Routine inspection·April 16, 2026

Licensing Program Analyst (LPA) Nancy Guillen made an unannounced visit for the purpose of conducting a required annual Inspection. LPA was greeted and granted entry by care provider Renato Galdones after explaining the purpose of the visit. LPA observed the administrator certificate was current with an expiration date of June 16, 2026. This is a Residential Care Facility for the Elderly (RCFE) licensed to six non-ambulatory residents and an approved hospice waiver for four. The facility is a one-story home with five resident bedrooms, one staff bedroom, three restrooms, a living room, dining room, kitchen and two car garage. During the inspection, LPA and staff conducted a tour of the inside and outside of the facility, common areas, resident rooms, garage and observed the following: LPA observed five resident in care and two staff present. LPA observed the See Something Say Something Poster (PUB 475) mounted on the wall in the living room. LPA observed that all resident bedrooms had the required furnishings. LPA observed all resident beds had linens and blankets with additional linens stored in the garage. LPA observed bathrooms were clean and equipped with grab bars, toilet paper, paper towels, and non-skid floor mats. Bathrooms were observed to be free of debris and mildew. Faucets and toilets were tested operational. Water temperature tested between 115 and 119.1 degrees Fahrenheit. LPA observed all windows were appropriately screened. LPA toured the outside of the facility and observed outdoor passageways were free of obstruction. LPA observed the backyard had a shaded sitting area with furniture for resident use. Continued on LIC 809C LPA observed the facility had a 2-day supply of perishables and a 7-day supply of non-perishable food as required by regulations. Gas stove, dish washer, microwave, washer and dryer were inspected and observed to be operable. Smoke detectors and carbon monoxide detectors tested operational. Fire extinguisher was observed to be fully charged with a service date of February 2026 and is located in the kitchen, staff room, and garage. Toxic chemicals, cleaning solutions, and disinfectants were observed to be locked and inaccessible to residents under the kitchen sink. Medication cabinet was observed to be locked and centrally stored in a dining room cabinet. LPA observed the First Aid Kit had all the required components. LPA observed the facility conducted their last emergency disaster drill on March 17, 2026. LPA began review of the records. LPA reviewed five resident records. All the required documentation was present and current in the residents files reviewed except for a signed copy of the Personal Rights of Residents form which was not signed by R1. LPA reviewed two employee records. All employees present have a criminal record clearance and were associated to the facility. LPA observed records reviewed have a current First Aid certificate. Upon record review LPA observed the Emergency Disaster Plan was not updated or reviewed since August 14, 2020; a deficiency was cited on today’s date. Facility was unable to provide proof of liability insurance; a deficiency was cited on today’s date. Based on the observations made during today’s inspection, deficiencies are being cited per Title 22 Division 6 of the California Code of Regulations. An exit interview was conducted, and a copy of this report, LIC 809C, LIC 809D, LIC 858, LIC 859, LIC 9102, Appeal Rights and the Legionnaire’s Disease fact sheet was left at the facility.