Routine inspection·January 23, 2026

Licensing Program Analyst (LPA) Hanna Gough made an unannounced visit to the facility to conduct the required annual inspection. LPA was greeted and granted entry by staff. LPA met with Administrator (AD) Carol Wilson and discussed the purpose of the visit. The facility has 5 residents in care of which all were observed relaxing and watching tv in their bedrooms. The facility is a one story home with 5 resident rooms, 3 bathrooms, kitchen, dining room, living room, den, staff room, backyard and 2 car garage. LPA observed the resident bedrooms to have all the required components and furnishings. LPA observed the staff room to be clean and free of medications or other supplies that should be inaccessible to residents in care. LPA observed the bathrooms to have paper towels, toilet paper and non slip mats in the shower. LPA tested the water to in the bathrooms to be between 106.7 and 112.4 degrees Fahrenheit. LPA observed a clean supply of linens for resident use in the hall cupboard located by the restrooms. LPA observed the kitchen to be clean and free of vermin. LPA observed the knives to be in a locked drawer by the kitchen sink and made inaccessible to residents in care. LPA observed the toxins and chemicals to be locked under the kitchen cabinet and made inaccessible to residents in care. LPA observed the centrally stored medication to be in a locked cabinet above the kitchen sink making them inaccessible to residents in care. LA observed a fire extinguisher in the kitchen charged and with a service date of January 11, 2026. LPA observed the garage to be used for extra storage. LPA observed the backyard to be free of debris and obstructions. LPA observed a shaded seating area for resident use. LPA and AD tested the fire alarms and smoke detectors and they were found to be operational. continue on LIC 809C LPA reviewed staff files and observed that Staff #1 did not have the required regulatory hours per topic for their 20 hours annual training. LPA reviewed resident files and observed that 2 of 5 residents do not have a tb test on file and 5 of 5 residents need updated needs and services plans. LPA reviewed resident medications and observed that medications are not being given and left in the bubble pack, but being signed off on the MAR with no explanation. LPA observed the last fire drill was conducted on January 8, 2026. All staff present are background cleared and associated to the facility. Based on observations during the inspection technical violations and citations were noted per Title 22 Division 6 of the California Code of Regulations. An exit interview was conducted and a copy of this report along with LIC 858, 859, 809D, technical violations and appeal rights were left at the facility.