Routine inspection·September 2, 2025

On September 2, 2025, at 12:30pm, Licensing Program Analysts (LPAs) Jenifer Tirre and Eboni Bentley conducted an unannounced required 1-Year annual visit using the CARE Inspection Tool. Upon arrival at the facility, LPAs were greeted and granted entry by Caregiver (CG) Janeth Meza and met with Administrator (AD) Rosa Figueroa and explained the purpose of the visit. The facility is licensed to operate for six (6) non-ambulatory residents and have a hospice waiver for four (4) residents. The building is a single-story structure located in a residential neighborhood. It consists of the following: five (5) resident bedrooms, three (3) bathrooms,, a living room area, dining area, kitchen, an outdoor covered seating area, and an attached two car garage. LPAs Tirre and Bentley toured inside and outside of the physical plant with AD Figueroa. There were no bodies of water or obstructions 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. Bathrooms were found to be clean and operational. The water temperature measured at 106.1 degrees F to 108 degrees F in bathrooms used by residents in care. A comfortable temperature of 74 degrees F was maintained in the facility. LPAs Tirre and Bentley 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. Emergency safety drills was last conducted on April 28, 2025 and conducted quarterly. First aid kit is maintained and contains all the necessary elements. CONTINUED ON 809C During the visit, LPAs Tirre and Bentley observed the facility's all mandated posters were posted. The smoke detectors and carbon monoxide detectors were operable. A working telephone (714-964-6310) remains available, and the facility has a device that can be used for video teleconference purposes. Emergency food, emergency water, and emergency supplies were stored in the garage. The facility has two (2) fire extinguishers that were charged and serviced on July 9, 2025. Liability Insurance is effective 6/26/2025 and expires on 6/26/2026. LPAs Tirre and Bentley conducted an audit of six (6) resident files (R1-R6), five (5) staff files (S1-S5), and medication and medication administration review. LPAs Tirre and Bentley conducted two (2) staff interview and two (2) resident interviews. The following Deficiencies were cited during this visit as per Title 22 Division 6 Chapter 8 of the California Code of Regulations. An exit interview was conducted, LIC 809 D, LIC811, Civil Penalty, a copy of this report and appeal rights were provided to Administrator Rosa Figueroa.