Routine inspection·December 9, 2025

On December 9, 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. Lead caregiver assisted 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 Josephine Teehankee. Josephine has an active Administrator's Certificate which expires on November 19, 2026. 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 Lead caregiver. For this visit, there are a total of five non-ambulatory residents in care, one ambulatory, 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 bedroom is for staff. 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 seven full 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 112.4 and 118.5 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 October 30, 2025. LPA observed the emergency disaster and evacuation plan, which is posted by the front entrance. LPA observed the facility conducted their last emergency disaster drill on September 18, 2025. Facility had back-up emergency food and water supplies, 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 a hallway, inaccessible to residents in care. Chemicals were observed to be locked 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 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, 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. Two resident interviews and one staff interview were conducted. Based on today's observations, there are no deficiencies being cited per Title 22 of the California Code of Regulations. An exit interview was conducted with Lead caregiver Shiella Cruz. This report was reviewed with the authorized representative and a copy was provided at the end of the visit.