Routine inspection·December 30, 2025

On December 30, 2025, Licensing Program Analyst (LPA) Eboni Bentley conducted an unannounced required 1-Year annual visit. LPA was greeted and granted entry after stating the purpose of the visit to Licensee/Administrator (LI) Consolacion Lumauig. The facility is licensed to operate for six (6) non-ambulatory residents and has a hospice waiver for four (4) residents. The facility is a single-story building located in a residential neighborhood. It consists of the following: six (6) resident bedrooms, two (2) resident bathrooms, one (1) staff bedroom, one (1) staff bathroom, two living room areas, dining area, kitchen, an outdoor covered seating area, and detached two car garage. LPA conducted a tour inside and outside of the physical plant with LI and requested copies of facility documents including: Resident Roster, Staff Roster, Staff Schedule, Resident Emergency Contact Forms, Physician’s Reports, Hospice/Home Health records, and Service Plans for residents. During the visit, LPA Bentley observed a comfortable temperature of 75 degrees F was maintained in the facility. The smoke detectors and carbon monoxide detectors were operable. The facility has one (1) fire extinguisher that was charged, mounted, and purchased on December 30, 2025. First aid kit is maintained and contains all the necessary elements. 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. CONTINUE TO LIC809-C.... Based on observations, interviews and record reviews LPA observed Physician’s Report for R1, indicating resident is Bedridden and the facility does not have an approved fire clearance for Bedridden residents. A deficiency is being cited during this visit as per Title 22 Division 6 Chapter 8 of the California Code of Regulations. CIVIL PENALTY ASSESSED. Due to to time constraints, LPA will address the following during the continuation annual visit: · Fire clearance for Bedridden · Medication and MAR · Food Storage · Staff Records · Resident Records LPA informed LI that subsequent visit will be conducted and additional deficiencies may be cited. LI stated they understood. An exit interview was conducted with Licensee/Administrator (LI) Consolacion Lumauig and a copy of this report, LIC809-D, and LIC421 were provided at the end of the visit.