Routine inspection·February 13, 2026

Licensing Program Analyst (LPA) Michael Tea conducted an unannounced visit. The purpose of today’s visit was to conduct the Annual Required inspection. LPA Tea was greeted and granted entry into the facility by caregiver staff and explained the reason for the visit. Licensee (LE) Ban Nguyen is currently out of the country, but LPA was able to communicate with him via text message. LE Nguyen would stand by for assistance if needed. The facility is licensed for six non-ambulatory residents with a hospice waiver for five. Currently there are six residents, of which none are on hospice during today's visit. LPA Tea reviewed six resident files and two staff files. There were discrepancies with resident files. Some resident files are missing forms and need updated physician’s reports. The facility is up to date with required quarterly emergency disaster drills, which were last conducted in February 11, 2026. The administrator certificate expires October 17, 2026. LPA Tea along with staff toured the facility. LPA toured the physical plant, checked the food service, and the first aid kit. The facility is a two-story home, the first floor consists of five resident bedrooms, two bathrooms, a living room, family den, dining area, kitchen and attached garage. The second floor is a private resident area; no care residents reside on the second floor. Private residents are background cleared. LPA observed smoke detectors/carbon monoxide in common areas and bedrooms are operational. Resident bedrooms had the required furniture, bed linens and closet/drawer space to accommodate each resident comfortably. Resident bathrooms were checked. Toilets and water faucets worked properly, grab bars were secure, and showers were free of mold/mildew. The water temperature measured between 116.9 to 118.9 Fahrenheit degrees. Resident bath towels, toiletries and personal hygiene supplies were adequately stocked at time of (Annual continuation on LIC809-C) visit. Common areas were clean and clear of hazards; doorways were free of obstructions. First aid kit had all the required elements including bandages, tweezers, thermometer, and scissors. Kitchen was inspected. Perishable and non-perishable food supply was checked and adequately stocked at the time of visit. LPA observed sharps locked and inaccessible to residents in a kitchen drawer. LPA also observed toxin substances secured underneath the kitchen sink and in cabinets in the garage. There were toxins placed underneath the bathroom sinks that were locked, but LPA felt the locks in place were not stable and suggested staff transfer toxins to the cabinet in the garage. The fire extinguisher in the dining area is fully charged. Kitchen appliances are operational during today's visit. LPA toured the outside grounds and there is ample seating underneath a shaded patio area in the backyard. There are two exit gates that are self-latching and operational on both sides of the house. LPA observed PPE supplies, emergency food and water stored in the garage. Facility provides activities based on resident personal choice and health condition. Residents like to play bingo and color. At the time of the visit, LPA observed residents lounging in the living room watching television and having lunch. LPA reviewed medication storage and administration. Medications are stored in a locked cabinets in the kitchen. Medications are being administered per physician order. LPA notice medication was incorrectly recorded for administration on the MAR record. LPA advised facility to be more diligent with MAR records and properly document dosages given. LPA interviewed residents regarding their quality of care and spoke to staff present regarding care provided. The following deficiency is being cited per Title 22 Division 6 of the California Code of Regulations. This report was reviewed with the facility and a copy of this report LIC809, 809-C, LIC858, LIC859, LIC809D and Appeal Rights were read and provided to the facility.