Routine inspection·November 24, 2025

On November 24, 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 (AD), Ngoc Mai. For this visit, there are two staff members on duty, including the AD, both of which are background cleared and associated. The PUB475 ‘See Something, Say Something’ poster was observed to be located in the hallway. LPA observed the Administrator's Certificate for Ngoc Mai, which expires on July 11, 2027. The facility is a Residential Care facility for the Elderly (RCFE) licensed for six residents, six of which may be non-ambulatory, two of which may be bedridden, and a hospice waiver for six. LPA toured the interior and exterior portions of the facility with the AD. For this visit, there are a total of two non-ambulatory and three ambulatory residents in care, one is on hospice, and none are bedridden. The facility is a single story home. There are a total of six bedrooms, five of which are resident bedrooms, and one bedroom is for staff. LPA toured each bedroom with the AD and observed that bedrooms were provided with furniture in good repair, clean linens, and adequate storage space. 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 bathrooms for both staff and residents. 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 112.6 degrees Fahrenheit. Facility met the minimum two-day perishable and seven-day non-perishable food supplies. Sharp items and knives were locked in the kitchen cabinet and inaccessible to residents in care. Fire extinguisher was charged, mounted and located in the kitchen. Fire extinguisher had a purchase date of June 1, 2025. LPA observed the emergency disaster and evacuation plan, which is in a binder in the office. Facility had back-up emergency food and water supply, located in the garage. LPA observed that the First Aid kit had all the required components. Medications were observed to be locked in a cabinet in the kitchen, inaccessible to residents in care. Chemicals were observed to be locked underneath the kitchen sink and 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 there are two exit gate in the backyard that can be opened in case of an emergency. There is a shed in the backyard which is locked and used for storage. No bodies of water were observed. During this visit, five resident files and two staff files were reviewed. All staff are background cleared and associated with the facility. LPA reviewed residents’ medication and medication records. Based on today's observations, there are deficiencies being cited per Title 22 of the California Code of Regulations. There is also a Technical Violation being issued during this visit. An exit interview was conducted with Ngoc Mai. This report was reviewed with the administrator and a copy was provided at the end of the visit. Appeal Rights were reviewed.