Routine inspection·September 30, 2025

Licensing Program Analyst (LPA) Ruth Martinez is conducting this unannounced visit for the purpose of completing an annual required inspection. LPA arrived at the facility and was greeted and granted entry by staff and LPA explained the nature of the visit. LPA met with Rico Mico, Administrator and explained the nature if the visit. There are five residents at the facility and there are two residents receiving hospice services currently. LPA accompanied by Administrator began the tour of the inside and outside of the facility. LPA observed required department postings throughout the facility. Facility stays within the capacity limitations. There is a minimum of one week of non-perishables foods and two days of perishables foods available. There is additional food storage located in the garage in a freezer and a spare refrigerator. The facility is maintained at a comfortable temperature. LPA inspected that medication is centrally stored in a safe locked storage closet located in the bedroom hallway. LPA reviewed medication and observed medication was labeled and stored inaccessible to residents in care. Medication cross checked for accuracy of date and dosage. LPA inspected the bathrooms, and LPA measured the hot water temperature which measured 107.9 Fahrenheit degrees. All bathrooms observed to have a supply of soap, toilet paper and towels. Bathrooms are equipped with required safety measures such as non-skid mats and grab bars. Lighting is sufficient to ensure safety and comfort. The facility is equipped with sufficient hand hygiene, cleaning, and disinfecting supplies. LPA observed that toxic chemicals, cleaning solutions and disinfectants are stored locked underneath kitchen sink and locked in the garage. The facility has an available clean supply of linens in the hallway storage and a Continued on LIC809-C storage closet by resident bedroom. LPA inspected residents’ bedrooms which has sufficient lighting to ensure safety and comfort. All bedrooms observed to have all required components. Storage space is provided for residents in their bedroom. Carbon monoxide and smoke detectors were tested and found to be operational. LPA toured the outside of the facility and observed outdoor passageways are free of obstructions. LPA observed there is several shaded seating areas for residents’ enjoyment. LPA observed a fire extinguisher with service date of November 1, 2023, mounted in the kitchen wall. LPA reviewed and verified fire drill logs. Facility has a second floor which is inaccessible to residents in care, door that leads to the second floor is in the garage. There are no residents residing on the second floor of the facility. LPA verified resident in care do not have access to the second floor. LPA began reviewing records. LPA reviewed five resident records. LPA reviewed three employee records. All employees present have a criminal record clearance and are associated with the facility. LPA observed records reviewed have a current First Aid certificate. Based on the observations made during today’s visit, deficiencies are being cited per Title 22 Division 6 of the California Code of Regulations. See LIC 809-D for deficiencies. This report was reviewed with the Administrator and a copy of this report LIC809, LIC809-D report was provided and left at facility. Appeal rights reviewed, and a copy provided.