Routine inspection·December 9, 2025

On December 9, 2025, Licensing Program Analyst (LPA) Garlli Tat conducted an unannounced visit to the facility for the purpose of a required annual inspection. LPA explained the purpose for the visit and was greeted and granted entry by Administrator KC. For this visit, there is one staff member on duty, who is background cleared and associated. AD assisted with the inspection. The PUB475 ‘See Something, Say Something’ poster was observed to be located by the front entrance. LPA observed the Administrator's Certificate for Administrator 1 has been renewed on February 6, 2025. The facility is a Residential Care facility for the Elderly (RCFE) licensed for six residents, six of which may be non-ambulatory, six of which may be bedridden, and a hospice waiver for six. LPA toured the interior and exterior portions of the facility with AD. For this visit, there are a total of two non-ambulatory residents in care, none are bedridden, and none are on hospice. The facility is a single story home. There are a total of four bedrooms, one of which is a private resident bedroom, two shared bedrooms, and one bedroom for staff. LPA toured each bedroom with the AD and observed that bedrooms were provided with furniture in good repair, clean linens, adequate storage space, and free of any hazards. LPA observed the staff room is kept locked and inaccessible to residents in care. Smoke and carbon monoxide detectors as well as auditory exit alarms were tested and operational. There are a total of two full bathrooms. Continued on LIC 809-C. Bathrooms were observed to be in good repair, toilets and faucets were operational and showers were equipped with grab bars and non-skid floor mats. Water temperature in the bathrooms were measured to be between 113.0 and 116.7 degrees Fahrenheit. Facility met the minimum two-day perishable and seven-day non-perishable food supplies. Sharp items and knives were locked underneath the sink and inaccessible to residents in care. Fire extinguisher was charged, mounted and located in the garage. Fire extinguisher had a purchase date of May 15, 2025. There is a fire sprinkler system in the kitchen. LPA observed the emergency disaster and evacuation plan, which is posted by the front entrance. LPA observed the facility conducted their last emergency disaster drill on September 18, 2025. Facility had back-up emergency food and water supplies, located in the garage. LPA observed that the First Aid kit had all the required components. Medications were observed to be locked in a medication cabinet in the garage, inaccessible to residents in care. Chemicals were observed to be locked in the garage. LPA observed the door leading to the attached two car garage is kept locked and inaccessible to residents in care. The garage is used for storage and laundry. For the exterior portion, LPA observed patio furniture under shading, and the grounds were free of any hazards or obstructions. There are two exit gates in the backyard that can be opened in case of an emergency. No bodies of water were observed. During this visit, two resident files and three staff files were reviewed. All staff are background cleared and associated with the facility. LPA reviewed residents’ medication and medication records and one resident interview was conducted. Based on today's observations, there are no deficiencies being cited per Title 22 of the California Code of Regulations. An exit interview was conducted with Administrator. This report was reviewed with the Administrator and a copy was provided at the end of the visit.