Routine inspection·January 15, 2026

On this day, Licensing Program Analyst (LPA) Kevin Saborit-Guasch made an unannounced visit to the facility to conduct the required annual inspection. LPA was greeted and granted entry by facility administrator Faith Rasouli after stating the purpose of the visit. There are currently six residents in care, none of which are receiving hospice care at this time. Residents are observed relaxing in their respective bedrooms and in the common areas. LPA accompanied by facility staff toured the physical plant. The facility is a one-story house with six private bedrooms used by residents and one locked staff room. There are two bathrooms used by residents, including one en-suite bathroom located in one of the rooms. None of the residents are assessed to be bedridden at this time. Physician orders for residents using postural supports verified to be on file. One resident currently admitted to skilled nursing is noted to have full rails despite not receiving hospice care. Consultation provided. All occupied bedrooms appear clean and sanitary. All resident bedrooms have the required furnishings. Bathrooms appear clean and sanitary and are all equipped with grab bars and slip mats. Hot water temperature measured at 108.4F in the shared bathroom with faucets used for personal grooming by residents. LPA observed the kitchen has a minimum two (2) day perishable and seven (7) day non-perishable food supply. Sharp items, cleaning supplies and the medication central storage are verified to be secure. Two wall-mounted fire extinguishers are present and verified to be charged. Receipts for purchase are dated December 31, 2025. Carbon monoxide and smoke detectors are present and operational. CONTINUED ON FORM LIC809-C CONTINUED FROM FORM LIC809 LPA and facility staff toured the outside of the facility. LPA observed a shaded outdoor seating area with outdoor furniture for resident use in the backyard. There are no bodies of water on the premises. The identified routes of egress are free of clutter and obstructions. There are self-latching gates on both sides of the premises. The facility does not utilize either locked perimeters or delayed egress. LPA reviewed six resident records which were found to include all necessary elements of documentation. LPA reviewed resident medication records and prescription orders with no discrepancies observed for all six residents. However, the physician report for one of the residents diagnosed with insulin-dependent diabetes indicates the resident is assessed to be unable to manage their injections or glucose monitoring in spite of being fully alert with no indications of mild cognitive impairment. One type B deficiency issued. Clarification provided on the updated requirement for an annual medical assessment for residents. LPA reviewed staff records for six staff members during the visit. All staff members on the schedule are background cleared and associated. Proof of current CPR training reviewed. Annual and initial training reviewed. Disaster drills are conducted quarterly. The administrator certificate is current. Based on the observations conducted during the present visit, one type B deficiency is being cited per Title 22 of the California Code of Regulations. An exit interview was conducted and a copy of this report along with appeal rights were provided to a facility representative.