Routine inspection·December 9, 2025

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 staff Noel Gutierrez after introducing himself and stating the purpose of the visit. Administrator Romuald Amante was notified of the visit via telephone. There are currently four residents in care, three of which are receiving hospice care at this time out of a waiver capacity of two hospice residents. Citation issued. Residents are observed relaxing in their respective bedrooms and in the common areas. LPA accompanied by facility staff toured the physical plant. The facility is a two-story house with three private and one shared bedrooms used by residents in addition to one staff room. The second floor as well as part of the first floor are for the exclusive use of the licensee and their family members. There are two bathrooms used by residents. None of the residents are assessed to be bedridden at this time. All occupied bedrooms appear clean and sanitary. Three residents have beds equipped with full rails. Postural supports orders are verified to be on file for two out of three and missing for the third one. Deficiency issued. One resident is observed to be wheelchair-bound with a seat belt in place. Deficiency issued. All resident bedrooms have the required furnishings. Bathrooms are equipped with grab bars and slip mats. Hot water temperature measured at 112F in one bathrooms but tested below 105F at multiple faucets and showers throughout the physical plant. Deficiency issued. One faucet is wobbly. 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. CONTINUED ON FORM LIC809-C CONTINUED FROM FORM LIC809 A wall-mounted fire extinguisher is present and verified to be charged. Deficiency issued. Carbon monoxide and smoke detectors are present and operational. Licensee unable to provide a copy of the facility's Emergency and disaster plan. Consultation issued. There is also no documentation for fire drills with the exception of one drill conducted in July 2025. Deficiency issued. 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 self-latching gates on both sides of the premises. There are no bodies of water on the premises and the facility does not utilize either locked perimeters or delayed egress. LPA reviewed four resident records which were found to include necessary elements of documentation. LPA reviewed resident medication records and prescription orders with no discrepancies observed for four residents. Licensee advised to not prepare medication for self-administration over 24 hours ahead of being provided to the residents. LPA reviewed staff records for three staff members during the visit. No current CPR on file. Deficiency cited. Deficiency issued. All staff members and residents are background cleared and associated. There is no current training on file. The administrator certificate is current. Based on the observation conducted during the present visit, two type A and eight type B deficiencies are being cited per Title 22 of the California Code of Regulations. An exit interview was conducted and a copy of this report and appeal rights was provided to a facility representative.