Routine inspection·October 7, 2025

On October 7, 2025, Licensing Program Analyst (LPA) Garlli Tat conducted an unannounced visit to the facility for the purpose of a required annual inspection. LPA explained the purpose for the visit and was greeted and granted entry by staff on duty. During the visit, staff on duty notified the facility administrator (AD) Marites Villanueva about the visit. For this visit, there are two staff members on duty, both of which are background cleared and associated. Designee Soledad Larcia, assisted with the inspection. The PUB475 ‘See Something, Say Something’ poster was observed to be located by the front entrance. LPA observed the Administrator's Certificate for Marites Villanueva, which expires on December 12, 2025. The facility is a Residential Care facility for the Elderly (RCFE) licensed for six residents, six of which may be non-ambulatory, none of which may be bedridden, and all of which may be on hospice. LPA toured the interior and exterior portions of the facility with Designee. For this visit, there are a total of four non-ambulatory residents in care and none are on hospice. The facility is a single-story home. There are a total of five bedrooms, two are private resident rooms, two are shared resident rooms, and one serves as staff quarters. LPA toured each bedroom with the Designee and observed that bedrooms were provided with furniture in good repair, clean linens, adequate storage space, and free of any hazards. LPA observed the staff quarters to be kept locked and inaccessible to residents in care. Smoke and carbon monoxide detectors as well as auditory exit alarms were tested. Auditory exit alarms were operational. However, LPA observed that the carbon monoxide alarm only had two batteries when three are necessary for it it operate properly. LPA also observed Staff 2 replaced the smoke detector when it was not working properly during the test. Continued on LIC 809-C. There are a total of two fully functioning bathrooms for residents and staff. Bathrooms were observed to be in good repair, toilets and faucets were operational and showers were equipped with grab bars and non-skid floor mats. Water temperature in the bathrooms were measured to be between 106.5 and 108.5 degrees Fahrenheit. Facility met the minimum two-day perishable and seven-day non-perishable food supplies. Sharp items and knives were locked in the kitchen and inaccessible to residents in care. Fire extinguisher was charged, mounted and located in the dining room. Fire extinguisher was dated and tagged on July 11, 2025. LPA observed the emergency disaster and evacuation plan, which is posted near the front entrance. Facility had back-up emergency food and water supply, located in the kitchen pantry. LPA observed that the First Aid kit had all the required components. Medications and toxins were also observed to be locked in a cabinet in the kitchen, inaccessible to residents in care. For the exterior portion, LPA observed patio furniture under shading, and the grounds were free of any hazards or obstructions. There is one self-latching gate in the backyard that can be opened in case of an emergency. No bodies of water were observed. LPA observed the Emergency Disaster Plan binder which did not consist of quarterly emergency drills, as required by California Code of Regulations 1569.695(c). Based on today's observations, there are two deficiencies being cited per Title 22 of the California Code of Regulations. Carbon monoxide and smoke detectors should be in working order at all times and staff shall conduct emergency drills on a quarterly basis. An exit interview was conducted with Soledad Larcia. This report was reviewed with the administrator designee and a copy was provided at the end of the visit. Appeal Right were reviewed.