Routine inspection·September 10, 2025

On September 3, 2025, Licensing Program Analyst (LPA) Eboni Bentley conducted an unannounced required 1-Year annual visit. Upon arrival at the facility, LPA Bentley was greeted and granted entry by Caregiver (CG) Jerome Macasaquit and explained the purpose of the visit. Administrator (AD) Cherry Aquila arrived a short time later and was present throughout the inspection visit. The facility is licensed to operate for six (6) non-ambulatory residents with a Hospice waiver for six (6). The facility is a single-story structure located in a residential neighborhood. It consists of the following: four (4) resident bedrooms, one (1) resident bathroom, one (1) staff bathroom, living room area, dining area, kitchen, an outdoor covered seating areas, and an attached two car garage. LPA Bentley toured inside and outside of the physical plant with CG Macasaquit. There were no bodies of water or obstructions on the premises. All rooms were inspected. Beds and bedding supplies were in good condition, storage for each client’s personal belongings was observed. Bed linens, comforters, and bath towels were adequately stocked at the time of visit. Bathrooms were found to be operational and clutter free. The water temperature measured at 117.1 degrees F to 117.5 degrees F. A comfortable temperature of 74 degrees F was maintained in the facility. LPA Bentley observed the facility to be appropriately furnished at the time of visit. Storage areas for personal hygiene, cleaning supplies, toxins, and sharps objects were stored and accessible to residents. The kitchen was inspected and there is a two-day supply of perishable and seven-day supply of non-perishable food available and maintained properly. Emergency safety drills are being conducted quarterly. First aid kit is maintained and contains all the necessary elements. Continued on LIC 809-C... During the visit, LPA Bentley observed the facility's smoke detectors and carbon monoxide detectors were operational. A working telephone (714-646-9217) remains available, and the facility has a device that can be used for video teleconference purposes. Emergency food, emergency water, and emergency supplies were observed. The facility has a (1) fire extinguisher that was charged, mounted, and serviced on January 14, 2025. Liability Insurance is effective 7/1/2025 and expires on 7/1/2026. LPA Bentley conducted an audit of six (6) resident files (R1-R6), four (4) staff files (S1-S4), and medication and medication administration review. LPA interviewed alert residents regarding their quality of care and spoke to staff present regarding care provided. (Continued on LIC 809-C) Based on today’s observations deficiencies were cited during this visit as per Title 22 Division 6 Chapter 8 of the California Code of Regulations. An exit interview was conducted, and a copy of this report and appeal rights were provided to Administrator Cherry Avila.