Routine inspection·November 14, 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 Dianna Manalo was notified and arrived later to assist. There are currently four residents in care, none of which are receiving hospice care at this time. One resident was admitted in the hospital on November 9, 2025 and is therefore not present on the premises. Residents are observed relaxing in the facility's common areas or in their respective bedrooms. LPA accompanied by facility staff toured the physical plant. The facility is a one-story house with four private and one shared bedrooms. There are two bathrooms used by residents, one of which is en-suite. None of the residents are bedridden at this time. All occupied bedrooms appear clean and sanitary. One resident uses half-length rails for postural support. Adequate physician orders reviewed. All resident 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 106F and 107F 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. Two 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. Emergency food is present in the pantry and emergency water supplies are stored in the garage. CONTINUED ON FORM LIC809-C CONTINUED FROM FORM LIC809 LPA and facility staff toured the outside of the facility. LPA observed multiple shaded outdoor seating areas with outdoor furniture for resident use around the property in addition to a shed which is used for storage. The identified route of egress is free of clutter and obstructions. There is one self-latching gate on the side of the premises. There is a fenced fountain on the premises. All residents but one clearly show no risk related to the water feature in their assessment. Consultation provided on the updated medical assessment form LIC602A. The facility does not utilize either locked perimeters or delayed egress. LPA reviewed four resident records. Multiple admission agreements reviewed are missing the facility representative signature. Consultation provided. Two residents are using glucose monitoring systems and insulin injections in spite of having physician reports stating they are unable to self-monitor their glucose levels and/or to self-inject insulin. Type B deficiency cited. 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 quarterly. All staff members scheduled are verified to be background cleared and associated to the licensed location. The administrator certificate is current. Based on the observation conducted during the present visit, one type B deficiency is being cited per Title 22 of the California Code of Regulations. An exit interview was conducted and a copy of this report along with appeal rights were provided to a facility representative.