Routine inspection·January 29, 2026

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 administrator Cristo Forero after introducing himself and stating the purpose of the visit. Administrator Olga Moreno joined the visit later. There are currently three residents in care, none of which are receiving hospice care at this time. Residents are observed relaxing in the common areas and enjoying lunch at the dining table. LPA accompanied by facility staff toured the physical plant. The facility is a two-story house with two shared bedrooms and one shared bathroom on the ground floor. The first floor is for use by the licensee and their family exclusively and is inaccessible to residents. LPA and staff toured the first floor as well. None of the residents are assessed to be bedridden at this time. Both occupied bedrooms appear clean and sanitary. All resident bedrooms have the required furnishings. Bathrooms appear clean and sanitary and are all equipped with grab bars and slip mats. Hot water temperature measured at 110F in the shared bathroom with faucets used for personal grooming by residents. 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 secure. One fire extinguisher is present and verified to be charged. Receipt for purchase are dated June, 2025. Carbon monoxide and smoke detectors are present and operational. CONTINUED ON FORM LIC809-C CONTINUED FROM FORM LIC809 LPA and facility staff toured the outside of the facility. LPA observed a shaded outdoor seating area with outdoor furniture for resident use in the backyard. There are no bodies of water on the premises. The identified routes of egress are free of clutter and obstructions. There is one self-latching gate on one side of the premises. The facility does not utilize either locked perimeters or delayed egress. LPA reviewed three resident records which were found to include all necessary elements of documentation. LPA reviewed resident medication records and prescription orders with no discrepancies observed for all three residents. LPA reviewed staff records for three staff members during the visit. All staff members on the schedule are background cleared and associated. CPR training has expired for two out of three staff members while the third one has not trained yet after started to work at the facility a few days prior to the visit. Type B deficiency assessed. Annual and initial training reviewed. Disaster drills are conducted quarterly. The administrator certificates are current. Based on the observations conducted during the present visit, one type B deficiency is being cited per Title 22 of the California Code of Regulations. An exit interview was conducted and a copy of this report along with appeal rights were provided to a facility representative.