Routine inspection·May 30, 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 caregiving staff. Administrator Susan Cambio was notified of the visit by telephone and arrived later to assist. There are currently five residents in care, none of which are receiving hospice care at this time. LPA observed residents relaxing in the facility's common living areas or in their respective bedrooms. LPA accompanied by facility staff toured the physical plant. The facility is a one-story house with an attached garage. The facility has three shared bedrooms along with one staff rooms and two shared bathrooms. Bedrooms appear clean and sanitary. No residents are observed using postural supports at the time of the visit. All resident bedrooms have the required furnishings. Bathrooms appear clean and sanitary and are equipped with grab bars and slip mats. Hot water temperature measured at 112F and 120F in two separate bathrooms equipped with faucets used for personal grooming. LPA observed the kitchen has a minimum two (2) day perishable and seven (7) day non-perishable food supply. Sharp items, cleaning supplies and the medication central storage are verified to be secured. The two wall-mounted fire extinguishers are charged. LPA tested the smoke and carbon monoxide detectors which were found to be operational. The garage is inaccessible to residents and used for laundry as well as additional storage of food and supplies. CONTINUED ON FORM LIC809-C CONTINUED FROM LIC809 LPA and facility staff toured the outside of the facility. LPA observed a shaded outdoor seating area with furniture for resident use. There is one self-latching gate on one side of the property and a double-wide gate on the other side of the property. The routes of egress are free of clutter and obstructions. There are no bodies of water on the premises. Facility does not utilize locked perimeters or delayed egress. LPA reviewed five resident records which included all necessary components. LPA reviewed resident medication records and prescription orders for all residents with no discrepancies observed. Oxygen is not currently in use on the premises. There is one resident currently assessed as being bedridden at the time of the visit per their physician report. Resident is however observed in the living room in a recliner and is stated to be able to ambulate with the help of a walker. Facility staff instructed to request an updated form LIC602 accurately reflecting the resident's condition. Resident interviews were conducted or attempted during the visit along with staff interviews. LPA reviewed staff records for two caregivers present during the visit. Present staff members have current CPR certificates on file. Annual training on file. Disaster drills are conducted however no proof of attendance is currently being generated. Consultation provided. Both staff members present are background cleared and associated to the licensed location. Based on the observations made during today’s visit, no deficiencies are being cited per Title 22 Division 6 of the California Code of Regulations. An exit interview was conducted and a copy of this report along were provided to a facility representative.