Routine inspection·June 6, 2025

Licensing Program Analyst (LPA) Celine Rodriguez conducted an unannounced visit to the facility for the purpose of conducting the required annual inspection. LPA Rodriguez explained reason for visit and was greeted and granted entry by staff on duty. For this visit, there are 6 residents in care, of which 3 are on hospice. For this visit, LPA Rodriguez met with house manager (S1) Efrain Matheus. LPA Rodriguez observed the facility administrator (AD) certificate for Hermelinda Perez which expires on 10/30/2026. LPA Rodriguez observed that the PUB475 "See Something, Say Something" poster was posted at the entrance of the facility. The facility has a total of 6 bedrooms, of which all 6 are private resident rooms. LPA Rodriguez toured each bedroom in the facility and observed that bedrooms were provided with furniture in good repair, clean linens, adequate storage space, and kept free of tripping hazards. Facility was observed to have 3 bathrooms, of which 2 are located inside the facility, and 1 outside, however it was verified that the bathroom located outside is not for resident use. Bathrooms were observed to be in good repair, toilets were operational, and grab bars and non-skid floor mats were provided. Smoke and carbon monoxide detector and auditory exit alarms were tested and operational. Hot water was measured at 112.3 degrees Fahrenheit. LPA Rodriguez observed that the facility had a two-day supply of perishables and a seven-day supply of non-perishable food. LPA Rodriguez observed hallways were free of obstructions. For the exterior portion, LPA Rodriguez observed patio furniture under shading, and the grounds were free of any hazards. There is 1 gate in the backyard, which is self-closing and self-latching. LPA Rodriguez observed that there is a body of water located in the backyard, however it is secured by a locked gate. LPA Rodriguez observed that the facility has fire extinguishers that were charged, mounted and located in the kitchen with a maintenance tag dated for 2025. Sharp items, and medications were observed to be locked and inaccessible to residents in care. Cleaning supplies were observed to be locked in the garage and laundry room. LPA Rodriguez observed the Emergency and Disaster Plan posted in the facility binder which is located at the facility entrance, and that the facility has emergency supplies located in the garage. LPA Rodriguez reviewed all six resident files. LPA Rodriguez reviewed staff files, and observed that current staff members are cleared and associated to the facility. For today's visit no deficiencies were issued per Title 22 Division 6 of the California Code of Regulations. No citations were issued. An exit interview was conducted with S1 Matheus. A copy of this report was explained and provided during the visit.