Routine inspection (multi-day)·October 9, 2025

On October 9, 2025, Licensing Program Analyst (LPA) Eboni Bentley arrived at the facility for an unannounced, subsequent annual continuation visit. Upon arrival at the facility, LPA Bentley was greeted and granted entry into the facility by Administrator (AD), Shirley Lomeda and explained the purpose of the visit. During the inspection, LPA Bentley toured the physical plant and the following was observed: All resident bedrooms had the necessary elements and were in compliance with regulation guidelines. Resident bath towels, toiletries and personal hygiene supplies were adequately stocked at time of visit. Resident and staff bathrooms were clean and organized. Hot water temperatures were measured in the range of 117.3 degrees Fahrenheit and 118.4 degrees Fahrenheit. All grab bars were tightly secured to the wall. Kitchen was inspected. Perishable and non-perishable food supply was observed. All appliances were observed working and operational. A perishable food supply that meets regulation requirements was observed in the refrigerator and a non-perishable food supply observed in the cabinets. During the tour, the garage was observed with three beds used for staff sleeping. LPA observed a emergency disaster kit with expired cans of non-perishable food items for residents and staff. There was a limited supply of emergency water available. The backyard was clean and organized, however, the walkway leading to the exit side gate had a drainage pipe leaking water in its path. A shaded patio area with a table and chairs was observed with no hazards. There is a shed that is used to store miscellaneous facility items no longer being used, including walkers, a bed frame mattress and other items. Continue to LIC809-C..... During the initial visit, a staff record review was completed for 4 staff members including Administrator Lomeda, 6 of 6 resident medications, and all 6 resident files were also reviewed. Record review revealed, five out of six resident (R1-R5) have Needs & Services appraisal that have not been updated within the past 12 months. LPA also noted five out of six residents (R1-R5) do not have physician's reports documented within the past 12 months. Three out of the five residents (R1, R4, & R5) have a diagnosis of Dementia. LPA observed smoke detectors/carbon monoxide in common areas and bedrooms are operational. First aid kits had all the required elements including tweezers, thermometer, scissors, and manual. A working telephone (714-886-2061) remains available, and the facility has a device that can be used for video teleconference purposes. The facility has two (2) fire extinguisher that was charged and last serviced on September 19, 2025. Liability Insurance is effective July 26, 2025 through July 26, 2026. Based on the observations made during today’s visit, deficiencies is being cited per Title 22 Division 6 of the California Code of Regulations. An exit interview was conducted, and a copy of this report, LIC809-D, LIC811 and appeal rights were provided to Administrator Shirley Lomeda at the end of the visit.