Routine inspection·July 21, 2025

On July 21, 2025, Licensing Program Analyst (LPA) Brandon Lopez made an unannounced visit to the facility to conduct the required annual inspection. LPA was greeted and granted entry into the facility by care giving staff after explaining the purpose for the visit. Administrator (AD) Saba Tesfay was notified via telephone and later arrived to assist with today's inspection. LPA observed that Saba Tesfay submitted an Administrator renewal application to the Administrator Certification Bureau (ACB) on May 6, 2025. The facility is a Residential Care Facility for the Elderly (RCFE) licensed for six residents, of which five can be non-ambulatory and one can be bedridden, and has a hospice waiver for three. The facility is a single story home with five resident bedrooms, one of which is shared, one staff bedroom, three bathrooms, a living room, a dining room, a kitchen, a laundry room, and an attached two car garage. LPA, accompanied by the AD, conducted a tour of the interior portions of the facility. On today's visit, LPA observed five resident in care and two care giving staff present. LPA observed residents relaxing in the living room and in their respective bedrooms. LPA inspected all five resident bedrooms and observed them to be free of hazards. LPA observed resident bedrooms to have the required furnishings of a bed, a chair, a chest of drawers, and a lamp. LPA observed resident beds to have clean linens and blankets. LPA observed additional linens to be stored in a hallway closet. LPA inspected the two shared resident bathrooms and observed them to be clean. Bathrooms were equipped with grab bars and non-skid floor mats. Faucets and toilets were operational. Hot water temperature measured between 117.1 and 118.2 degrees Fahrenheit. LPA observed the staff bedroom to be kept locked and inaccessible to residents in care. LPA observed the facility has a two day perishable and a seven day non-perishable food supply on hand in the kitchen. CONTINUED ON 809-C LPA observed kitchen appliances to be clean and operational. LPA observed kitchen knives and sharps to be stored in a locked kitchen cabinet. LPA observed chemicals and toxins to be stored in a locked kitchen cabinet under the sink. LPA observed fire extinguishers to be mounted on the wall in the kitchen and in the resident hallway. Fire extinguishers were observed to be charged and up to date on service. LPA tested the wired smoke detectors/carbon monoxide detectors which tested operational. LPA observed the facility conducted their last emergency disaster drill on June 10, 2025. LPA observed the centrally stored medication to be kept in a locked cabinet located in the kitchen. LPA observed the facility has a First Aid Kit stored in a kitchen cabinet and it had all the required components. LPA observed a fire place in the dining room and it was observed to be adequately fenced and not in operation at time of visit. LPA observed the door leading to the laundry room to be kept locked and inaccessible to residents in care. LPA observed chemicals and toxins to be stored in the laundry room. LPA observed the door leading to the attached two car garage to be kept locked and inaccessible to residents in care. LPA observed the garage to be used for storage. LPA observed the facility has a three day emergency food and water supply stored in the garage. LPA, accompanied by the AD, conducted a tour of the exterior portion of the facility. The exterior portion was observed to be free of hazards and obstructions. LPA observed a shaded outdoor seating area with furniture for resident use. LPA observed the perimeter gate of the facility to be self latching and can be opened in an evacuation. There are no bodies of water on the premises. LPA reviewed all six resident files. All the required documentation were present and current in the resident file reviewed. LPA reviewed the residents' medication and medication records. LPA reviewed two staff files. All staff are background cleared and associated to the facility. Based on the observations made during today's visit, no deficiencies are being cited per the Title 22 of the California Code of Regulations. An exit interview was conducted with Administrator Saba Tesfay and a copy of the report was provided.