Routine inspection·March 24, 2025

Licensing Program Analyst (LPA) Sarah Hurt conducted an unannounced visit today for the facility’s annual inspection. LPA met with Maria Estamo, Continual Administrator's Certification expires 02/17/2026. There are currently 3 residents who reside at this home and there is 0 residents on hospice at this time. LPA inspected the interior and the exterior of the facility including the common living spaces, resident bedrooms and bathrooms, activity rooms, medication storage, kitchen, garage and outdoor areas. Bedrooms were clean and in good repair. There is a locked storage for medications. Food supply is adequate for 2-day perishable and 7-day nonperishable. Fire extinguisher is within the safety regulation period. Smoke alarms were tested and are operational. The home has a carbon monoxide detector and performs disaster drills as required. Water temperature was tested at 112 degrees. First Aid kit is on site and complete. Toxins and cleaning supplies are locked and inaccessible. LPA reviewed Infection control plan. Resident 1 does not have complete medical assessment. The facilities PUB 475 is not required size (20x26). Facilities LIC610E Emergency Disaster Plan is not complete or on updated current form. LPA observed Resident 2's bedroom does not have required furnishings (lamp). Staff 1 and staff 2 do not have files at the facility for review. LPA observed Resident 3 has full bed rails. The following deficiencies observed or cited during today's inspection per California Code of Regulations, Title 22. LPA's requested the following documents: LIC 500 Personnel Report, LIC 308 Designation of Administrative Responsibility, LIC 610-E the Emergency Disaster Plan and copy of current Administrator’s Certificate to update the facility file. Listed documents shall be sent to Licensing. Exit interview conducted with Maria Estamo, and copy of report left at facility