Routine inspection·April 14, 2026

On April 14, 2026, Licensing Program Analyst (LPA) Garlli Tat conducted an unannounced visit to the facility for the purpose of a required annual inspection. LPA explained the purpose for the visit and was greeted and granted entry by staff on duty. During the visit, the facility administrator (AD) Raymond Mendoza assisted with the inspection. For this visit, there are two staff members on duty, both of which are background cleared and associated. The PUB475 ‘See Something, Say Something’ poster was observed to be located near the front entrance. LPA observed that Raymond Mendoza has a valid Administrator certificate that expires on January 13, 2028. The facility is a Residential Care facility for the Elderly (RCFE) licensed for six residents, six of which may be non-ambulatory, none of which may be bedridden, and a hospice waiver for four. LPA toured the interior and exterior portions of the facility with AD. For this visit, there are a total of five non-ambulatory residents in care, three of which are on hospice, and none are bedridden. The facility is a single story home. There are a total of seven bedrooms, six of which are private resident bedrooms and one is a staff bedroom. LPA toured each bedroom with the AD and observed that bedrooms were provided with furniture in good repair, clean linens, adequate storage space, and free of any hazards. LPA observed the staff room is kept locked and inaccessible to residents in care. Smoke and carbon monoxide detectors as well as auditory exit alarms were tested and operational. There are a total of five bathrooms, four are for residents and one is for staff. Continued on LIC 809-C. Bathrooms were observed to be in good repair, toilets and faucets were operational and showers were equipped with grab bars and non-skid floor mats. Water temperature in the bathrooms were measured to be between 105.8 and 106.1 degrees Fahrenheit. Facility met the minimum two-day perishable and seven-day non-perishable food supplies. Sharp items and knives were locked in a kitchen cabinet and inaccessible to residents in care. Fire extinguisher was charged, mounted and located in the kitchen. Fire extinguisher was dated and tagged on April 14, 2026. LPA observed the emergency disaster and evacuation plan, which is posted in the dining room. LPA observed the facility have not had their emergency disaster drill in 2026. Facility had back-up emergency food and water supply, located in the kitchen. LPA observed that the First Aid kit had all the required components. Medications were observed to be locked in a medication cabinet in the kitchen, inaccessible to residents in care. Chemicals were observed to be locked underneath the kitchen sink. LPA observed the door leading to the attached two car garage is kept locked and inaccessible to residents in care. The garage is used for storage and laundry. For the exterior portion, LPA observed patio furniture under shading, and the grounds were free of any hazards or obstructions. There are two exit gates in the backyard that can be opened in case of an emergency. No bodies of water were observed. During this visit, five resident files and one staff file were reviewed. All staff are background cleared and associated with the facility. LPA reviewed residents’ medication and medication records and three resident interviews were conducted. Based on today's observations, there are deficiencies being cited per Title 22 of the California Code of Regulations. A technical violation was issued. An exit interview was conducted with Administrator. This report was reviewed and a copy was provided at the end of the visit. Appeal Rights were reviewed.