Routine inspection·September 2, 2025

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. House Manager (HM) Marla Punzalan arrived shortly to assist with the visit. Facility is licensed for 6 non-ambulatory residents and 1 maybe bedridden with a hospice waiver for six. Currently there are five residents, of which one is on hospice during today's visit. LPA Tea reviewed five resident files and two staff files. Resident files and staff files contained all the required documentation. The administrator certificate expires on March 27, 2027. LPA Tea along with caregiver toured the facility at 10:00 AM. LPA toured the physical plant, checked the food service, and the first aid kit. The facility is a single-story home that consists of six resident bedrooms, one caregiver room, storage room, six bathrooms, living room, dining room, kitchen, laundry and attached garage. LPA observed smoke detectors/carbon monoxide in common areas and bedrooms and are operational. There are cameras without sound in common areas. 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 shower was free of mold/mildew. The water temperature measured between 111.2 to 118.5 Fahrenheit degrees. Resident bath towels, toiletries and personal hygiene supplies were adequately stocked at time of visit. Common areas were clean and clear of hazards; doorways were free of obstructions. First aid kit had all the required elements including bandages, dressing, 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 in a kitchen drawer. LPA also observed toxin substances to be locked and (Annul Inspection continued on LIC809-C) inaccessible to clients underneath the kitchen sink and in the laundry room. The fire extinguisher by the dining room is fully charged. Kitchen appliances for the most part are operational during today's visit. Only one minor issue with a burner on the stove, the ignitor was not working. Facility will replace or fix it as soon as possible. LPA toured the outside grounds and there is ample seating with shade and two exit gates on both sides of the facility are self-latching and operational. LPA observed emergency supplies, food and water supply in the medication closet and garage. Facility provides activities based on resident interests and physical condition. The residents do puzzles, play cards, and do coloring. They walk around the house and the residents go sunbathing in the backyard when the weather permits. At the time of the annual visit, LPA observed residents watching television in their rooms and hanging out in the dining room. One resident had family visiting and was taken out to lunch. LPA reviewed medication storage and administration. Medications are stored in a locked closet by the living room. Medications are being administered per physician. LPA interviewed residents regarding their quality of care and spoke to staff present regarding care provided. Based on the observation made during today’s visit, no deficiencies were noted today in the areas inspected per Title 22 Division 6 of the California Code of Regulations. An exit interview was conducted with House Manager Marla Punzalan and a copy of these reports were given to the facility along with a copy of the LIC858; 859.