Routine inspection·April 15, 2026

Licensing Program Analyst (LPA) Rose Ruppert made an unannounced visit to conduct an Annual Required Evaluation. LPA was greeted and granted entry by Staff #1 (S1) at 8am LPA met with House Manager Miriam Esquivel and explained the purpose of the visit. The facility is a four bedroom, three bathroom single story residence in which one bedroom and one bathroom is used by live-in staff. The facility has an approved fire clearance of four ambulatory; of which two are approved for hospice. The facility currently has a census of four residents in care and none receive hospice services. During the visit LPA toured the kitchen and all appliances were in working order. The refrigerator had two-days of perishable items and seven-days of non-perishable food on-hand. Emergency water and supplies were observed in the garage with the washer and dryer. Sharps and knives were secured in a locked toolbox and cleaning supplies were stored in a locked storage closet. The facility was clean and there were no odors detected. LPA observed resident rooms had all of the required furnishings and were clean. LPA measured the hot water temperature in two of two resident bathrooms and hot water measured between 107.0-108.5 degrees Fahrenheit. All bathrooms had non-skid mats and grab bars. The smoke and carbon monoxide detectors were inspected and detectors were operational. The fire extinguisher was charged and inspected on April 1, 2026. The facility's last fire drill was documented on March 12, 2026 on the fire log. LPA requested the Emergency Disaster Plan which was not posted. A Technical Violation will be given for LIC 610E to be posted and updated. (Continued on LIC 809-C) (Continued from LIC 809) LPA toured the exterior of the facility and there is ample space for activities and a shaded seating area was observed. There were no obstructions in pathways. A patio screen needed repair and a work order has been requested to repair the patio screen. Cameras are outdoors and in main living room facing front door. Audio is disabled at this time. LPA observed medication storage and reviewed the centrally stored medications. Per review medications are being given as prescribed. The facility has a First Aid Kit with the required elements and a First Aid Manual. LPA confirmed the facility has current liability insurance and surety bond. LPA reviewed three of three staff training and fingerprint records and conducted a complete review of resident records. Resident P&I records were reviewed and were accurate . LPA interviewed alert residents regarding their quality of care and spoke to staff present regarding care provided. LPA confirmed that administrator has a current administrator certificate which expires on May 9, 2026. Based on the observations made during today’s visit, the facility appears to be in compliance with Title 22 Division 6 of the California Code of Regulations, no deficiencies cited on this date. A Technical Violation was provided for the Emergency Disaster Plan (LIC 610E) to be reviewed and updated. A fact sheet of Legionnaire's Disease was also left with the facility for review, An exit interview was conducted with Miriam Esquivel, House Manager and a copy of the report, LIC 9102-TV and files reviewed (LIC 858 & LIC 859), were given at the time of the visit.