Routine inspection·July 24, 2025

On July 24, 2025, Licensing Program Analyst (LPA) Brandon Lopez made an unannounced visit to the facility to conduct the required annual inspection. LPA was greeted and granted entry into the facility by care giving staff after explaining the purpose for the visit. Administrator (AD) Maria Mirabueno was notified via telephone but could not arrive to assist with the inspection. LPA observed Maria Mirabueno has a valid Administrator certificate which expires on November 1, 2026. House Manager (HM) Basilio Aquino was present and assisted LPA on today's inspection. The facility is a Residential Care Facility for the Elderly (RCFE) licensed for six non-ambulatory residents and has a hospice waiver for six. The facility is a single story home with four resident bedrooms, two of which are shared, one staff bedroom, three shared bathrooms, a living room, a dining room, a kitchen, and an attached two car garage. LPA, accompanied by the HM, conducted a tour of the interior portions of the facility. On today's visit, LPA observed six resident in care and two care giving staff present. LPA observed residents relaxing in the living room. LPA observed the See Something, Say Something poster, (PUB 475) mounted on the wall in the living room. LPA inspected all four resident bedrooms and observed them to be free of hazards. LPA observed resident bedrooms to have the required furnishings of a bed, a chair, a chest of drawers, and a lamp. LPA observed resident beds to have clean linens and blankets. LPA observed additional linens to be stored in a hallway drawer. LPA inspected the two shared resident bathrooms and observed them to be clean. Bathrooms were equipped with grab bars and non-skid floor mats. Faucets and toilets were operational. Hot water temperature measured between 115.6 to 115.7 degrees Fahrenheit. LPA observed the staff bedroom to be kept locked and inaccessible to residents in care. CONTINUED ON LIC809-C LPA observed kitchen appliances to be clean and operational. LPA observed the five burner gas stove lights unassisted. LPA observed kitchen knives and sharps to be stored in a locked kitchen cabinet. LPA observed the facility has a First Aid Kit stored in a kitchen cabinet and it had all the required components. LPA observed fire extinguishers to be mounted on the wall in the kitchen and it was observed to be charged and serviced as of September 6, 2024. LPA tested the wired smoke detectors/carbon monoxide detectors which tested operational. LPA observed the facility conducted their last emergency disaster drill on July 6, 2025. LPA observed the centrally stored medication to be kept in a locked cabinet located in the dining room. LPA observed a fire place in the living room and it was observed to be adequately fenced and not in operation at time of visit. LPA observed the door leading to the attached two car garage to be kept locked and inaccessible to residents in care. LPA observed the garage to be used for storage and laundry. LPA observed chemicals and toxins to be stored in the locked garage. LPA observed the facility has a three day emergency food and water supply stored in the garage. LPA, accompanied by the HM, conducted a tour of the exterior portion of the facility. The exterior portion was observed to be free of hazards and obstructions. LPA observed a shaded outdoor seating area with furniture for resident use. LPA observed the perimeter gates of the facility to be self latching and can be opened in an evacuation. There are no bodies of water on the premises. LPA reviewed all six resident files. All the required documentation were present and current in the resident file reviewed. LPA reviewed the residents' medication and medication records. LPA reviewed two staff files. All staff are background cleared and associated to the facility. Based on the observations made during today's visit, no deficiencies are being cited per the Title 22 of the California Code of Regulations. An exit interview was conducted with House Manager (HM) Basilio Aquino and a copy of the report was provided.