Routine inspection·November 12, 2025

On this day, Licensing Program Analyst (LPA) Kevin Saborit-Guasch made an unannounced visit to the facility to conduct the required annual inspection. LPA was greeted and granted entry by facility caregiving staff after introducing himself and stating the purpose of the visit. Administrator Arnel Mojica was also present on the premises. There is currently one resident in care who is also receiving hospice care at this time. Resident is observed to be sleeping and/or relaxing in their respective bedroom. LPA accompanied by facility staff toured the physical plant. The facility is a one-story house with six private bedrooms, only one of which is observed to be occupied. One additional locked room is assigned for use by overnight staff. There are two full bathrooms for use by the residents along with three half bathrooms on the premises. The current resident is not presently assessed to be bedridden. All occupied and vacant bedrooms appear clean and sanitary. The resident in care uses full rails for postural support, with adequate orders reviewed to be present in the resident's hospice plan of care. All bedrooms have the required furnishings. Bathrooms appear clean and sanitary and are all equipped with grab bars and slip mats. Hot water temperature measured at 118F and 119F at two separate sinks used for personal grooming. LPA observed the kitchen has a minimum two (2) day perishable and seven (7) day non-perishable food supply. Sharp items, cleaning supplies and the medication central storage are verified to be secure. CONTINUED ON FORM LIC809-C CONTINUED FROM FORM LIC809 Wall-mounted fire extinguishers are present and verified to be charged with up-to-date maintenance tags. Carbon monoxide and smoke detectors were found to be present and operational. LPA and facility staff toured the outside of the facility. LPA observed a large shaded outdoor seating area with outdoor furniture for resident use. The two identified routes of egress are free of clutter and obstructions. There are two self-latching gate on the side of the premises. There are no bodies of water on the premises and the facility does not utilize either locked perimeters or delayed egress. Landscaping work is observed to be in progress, however some outdoor space remains accessible for resident use. LPA reviewed records for one resident. Records reviewed include all necessary components. LPA reviewed resident medication records and prescription orders with no discrepancies observed. LPA reviewed staff records for three staff members during the visit. Proof of current CPR training reviewed. Disaster drills are conducted in a timely manner. All staff members scheduled are verified to be background cleared and associated to the licensed location. The administrator certificate is current. Based on the observations conducted during the present visit, no deficiencies are being cited per Title 22 of the California Code of Regulations. An exit interview was conducted and a copy of this report was provided to a facility representative.