Routine inspection·November 25, 2025

On November 25, 2025, Licensing Program Analyst (LPA) Eboni Bentley conducted an unannounced required 1-Year annual visit using the CARE Inspection Tool. Upon arrival at the facility, LPA Bentley introduced self and was granted entry into the facility by staff, after stating the purpose of the visit. Administrator (AD) Joey Encarnacion arrived at the facility and remained to assist during the visit. The facility is licensed to operate for six (6) non-ambulatory residents, of which one (1) may be bedridden with a hospice waiver for six (6) residents. The facility is a one-story house with five (5) resident bedrooms, two (2) staff bedrooms, two (2) bathrooms, living room, dining room, kitchen, an attached 2 car garage, and an outdoor covered seating area. During the visit, LPA toured inside and outside of the physical plant with staff. There were no bodies of water or obstructions on the premises. All rooms were inspected. Beds and bedding supplies were in good condition, adequate lighting was provided, storage for each resident’s personal belongings was observed. Bed linens, comforters, and bath towels were adequately stocked at the time of visit. Bathrooms were found to be clean and operational. The water temperatures measured between 116.2 degrees F to 116.7 degrees F. LPA observed the facility to be sanitary and appropriately furnished at the time of visit. Storage areas for cleaning supplies, toxins, and sharps objects were stored and not accessible to residents. The kitchen was inspected and there is a two-day supply of perishable and seven-day supply of non-perishable food available and maintained properly. LPA toured the backyard and observed a shaded seating area with tables and chairs for residents to sit outside. Continues on LIC 809-C... The smoke detectors and carbon monoxide detectors were observed operable. Emergency safety drills were last conducted on September 7, 2025 and are conducted quarterly. First aid kit is maintained and contains all the necessary elements. A working telephone (714)839-4417 remains available, however, the facility does not have a device that can be used for video teleconference purposes. Emergency food, emergency water, and emergency supplies were stored in the garage. The facility has two (2) fire extinguishers that were charged, mounted, and serviced on September 2, 2025. Liability Insurance is effective June 1, 2025 and expires on June 1, 2026. LPA conducted an audit of six (6) resident files (R1-R6), five (5) staff files (S1-S5), and medication and medication administration review. Resident and staff interviews were conducted. No Deficiencies were cited during the time of the visit. An exit interview was conducted, and a copy of this report was provided to Administrator Joey Encarnacion at exit.