Routine inspection·August 11, 2025

On August 11, 2025, at 12:30PM, Licensing Program Analyst (LPA) Edward Kim conducted an unannounced required 1-Year annual visit using the CARE Inspection Tool. Upon arrival at the facility, LPA Kim met with Administrator Nicolae Gavrilas and explained the purpose of the visit. The facility is licensed to operate for four (4) non-ambulatory of which one (1) may be bedridden and have a hospice waiver for two (2) residents. The facility is a single-story building located in a residential neighborhood. It consists of the following: three (3) resident bedrooms, two (2) bathrooms, living area, dining area, kitchen, attached 2-car garage, and an outside covered patio area.` LPA Kim toured the indoor and outdoor of the physical plant with Caregiver Marioara Gavrilas. There are no obstructions or bodies of water on the premises. All rooms were inspected. Beds and bedding supplies were in good condition, adequate lighting was provided, storage for each resident’s personal belongings was observed. Bed linens, comforters, and bath towels were adequately stocked at the time of visit. All bedrooms were inspected: Resident Room 1, Resident Room 2, and Resident Room 3. Bathrooms were found to be within Title 22 regulations and were clean and operational. The water temperature measured between 115.3 degrees F and 115.7 degrees Fahrenheit. A comfortable temperature of 78 degrees F was maintained in the facility. LPA Kim observed the facility to be sanitary and appropriately furnished at the time of visit. Storage areas for personal hygiene, cleaning supplies, toxins, and sharps objects were stored and not accessible to residents. The kitchen was inspected and there is a two-day supply of perishable and seven-day supply of non-perishable food available and maintained properly. Evaluation Report Continues on LIC 809-C During the visit, LPA Kim observed the facility's infection control practices, plan of operation, and screening protocols for visitors, staff, and residents. LPA observed the facility has a 30-day supply of Personal Protective Equipment (PPE). LPA observed two of the four burners on the gas stove did not light unassisted. Emergency food, water, and supplies are stored in the garage. The facility has one (1) fire extinguisher that is charged, and smoke/carbon monoxide detectors that were operable. A working telephone (714-777-7030) remains available. First Aid Kit contained all the necessary elements. LPA conducted an audit of resident files (R1-R3), staff files (S1-S3), and medication and medication administration review that were all in order and complete. LPA Kim conducted interviews with 2 residents and 2 staff. Based on today’s visit, a deficiency was cited per Title 22 Division 6 Chapter 8 of California Code of Regulations (CCR). LPA observed two out of four burners on the gas stove did not light up unassisted. An exit interview was conducted, and a copy of this report and appeal rights were provided to Administrator Nicolae Gavrilas.