Routine inspection·December 1, 2025

On December 1, 2025, 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, staff on duty contacted the facility administrator (AD) Josephine Teehankee about the visit. For this visit, there are two staff members on duty, both of which are background cleared and associated. AD later arrived to assist with the inspection. The PUB475 ‘See Something, Say Something’ poster was observed to be located by the front entrance. LPA observed the Administrator's Certificate for Rafael Teehankee, which expires on January 27, 2027. The facility is a Residential Care facility for the Elderly (RCFE) licensed for six residents, six of which may be non-ambulatory, one 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 six non-ambulatory residents in care, five of which are on hospice, and one is bedridden. The facility is a single story home. There are a total of seven bedrooms, six of which are private resident bedrooms and one 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. 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 129.2 and 130.6 degrees Fahrenheit. Facility met the minimum two-day perishable and seven-day non-perishable food supplies. Sharp items and knives were locked in the kitchen cabinet and inaccessible to residents in care. Fire extinguisher was charged, mounted and located in the kitchen. LPA observed the emergency disaster and evacuation plan, which is posted in the living room. LPA observed the facility conducted their last emergency disaster drill on September 3, 2025. Facility had back-up emergency food and water supply, located in the garage. LPA observed that the First Aid kit had all the required components. Medications were observed to be locked in a medication cabinet in the dining room, inaccessible to residents in care. Chemicals were observed to be locked underneath the kitchen sink and in the garage. 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 attached 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. There is a gazebo in the backyard for seating. No bodies of water were observed. During this visit, six resident files and two staff files were reviewed. All staff are background cleared and associated with the facility. LPA reviewed residents’ medication and medication records and two 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 at the time of the visit. An exit interview was conducted with staff. This report was reviewed with staff and a copy was provided at the end of the visit. Appeal Rights were reviewed.