Routine inspection·August 19, 2025

Licensing Program Analyst (LPA) Hanna Gough arrived at the facility to conduct the required annual inspection. LPA was greeted and granted entry by staff. LPA met with Assistant Administrator Kian Pascual and discussed the purpose of the visit. The facility currently has six residents in care. The facility is a one story home with six resident bedrooms, one staff bedroom, four bathrooms, kitchen, living room, sitting room, dining room, and attached two car garage. Facility appears clean, safe and sanitary. LPA observed the kitchen to be free of vermin. LPA observed a two day perishable and seven day non-perishable food supply on hand. LPA observed the knives to be locked in a drawer made inaccessible to residents in care. LPA observed toxins and chemicals to be under the kitchen sink in a locked cabinet. LPA observed The centrally stored medication to be in a locked cabinet in the dining room, making them inaccessible to residents in care. LPA observed all resident bedrooms had the required components and furnishings. LPA observed the bathrooms to be stocked with toilet paper, paper towels, non-slip mats and flooring. LPA observed the water temperature in the bathrooms to be between 114-118.4 degrees Fahrenheit. LPA observed a clean supply of extra linens to be stored in the hall cabinet. LPA observed fire extinguishers throughout the facility to be charged and with a service date of April 21, 2025. LPA observed the garage to have extra refrigerators and freezers for food storage. LPA observed chemicals stored in the garage to be locked in a cabinet. LPA observed the emergency food and water supply to be stored in the garage. LPA observed the backyard to have shaded seating for resident use and is free of debris and obstructions. Continue on LIC 809-C LPA reviewed staff files and no discrepancies were observed. LPA reviewed resident files and 2 of 6 residents do not have TB tests on files. LPA observed 1 of 6 residents did not have a needs and services plan. LPA observed the centrally stored medication and 1 of 6 residents do not have prescriptions for 2 over the counter medications on file. LPA observed the last fire drill was conducted on June 3, 2025. LPA and staff tested the fire alarms and smoke detectors and they were found to be operational. All staff present are background cleared and associated to the facility. Based on today’s observations two citations and a technical violation are being given per Title 22 Division 6 of the California Code of Regulations. An exit interview was conducted with Assistant Administrator Kian Pascual and a copy of this report along with LIC809D, LIC858, technical violation, and appeal rights were left at the facility.