Routine inspection·January 12, 2026

On January 12, 2026, Licensing Program Analyst (LPA) Eboni Bentley conducted an unannounced required 1-Year annual visit using the CARE Inspection Tool. Upon arrival at the facility, LPA Bentley introduced self and was granted entry into the facility by staff, after stating the purpose of the visit. Licensee (LI) Mai Nguyen was contacted via telephone and granted permission of Caregiver Tuyet Nguyen to sign the facility report in her absence. The facility is licensed to operate for six (6) non-ambulatory residents, with a Hospice waiver for two (2) residents. The building is a single-story home located in a residential neighborhood. It consists of the following: five (5) resident bedrooms, two (2) bathrooms, living room area, dining area, kitchen, an outdoor covered seating areas, and an attached two car garage. During the visit, LPA toured inside and outside of the physical plant with staff and spoke with LI via telephone. There were no bodies of water or obstructions on the premises. All rooms were inspected. Beds and bedding supplies were in good condition, storage for each resident’s personal belongings was observed. Bed linens, comforters, and bath towels were adequately stocked at the time of visit. A comfortable temperature of 70 degrees F was maintained in the facility. Bathrooms were found to be clean and operational; however, the water temperature in two resident bathrooms measured between 131.2 degrees F and 139.1 degrees F. The kitchen was inspected and LPA observed four non-operational range burners on the stove, used for preparing meals for residents in care. Deficiencies were being cited. Continues on LIC 809-C ... The smoke detectors and carbon monoxide detectors were operable. First aid kit is maintained and contains all the necessary elements. Emergency safety drills were last conducted on October 12, 2025. The facility has one (1) fire extinguisher that was charged and purchased on January 12, 2026. Current Liability Insurance was provided during the visit with a policy start date of June 17, 2025, through June 17, 2026. A working telephone (714)274-9802 remains available. No emergency food, emergency water, or emergency supplies were observed. A deficiency was cited. The facility does not currently have a device that can be used for video teleconference purposes. LPA provided Technical Assistance. LPA conducted an audit of five (5) resident files (R1-R5), three (3) staff files (S1-S), and medication and medication administration review. Resident and staff interviews were conducted. Based on record review, the facility currently has one bedridden Resident #1 (R1) with a fire clearance for six (6) non-ambulatory only residents. A deficiency was cited during this visit, as per Title 22 Division 6 Chapter 8 of the California Code of Regulations. An exit interview was conducted, and a copy of this report, LIC809-D, Technical Assistance, and appeal rights were provided to staff at exit.