Routine inspection·June 5, 2025

On June 5, 2025 at 8:00am, Licensing Program Analyst (LPA) Eboni Bentley arrived at the facility to conduct an unannounced required 1-Year annual visit using the CARE Inspection Tool. LPA announced self and stated the purpose of the visit to Caregiver (CG) Yuriria Rebollar and was granted entry. Administrator (AD) Deana “Chris” Landon was contacted by telephone, arrived at the facility a short time later, and was present throughout the inspection. Administrator certificate for Deana Landon expires on December 27, 2025. There are five residents on census. Two residents on Hospice and two residents with dementia currently living at the facility. During today’s visit, five residents and six staff are present. LPA obtained copies of pertinent documents for clients and staff, including facility records: residents/staff rosters, Personnel Record (LIC500), resident and staff records. The facility is a two-story home licensed for 6 non-ambulatory residents and has a Hospice waiver for 5. There are 6 resident bedrooms, 1 caregiver bedroom located upstairs, a living room area, a kitchen, a dining room area, and attached two car garage. There are 7 bathrooms, one located inside each bedroom. Around 8:45am, LPA conducted a tour of the facility with AD Landon and the following was observed: Resident bedrooms had the required furniture, bed linens and closet/drawer space to accommodate each resident comfortably. Resident bathrooms were checked. Toilets and water faucets worked properly, grab bars were secure and shower was free of mold/mildew. Water temperature measured between 110.3 degrees F. and 115.7 degrees F. Resident bath towels, toiletries and personal hygiene supplies were adequately stocked at time of visit. Continues on LIC 809-C Common areas were clean and clear of hazards, doorways were free of obstructions. Kitchen was inspected and found clean and sanitary. Perishable and non-perishable food supply was checked and adequately stocked at time of visit. LPA observed knives and sharps locked in a kitchen drawer. LPA also observed toxin substances to be secured and locked and inaccessible to residents in care. Kitchen appliances are operational during today's visit. LPA toured the outside grounds and there is ample seating with shade and the exit gate is self-latching and operational. During tour, LPA observed Resident #1(R1), Resident #4 (R4), and Resident #5 (R5) beds all have 1/2 bed rails attached. Licensee stated she did not have orders for the three bed rails and did not know a physician's order was required for 1/2 bed rails. LPA also observed, scissors unlocked/unsecured in Resident #1 (R1), Resident #2 (R2), and Resident #3 (R3) dresser drawers, desk, and shelf. (See LIC809-D attached) Carbon monoxide/smoke detectors in common areas and bedrooms are operational. The facility’s last fire drill was conducted on March 16, 2025. Emergency food and water supply observed in the garage. First aid kit had all the required elements. Two fire extinguishers are fully charged with a service date of May 5, 2025. A working telephone (714-351-7800) remains available, and the facility has a device that can be used for video teleconference purposes. Liability Insurance is effective February 1, 2025, through February 1, 2026. LPA Bentley conducted an audit of five (5) resident files (R1-R5), five (5) staff files (S1-S5), and conducted three (3) staff interviews, and four (4) resident interviews. Residents’ medication was found locked, and a review of the Medication and Medication Administration Record (MAR) was conducted. Based on today’s observations, deficiencies are being cited during this visit as per Title 22 Division 6 Chapter 8 of the California Code of Regulations. An exit interview was conducted with administrator, Deana Landon and a copy of this report LIC809, 809-C, LIC809-D, LIC811, and appeal rights provided.