Routine inspection·March 17, 2025

Licensing Program Analyst (LPA) Rose Ruppert made an unannounced visit to the facility today to conduct an Annual Required Evaluation. LPA was greeted and granted entry by Staff #1 at 8am. During today’s visit, LPA met with Mark Cruz, Administrator (AD). The facility is a single story residence with four resident bedrooms and one staff bedroom. The residence has an approved fire clearance of six non-ambulatory residents of which four may be on hospice . The facility currently has a census of six residents in care with two receiving hospice services. During today’s visit, LPA toured the facility and inspected the physical plant, including but not limited to testing all smoke detectors, testing hot water temperature in three of three resident bathrooms, and testing auditory devices on all exits. The hot water temperature measured between109.4 and 116.4 degrees Fahrenheit and all smoke and carbon monoxide detectors were operational . The fire extinguishers are charged and were serviced on March 5, 2025. The facility’s last fire drill was conducted on January 29, 2025. LPA toured the exterior and there were no hazards in passageways and both exterior gates were self-latching. LPA inspected the facility food supply and observed the facility retained a minimum of two days perishable and seven days non-perishable food on hand and a grocery delivery was arriving on this date. Knives were secured in a locked cabinet and storage container and cleaning supplies were secured in the garage. LPA observed medication storage and reviewed the centrally stored medications. Per review medications are being given as prescribed. LPA observed the First Aid Kit had required elements and a First Aid Manual. LPA reviewed three of three staff training and fingerprint records and conducted a complete review of resident records. LPA interviewed alert residents regarding their quality of care and spoke to staff present (Continued on LIC 809-C) (Continued from LIC 809) regarding care provided. LPA confirmed that administrator has a current administrator certificate which is pending but will expire November 22, 2026. LPA observed the Emergency Disaster plan, weekly menus and required See Something, Say Something poster in the entryway. At time of entry residents were enjoying breakfast and were socializing. LPA observed activities calendar and was shown pictures by the Administrator of activites. One resident attends a community program Monday through Friday. Based on the observations made during today’s visit, the facility appears to be in compliance with Title 22 Division 6 of the California Code of Regulations, no deficiencies cited on this date. An exit interview was conducted with Mark Cruz, Administrator and a copy of the report and files reviewed (LIC 858 & LIC 859) were given at the time of the visit.