Routine inspection·April 7, 2026

This unannounced inspection is being conducted by Licensing Program Analyst (LPA) Sean Haddad for the purpose of conducting a Required – 1 Year Inspection. LPA met with Administrator (AD) Maria Go and discussed the purpose of the inspection. LPA reviewed Infection Control requirements. At about 2:30PM, LPA and AD conducted a tour of the inside and outside of the facility, common areas, resident rooms, kitchen, and garage and observed the following: Structure: facility is a 5-bedroom, 3-bathroom, one-story house with an attached garage that is used for storage. There is a back yard with a patio cover for the residents. LPA and AD observed 1 staff and 2 residents present at the facility. Resident Bedrooms: the 3 resident bedrooms are spacious and will easily accommodate the residents’ furnishings. Furniture for each resident bedroom inspected. Staff Bedrooms: LPA inspected the two staff bedrooms. Bathrooms: the bathrooms were clean, faucets and toilets were operational. Water temperature: tested between 116 and 122 degrees F in the 2 resident bathrooms, before corrections. Linens & Hygiene Supplies: new linens and fully stocked linen closets were observed. Emergency Phone Numbers, Exit Plan & Menu: reviewed. Food Service: LPA observed the facility has a 2-day supply of perishables and a 7-day supply of non-perishable food is available as required by regulations. Carbon Monoxide, Smoke Detectors, Fire Extinguisher: observed and tested. Appliances: stove burners, microwave, washer, and dryer inspected. Knives: observed locked in the kitchen. Toxins: observed locked in the laundry room and storage sheds, after corrections. Medication cabinet: observed to be locked. First-Aid Kit and Activity Supplies: observed and available. Facility’s licensing fees are paid. At about 12:45PM, LPA reviewed 2 resident files and 4 staff files, interviewed 1 resident and 2 staff, and inspected medications for 2 residents. Facility does not handle resident money During the inspection, LPA and AD observed the following: based on documents, R1's physician's report indicates they are bedridden, but the facility does not have a bedridden fire clearance; based on observations, the faucet in the common resident bathroom tested at 122 degrees F; based on observation, the licensee did not ensure dangerous items, such as nail polish remover, industrial solvents, and cleaning products were inaccessible in the non-lockable toiletries closet, staff bedroom, and outdoor storage shed, where R2 was not assessed as being able to safety handle these items; and based on documents, R2's physician's report is on the old form and does not include required information, including behavioral expressions. Based on the observations made during today’s inspection, deficiencies are being cited per Title 22 Division 6 of the California Code of Regulations. See LIC809D. Immediate civil penalties are being assessed. See LIC421IM. An exit interview was conducted and a copy of this report and appeal rights was discussed with and provided to facility representative.