Routine inspection·September 23, 2025

Licensing Program Analyst (LPA) Hanna Gough arrived at the facility to conduct the required annual inspection. LPA was greeted and granted entry by staff. LPA met with Administrator (AD) Evangeline Bruno and discussed the purpose of the visit. The facility currently has six residents in care. The facility is a one story home with three resident bedrooms, one staff room, two bathrooms, living room, kitchen, dining room, laundry room, and detached two car garage. Facility appears clean, safe and sanitary. LPA observed the residents napping and watching tv. LPA observed the kitchen to be clean and free of vermin. LPA observed a two day perishable and seven day nonperishable food supply on hand. LPA observed the knives to be locked and made inaccessible to residents in care. LPA observed toxins to be locked and made inaccessible to residents in care. LPA observed the centrally stored medication to be locked in a kitchen cabinet and made inaccessible to residents in care. LPA observed a fire extinguisher in the kitchen to be charged and with a service date of March 10, 2025. LPA observed the restrooms to have non-slip mats in the shower, grab bars and toilet paper. LPA tested the water to be between 101.9 and 102.2 degrees Fahrenheit. LPA observed a clean supply of linens in the hall cabinet for resident use. LPA observed all resident bedrooms to have the required components and furnishings. LPA observed the emergency food and water supply to be located in the laundry room. LPA observed the garage to be locked and made inaccessible to residents in care and is used for storage. LPA observed the backyard to have a shaded seating area for resident use. LPA observed that the backyard was free of debris and obstructions. LPA and AD tested the carbon monoxide and smoke detectors and they were found to be operational. Continue on LIC809C LPA reviewed staff files and no discrepancies were observed. LPA reviewed resident files and one of six residents do not have a medical assessment on file and six of six residents do not have updated needs and services plans. LPA observed resident medication and no discrepancies were observed. LPA advised AD to document medication beyond monthly audits and to keep record. LPA observed the last fire drill was conducted on January 1, 2025. All staff present are background cleared and associated to the facility. Based on observations made during today’s inspection deficiencies and technical violations are being given per Title 22 Division 6 of the California Code of Regulations. An exit interview was conducted with AD Evangeline Bruno and a copy of this report along with LIC809D, LIC858, LIC9102 and appeal rights were given the time of the inspection.