Routine inspection·December 5, 2025

On this day, Licensing Program Analyst (LPA) Kevin Saborit-Guasch made an unannounced visit to the facility to conduct the required annual inspection. LPA was greeted and granted entry by facility caregiving staff after introducing himself and stating the purpose of the visit. Administrator Jennifer Perez was also present on the premises and available to assist. There are currently six residents in care, two of which are receiving hospice care at this time. Residents are observed relaxing in their respective bedrooms and in the common areas. LPA accompanied by facility staff toured the physical plant. The facility is a two-story house with three shared bedrooms used by residents in addition to one staff room. The second level of the house is for the exclusive use of the licensee and their family. There are two bathrooms used by residents. None of the residents are bedridden at this time. All occupied bedrooms appear clean and sanitary. Postural supports orders are verified to be on file. One resident has full rails in place but has been discharged from hospice. Consultation provided. All resident bedrooms have the required furnishings. Bathrooms appear clean and sanitary and are all equipped with grab bars and slip mats. Hot water temperature measured at 114F and 118F in the shared bathrooms. LPA observed the kitchen has a minimum two (2) day perishable and seven (7) day non-perishable food supply. Sharp items, cleaning supplies and the medication central storage located in the kitchen and living room are verified to be secure. CONTINUED ON FORM LIC809-C CONTINUED FROM FORM LIC809 A wall-mounted fire extinguisher is present and verified to be charged, with a purchase receipt dated August 2025. Carbon monoxide and smoke detectors are present and operational. Emergency water supplies are stored in the garage. LPA and facility staff toured the outside of the facility. LPA observed a shaded outdoor seating area with outdoor furniture for resident use in the backyard. The identified routes of egress is free of clutter and obstructions. There are self-latching gates on both sides of the premises. There are no bodies of water on the premises and the facility does not utilize either locked perimeters or delayed egress. LPA reviewed six resident records which were found to include all necessary elements of documentation. LPA reviewed resident medication records and prescription orders with no discrepancies observed. LPA reviewed staff records for three staff members during the visit. All staff members are background cleared and associated. Proof of current CPR training reviewed. Disaster drills are conducted quarterly. The administrator certificate is current. Based on the observation conducted during the present visit, no deficiencies are being cited per Title 22 of the California Code of Regulations. An exit interview was conducted and a copy of this report was provided to a facility representative.