Routine inspection·October 13, 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 Ryan Fisk was notified and arrived shortly afterwards to assist. There are currently six residents in care, three of which are receiving hospice care at this time. 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 six private bedrooms. There are five shared bathrooms used by residents, three of which are en-suite. None of the residents are bedridden at this time. All occupied bedrooms appear clean and sanitary. Two residents use half-length rails for postural support and one has full rails. Adequate physician orders and hospice plans of care reviewed and on file. 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 113F and 115F 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. Emergency food is present in the pantry and emergency water supplies are stored in the garage. 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. The identified route of egress is free of clutter and obstructions. There are one 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. LPA reviewed six resident records which included all necessary components. LPA reviewed resident medication records and prescription orders with no discrepancies observed. LPA reviewed staff records for four 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, 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.