Routine inspection·October 10, 2025

Licensing Program Analyst (LPA) Rose Ruppert made an unannounced visit to the facility to conduct an Annual Required Evaluation. LPA was greeted and granted entry by staff at 12:30pm and explained the purpose of the visit. LPA met with Licensee, Concordia "Cora" Velasco. The facility is a six bedroom, single- story residential home with an approved fire clearance of six non-ambulatory residents . The facility currently has a census of five residents in care. During today’s visit, LPA toured the facility and inspected the physical plant, including testing smoke and carbon monoxide detectors, testing hot water temperature in one of one resident bathrooms, and testing auditory devices on all exits . The hot water temperature measured 109.5 degrees Fahrenheit and smoke detectors were operational . The fire extinguisher is charged and was serviced on May 18, 2024. The facility’s last fire drill was conducted on August 2, 2025 . LPA inspected the facility food supply and observed the facility retained a minimum of two days perishable and seven days non-perishable food on hand. LPA observed emergency canned goods were expired and an LIC 9102-TV was given. All appliances were in working order, knives and sharps were secured and cleaning chemicals were stored in a locked hallway storage cabinet. LPA toured the exterior of the property and there was a shaded seating area and plenty of outdoor space for activities. LPA observed a broken patio door handle but Licensee has already scheduled the contractor for this coming weekend. The exterior gate is self-latching and in working order. (Continued on LIC 809) (Continued from LIC 809) LPA observed medication storage and reviewed the centrally stored medications. Per review medications are being given as prescribed. L PA reviewed three of three staff training and fingerprint records and LPA conducted a complete review of resident records. One of five residents did not have a Medical Assessment. Two of five residents did not have physician orders for bed rails. Deficiencies were cited. Two of two staff were missing Health Screening Reports in their file and LPA observed canned emergency food items which were expired. Technical Violations are being given for the Health Screening Reports and expired emergency supplies. LPA interviewed alert residents regarding their quality of care and spoke to staff present regarding care provided. LPA confirmed that administrator has a current administrator certificate which expires on January 24, 2027. The following deficiencies are being cited per Title 22 Division 6 of the California Code of Regulations. An exit interview was conducted with Concordia Velasco and a copy of this report was given to the facility along with a copy of the LIC 858, LIC 859; LIC 809-D, LIC 9102-TV and Appeal Rights.