Routine inspection·August 7, 2025

On this day Licensing Program Analyst (LPA) Fred Arias made an unannounced visit to conduct a required annual visit. LPA was greeted and granted entry into the facility by staff and explained the reason for the visit. Facility is licensed for 6 non-ambulatory residents. Facility has an approved hospice waiver for 3 residents and the home currently has 4 residents, with 2 residents on hospice. Administrator (AD) Nicoleta Blaga arrived shortly to conduct facility tour. AD provided updated liability insurance that expires on 08/06/2026. LPA along with AD toured the facility at 2:00 PM. LPA toured the physical plant, checked food service, and facility documentation. The home consists of 5 resident bedrooms, living room, dining room, and kitchen as well as 4 bathrooms. Resident bedrooms had the required furniture, bed linens and closet/drawer space to accommodate each resident comfortably. Resident bathrooms were checked. Toilets and water faucets worked properly, grab bars were secure and shower was free of mold/mildew. Water temperature measured between 111.5 degrees F and 112.5 degrees F in all bathrooms checked. Resident bath towels, toiletries and personal hygiene supplies were adequately stocked. Common areas were clean and clear of hazards. Auditory exit alarms were operational during today's visit. LPA toured the kitchen and observed sharps locked in a cabinet during today's visit. Perishable and non-perishable food supply was checked and adequately stocked at time of visit. Kitchen appliances were operational during today's visit. Smoke detectors tested operational during today's visit. Fire extinguishers were fully charged. Facility conducts quarterly emergency drills with the last drill conducted on 06/25/2025. Outside grounds were toured. There is shaded outdoor seating for residents. Exit gates are unlocked and operational. First aid kit contained all required items including tweezers, scissors and thermometer. Facility conducts activities in the form of music therapy. LPA observed the emergency food and water supply. LPA reviewed four resident files and two staff files. Continued on LIC 809-C dated 08/07/2025. All resident files contained required documentation including admission agreements, physician reports, resident appraisals, and physician orders for bed rails as indicated. Staff files reviewed contained documentation including required annual training, TB test, criminal record clearance and proof of CPR training. LPA reviewed medication storage and administration. Medications are stored in a locked closet. Medications are being administered per physician order. Based on the observations made during today’s visit, no deficiencies are being cited per Title 22 Division 6 of the California Code of Regulations. This report was discussed with the facility representative and a copy was provided.