Routine inspection·September 17, 2025

Licensing Program Analyst (LPA) Ruth Martinez is conducting this unannounced visit for the purpose of completing an annual inspection. LPA arrived at the facility was greeted at the door by caregiver and granted entry. Six (6) residents currently reside at this location and hospice services are being provided to four (4) residents at this time. LPA began the tour of the inside and outside of the facility which is a one story home with attached garage. LPA observed that the facility stays within the capacity limitations. There are no bodies of water or firearms at this location. There is a minimum of one week of non-perishable foods and two days of perishable foods available. There is additional food storage in the attached garage in refrigerator and freezer. The facility is maintained at a comfortable temperature. The hot water temperature measures 108.8 Fahrenheit degrees in residents’ restrooms. Restrooms are equipped with required safety measures such as non-skid mats and grab bars Lighting is sufficient to ensure safety and comfort. The facility provides personal hygiene items such as soap, toilet paper, toothbrush, and toothpaste. The facility has an available a clean supply of linen. LPA inspected resident’s bedroom which had sufficient lighting to ensure safety and comfort. Storage space is provided for resident. Smoke detectors and alarms were tested and operational. Continued on LIC809-C LPA checked if medications are centrally stored in a safe locked storage closet located in the bedroom hallway. LPA reviewed medication. Residents’ medication was labeled and stored inaccessible to the residents in care. LPA inspected and observed that toxic chemicals, cleaning solutions and disinfectants are locked underneath kitchen sink and in garage and inaccessible to residents. LPA toured the outside parameters of facility and observed outdoor passageways are free of obstruction. LPA reviewed staff; fingerprint records. All employees have a criminal record clearance. LPA spoke with alert residents regarding the quality of their care. During the inspection, LPA reviewed three resident records and three staff records. Staff records have a current first aid certificate. LPA as a reminder provided annual due fees which are due September 27, 2025. Based on the observations made during today’s visit, no deficiencies were noted today per Title 22 Division 6 of the California Code of Regulations . This report was reviewed with facility representative, and a copy of this report was provided and left at facility.