Routine inspection·April 1, 2026

Licensing Program Analyst (LPA) Jessica Cho arrived at the facility unannounced for the purpose of conducting the Required 1-Year annual evaluation using the CARE Inspection Tool. LPA was greeted and granted entry by Caregiver Esmeralda Flores Quijada after introducing and stating the reason for the visit. Administrator (Admin) Rebekah Buboi arrived on premise. Admin does not have a valid administrator's certificate and registered course work on today's date. The following was observed during the inspection: This is a two story property comprised of five resident bedrooms and two resident bathrooms. The second second floor is occupied by the licensee's family member which residents do not have access to. Facility is operating within the conditions and limitations specified on the license. LPA observed one staff on duty as the second individual was out grocery shopping. LPA observed six residents in care, one of which is receiving hospice service. LPA toured the interior portion of the facility. The facility is clean and in good repair. All common areas were inspected including the attached two car garage. LPA inspected all resident bedrooms. The resident bedrooms' were appropriately furnished, beds and bedding supplies were in good condition, adequate lighting was provided, and sufficient storage space for each residents' personal belongings were observed. All bathrooms were found be in compliance, clean, and operational. Slip resistant mats were available. The hot water temperature in the bathrooms measured at 120.0 and 116.7 degrees Fahrenheit. Toxins, disinfectants, sharps, and medications were secured and inaccessible. LPA observed sufficient two-day supply of perishables and seven-day supply of non-perishable food. LPA toured the exterior portion of the facility. The outdoor passageway is free of obstruction. The exit gates are operational, and there were sufficient seating and shading in the patio area. There are no bodies of water on premise. The fire extinguisher was mounted, charged, and purchased on April 1, 2026. The auditory devices and dual functioning smoke/carbon monoxide detectors were tested and operational. Facility maintains emergency food but insufficient water. Complaint Poster, 'See Something, Say Something,' (PUB 475) was available and posted in the correct size. LPA reviewed one personnel file in which no discrepancies were found. LPA reviewed six of six resident files in which discrepancies were found as there were no current needs and services plan for all residents. Medications were audited for two of six residents. A discrepancy was found as one medication for one resident was not administered timely according to the physician's order. Present staff is background cleared however is not associated to the facility. Staff training is completed per Admin but there were no documentation to verify training was completed. Disaster drills are conducted quarterly as last known drill per log was conducted on March 28, 2026. LPA consulted on the following: to ensure that the resident/personnel files including training documentation are maintained and organized to prevent future delays, to maintain a current and accurate medication list, to ensure medications are administered according to the physician's directions, to ensure staff are associated to the facility prior to working or volunteering, to obtain disaster supplies noted on the Emergency Disaster Plan (LIC610E), and to complete the administrator's courses as soon as possible. Based on the observations made during today's visit, deficiencies are being cited and civil penalty is issued. Technical Violations are also being issued. An exit interview was conducted with Administrator Rebekah Buboi, and a copy of this report including the appeal rights were provided at exit.