Routine inspection·June 27, 2025

Licensing Program Analyst (LPA) William Vanegas conducted an unannounced visit for the purposes of conducting an annual inspection. Upon arrival LPA Vanegas was greeted and granted entry to the facility by Facility Manager (FM) Mylene Baldazo. LPA Vanegas explained the purposes of the visit and began a tour of the facility. LPA Vanegas observed the following. This is a one storied home with four bedrooms three of which are resident rooms, and one of which is a staff room. There is one and a half bathrooms that are both shared. There is a large backyard big enough to participate in outdoor activities upon resident request. LPA Vanegas observed kitchen area to be clean and free of any mildew or debris. LPA Vanegas observed there to be a gas stove, microwave, refrigerator, washer, and dryer all appeared to be in good repair and tested operational. LPA Vanegas observed there to be a seven day supply of non perishable food, and two day supply of perishable food, and a sufficient amount of emergency water on hand for residents in care. LPA Vanegas observed resident restrooms to be clean and free of any mildew or debris. LPA Vanegas observed restrooms to have all required furnishings such as slip resistant floor matts, grab bars, and a shower chair. LPA Vanegas observed water faucets, and toilets to be operational. Restroom water tested between 117.0 and 118.9 degrees. LPA Vanegas observed all resident rooms to have all required furnishings such as beds, clean linens in good repair; meaning no strains or tares, chest drawer, a reading lamp, and enough storage for personal items. CONTINUED ON LIC809C LPA Vanegas observed all fire extinguishers to be fully charged and up to date, LPA Vanegas observed all smoke and carbon monoxide detectors to be in good repair, and tested operational. LPA Vanegas observed first aid kit to have all required items such as adhesive tape, bandages, first aid manual, tweezers, scissors, and a thermometer. LPA Vanegas observed the outside of the facility to have a large backyard, and for there to be no obstructions along the exit routes. LPA Vanegas observed there to be an outdoor shaded seating area, and for the side gates to be self latching and unlocked. Backyard is large enough to participate in outdoor activities upon resident request. LPA Vanegas reviewed 6 resident records, and 4 staff records. All records (Staff and Resident) had all required documents. LPA Vanegas reviewed medications with FM Mylene Baldazo. Per LPA Vanegas review all medications are being documented correctly, and being administered per physicians orders. Based on observations made during today's inspection. No deficiencies will be cited per title 22 chapter 8 division 6 of the California Code of Regulations. An exit interview was conducted with FM Mylene Baldazo, and a copy of this report was provided to the facility.