Routine inspection·February 12, 2025

Licensing Program Analyst (LPA) Alvaro Ramirez, Jr. conducted an unannounced visit for the Required 1 Year Inspection. LPA explained the purpose of today’s visit, and was greeted and granted entry by Caregiver Arthur Aguas. Administrator (AD) Juan Diaz arrived shortly after. For today’s visit, LPA observed a total of four residents in care and two staff members on duty. LPA observed the Administrator's Certificate for facility AD Juan Diaz which expires on May 24, 2026. LPA Ramirez toured the interior and exterior portions of the facility with AD Diaz. The facility is a single level structure and is licensed for six non-ambulatory residents, of which two may be on hospice and zero bedridden. There are a total of four bedrooms, of which four are resident bedrooms. LPA Ramirez toured each bedroom in the facility and observed that bedrooms were provided with furniture in good repair, clean linens, adequate storage space, and kept free of tripping hazards. Smoke and carbon monoxide detector and auditory exit alarms were tested and operational. There are a total of two restrooms of which one is for staff and one is for residents. Restrooms were observed to be in good repair, toilets were operational, and grab bars and non-skid floor mats were provided. Water temperature tested between 109.5-113.5 degrees Fahrenheit. Facility met the minimum two-day perishable and seven-day non-perishable food supplies. Sharp items and knives were locked and inaccessible to residents in care. Knives are locked in a kitchen cabinet. Fire extinguisher was charged, mounted and located by the kitchen. CONTINUED ON LIC809-C.. LPA Ramirez observed the emergency disaster and evacuation plan, which is posted by the entrance hallway. LPA observed that the First Aid Kit had all the required components. LPA observed that medications and toxins were locked and inaccessible to residents in care. The medications are locked in a cabinet by the dining room. For the exterior portion, LPA Ramirez observed patio furniture, and the grounds were free of any hazards. There is one gate in the backyard, which is both self-closing and self-latching. No bodies of water were observed. LPA reviewed four resident files and three staff files. LPA observed that one of four resident files did not have a pre-admission appraisal; a Deficiency was issued today. LPA interviewed residents and staff present. For today's visit one deficiency was issued per Title 22 Division 6 of the California Code of Regulations. An exit interview was conducted with AD Diaz. A copy of this report and Appeal Rights were provided at the time of exit.