Routine inspection·April 16, 2026

Licensing Program Analyst (LPA) Nancy Guillen made an unannounced visit for the purpose of conducting a required annual Inspection. LPA was greeted and granted entry by care staff after explaining the purpose of the visit. LPA observed Administrator (AD) Carmen Achim’s certificate was current with an expiration date of December 01, 2027. This is a Residential Care Facility for the Elderly (RCFE) licensed to six non-ambulatory residents and an approved hospice waiver for three. The facility is a one-story home with six resident bedrooms, one staff bedroom, seven restrooms, a living room, family room, dining room, kitchen and two car garage. During the inspection, LPA and staff conducted a tour of the inside and outside of the facility, common areas, resident rooms, garage and observed the following: LPA observed five residents in care and two staff present. LPA observed the See Something Say Something Poster (PUB 475) mounted on the wall in the living room. LPA observed that all resident bedrooms had the required furnishings. LPA observed all resident beds had linens and blankets with additional linens stored a hallway closet. LPA observed bathrooms were clean and equipped with grab bars and non-skid floor mats. Bathrooms were observed to be free of debris and mildew. Faucets and toilets were operational. Water temperature tested between 105.8 and 113.3 degrees Fahrenheit. LPA observed all windows were appropriately screened. LPA toured the outside of the facility and observed outdoor passageways were free of obstruction. LPA observed the backyard had a shaded sitting area with furniture for resident use. Continued on LIC 809C LPA observed the facility had a 2-day supply of perishables and a 7-day supply of non-perishable food as required by regulations. Gas stove, dish washer, microwave, washer and dryer were inspected and observed to be operable. Smoke detectors and carbon monoxide detectors tested operational. Fire extinguisher was observed to be fully charged with a service date of March 27, 2026 and located by the exit to the back patio. Toxic chemicals, cleaning solutions, and disinfectants were observed to be locked and inaccessible to residents under the kitchen sink. Medication cabinet was observed to be locked and centrally stored in a hallway cabinet. LPA observed the First Aid Kit had all the required components. Per interview, disaster drills have not been conducted for the last quarter. Disaster drills were not present at the facility to be reviewed. LPA began review of the records. LPA reviewed five resident records. All the required documentation was present and current in the residents files reviewed. LPA reviewed two employee records. LPA observed Staff 1 (S1) did not have a health screening on file. LPA observed records reviewed have a current First Aid certificate. Based on the observations made during today’s inspection, 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, LIC 809C, LIC 809D, LIC 858, LIC 859, LIC 9102, Appeal Rights and the Legionnaire’s Disease fact sheet was left at the facility.