Routine inspection·July 21, 2025

Licensing Program Analyst (LPA) Joseph Alejandre made an unannounced visit to conduct the required annual inspection. LPA was greeted by staff and granted entry. LPA met with Administrator Hannah Pichon and explained the reason for the visit. Hannah Pichon's Administrator's Certificate expires on December 18, 2026. Facility is licensed for 6 non-ambulatory residents of which 6 can be bedridden and a hospice waiver for 3. LPA and staff toured the facility. LPA observed all six 6 resident rooms have the required furnishings. LPA observed clean linens stored in the hall closet. LPA observed all 5 bathrooms are clean and operational. Hot water measured 120.0 degrees Fahrenheit in both (2) shared bathrooms. Medications are kept locked in the hall closet. LPA observed medication for all 6 residents, for July 21 and July 22 (AM medications only) stored in plastic cups, staff reported that the medication stored in the plastic cups are going to be administered later today and tomorrow morning July 22, 2025. LPA observed medications (for all 6 residents) for July 23 and the rest of July are stored in their original containers. LPA inspected the first aid kit. The First aid kit has all the required elements. LPA observed a 2 day perishable and a 7 day non-perishable food supply on hand in the kitchen. LPA observed knives are kept locked under the kitchen sink. The 4 burner gas stove lights unassisted. There is no record of a recent emergency drill being conducted in the last 4 months. Smoke detectors/carbon monoxide detectors tested operational except for the smoke detector/carbon monoxide detector in the hallway between bedroom 5 and bedroom 6. LPA observed the garage is used for storage of cleaning supplies and old furniture. LPA observed the lock on the garage door knob is not operational. LPA observed and staff verified there is no 3 day emergency food and water supply at the facility. LPA and staff toured the backyard. No bodies of water observed. There is a covered patio with a shaded seating area for residents to sit outside. Both exit gates are operational and self closing. LPA reviewed 6 resident files, no discrepancies observed. LPA reviewed 6 resident medications, no discrepancies observed. LPA reviewed 2 staff files. LPA observed Staff 2 (S2) did not have any annual training covering, hospice care, postural supports and restricted health conditions. No obstacles or hazards observed inside or outside of the facility. Deficiencies are being cited (see LIC809Ds) per Title 22, Division 6 of the California Code of Regulations. Civil penalties assessed, see LIC421IM and LIC421FC. An exit interview was conducted and a copy of the report was provided along with appeal rights.