentieva.