Routine inspection·June 13, 2025

Licensing Program Analyst (LPA) William Vanegas conducted an unannounced inspection for the purposes of completing an annual inspection. Upon arrival LPA Vanegas was greeted and granted entry to the facility by Administrator (AD) Nellie Mai Caudle. LPA Vanegas explained the purpose of the inspection and being a tour of the facility LPA Vanegas observed the following. This is a one storied house with four bedrooms, and two bathrooms. There is an attached two car garage, and a large backyard in the facility. LPA Vanegas observed the kitchen area to be clean and free of any debris. LPA Vanegas observed a seven day supply of non-perishable foods, and a two day supply of perishable foods LPA Vanegas also observed a sufficient amount of emergency water. LPA Vanegas observed an electric stove, refrigerator, microwave, dishwasher, washer, and dryer that all appeared in good repair, and tested operational. LPA Vanegas observed all fire extinguishers to be fully charge and up to date. LPA Vanegas observed smoke and carbon monoxide detectors to be in good repair and operational. LPA Vanegas observed all resident rooms to be clean and free of any debris. LPA Vanegas observed all resident rooms to have required furnishings such as chest drawers, a bed, clean linens in good repair; meaning no strains or tears, enough storage space to store personal belongings, and a reading lamp. LPA Vanegas observed resident bathrooms to have all required furnishings such as a shower chair, slip resistant floor matts, and grab bars. Water faucets and toilets tested operational. Water temperature tested between 112.8 and 113.0 degrees. CONTINUED ON LIC809C LPA Vanegas observed the out side of the facility to have a large back yard, and a pool that is fully fenced. The fence measured to be 4ft and 9in. The gaps in between the fence measured to be 5in apart. The pool gate was locked and when open the door swings into the pool area. LPA Vanegas observed some items that are to be discarded in the backyard, and along the exit routes. An advisory note was issued to discard of these items as soon as possible. Side doors are self latching and unlocked LPA Vanegas observed first aid kit to have all required items. LPA Vanegas observed one staff files, and two resident files all resident files consisted of all required forms. However staff on duty was unable to present their first aid and cpr training, and the annual training was not provided for review.LPA Vanegas observed medications with AD and per LPA Vanegas review all medications are being documented correctly and being administered per physicians orders. Based on observations made during today's inspection no deficiencies will be issued per title 22 chapter 8 division 6 of the California Code of Regulations. An exit interview was conducted with AD Nellie Mai Caudle, and a copy of this report was provided to the facility.