Routine inspection·December 2, 2025

On this day, Licensing Program Analyst (LPA) Kevin Saborit-Guasch made an unannounced visit to the facility to conduct the required annual inspection. LPA was greeted and granted entry by facility administrator Susana Cambio after stating the purpose of the visit. Administrator Leo Cambio also arrived shortly afterwards to assist with the visit. There are currently five residents in care, none of which is receiving hospice care at this time. Residents are observed relaxing in their respective bedrooms and having lunch in the facility's kitchen. Flooring renovation is under way in the caregiver room and living room. Resident bedrooms flooring have been replaced the day leading up to the visit. LPA accompanied by facility staff toured the physical plant. The facility is a one-story house with two shared bedrooms and one single bedroom, along with one room used by overnight caregiving staff. There are two shared bathrooms used by residents. None of the residents are bedridden at this time. All occupied bedrooms appear clean and sanitary. All resident bedrooms have the required furnishings. Bathrooms appear clean and sanitary and are all equipped with grab bars and slip mats. Hot water temperature measured at 109F in the shared bathroom. Unsecured cleaning products observed under one of the bathroom sinks as well as in the kitchen. Type B deficiency cited. LPA observed the kitchen has a minimum two (2) day perishable and seven (7) day non-perishable food supply. Sharp items are verified to be secure in a locked cabinet in the kitchen. The medication central storage is in a locked cabinet inside the caregiver room. CONTINUED ON FORM LIC809-C CONTINUED FROM FORM LIC809 Wall-mounted fire extinguishers are present and verified to be charged, however maintenance tags are not present and maintenance could not be verified. Type B deficiency cited. Carbon monoxide and smoke detectors were found to be present and operational. Emergency water supplies are stored in the garage. LPA and facility staff toured the outside of the facility. LPA observed a shaded outdoor seating area with outdoor furniture for resident use in the backyard. The identified route of egress is free of clutter and obstructions. There are self-latching gates on both sides of the premises. There are no bodies of water on the premises and the facility does not utilize either locked perimeters or delayed egress. LPA reviewed five resident records. All necessary elements of documentation are present per Title 22 requirements. Physician reports are up to date for all residents LPA reviewed staff records for four staff members during the visit. Proof of current CPR training reviewed. Disaster drills are conducted quarterly. The administrator certificates are current. Initial and annual training records are present and meet Title 22 requirements. All staff members on the roster are verified to be cleared and associated to the present licensed location Based on the observations conducted during the present visit, two type B deficiencies are being cited per Title 22 of the California Code of Regulations. An exit interview was conducted and a copy of this report along with appeal rights were provided to a facility representative.