Routine inspection·May 30, 2025

On May 30, 2025 at 8:00am, Licensing Program Analyst (LPA) Eboni Bentley conducted an unannounced required 1-Year annual visit using the CARE Inspection Tool. Upon arrival at the facility, LPA Bentley was greeted and granted entry by the administrator, Dulce Argosino and explained the reason for the visit. Facility is licensed for six non-ambulatory residents, with a hospice waiver for six. Currently there are six residents, of which two are on hospice during today's visit. Administrator certificate expires on March 23, 2027. At 9:35 AM, LPA Bentley, along with the Administrator toured the facility, checked food service, and the first aid kit. The home consists of 5 resident bedrooms, of which one is shared, 1 staff room, 2 full bathrooms, living room, dining room, and kitchen. 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. Water temperature measured between 110.6 degrees F. and 114.0 degrees F. 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. Kitchen was inspected and found clean and sanitary. Perishable and non-perishable food supply was checked and adequately stocked at time of visit. LPA observed sharps locked in a kitchen cabinet. LPA also observed toxin substances to be secured and locked and inaccessible to clients in the garage. Kitchen appliances are operational during today's visit. LPA toured the outside grounds and there is ample seating with shade and the exit gate is self latching and operational. The backyard has a small garden area. CONTINUE TO LIC 809-C Facility provides activities in the form of outdoor activities such as going on walks and exercises. The residents do puzzles such as sudoku, and reading newspapers, books, and magazines. Residents also enjoy watching sports events, news and game shows.. LPA observed smoke detectors/carbon monoxide in common areas and bedrooms are operational. The facility’s last fire drill was conducted on March 1, 2025. Emergency food and water supply observed in the garage. First aid kit had all the required elements. Two fire extinguishers are fully charged with a service date of February 5, 2025. A working telephone (714-418-0341) remains available, and the facility has a device that can be used for video teleconference purposes. Liability Insurance is effective June 13, 2024 through June 13, 2025. LPA Bentley conducted an audit of six (6) resident files (R1-R6), three (3) staff files (S1-S3), and conducted two (2) staff interviews, and six (6) resident interviews. Residents’ medication was found locked and secure and a review of the Medication and Medication Administration Record (MAR) was conducted. LPA observed four out of six residents, Residents #1, Resident #2, Resident #3, and Resident #4 (R1-R4) with medication not listed on MAR. During tour, LPA observed two medications unsecured in Resident #3’s (R3) chest of drawers. LPA observed two oxygen tanks sitting on floor in hallway closet, without rack. Based on today’s observations, deficiencies are being cited during this visit as per Title 22 Division 6 Chapter 8 of the California Code of Regulations. An exit interview was conducted with administrator, Dulce Argosino and a copy of this report LIC809, 809-C, LIC809-D, LIC811, and appeal rights provided.