Routine inspection·April 22, 2026

Licensing Program Analyst (LPA) Rose Ruppert made an unannounced visit to conduct an Annual Required Evaluation. LPA was greeted and granted entry by Staff #1 at 1:15pm. LPA met with Administrator (AD) Ahl Agustin and explained the purpose of the visit. The facility is a four bedroom, three bathroom residential home with a fire clearance of six non-ambulatory; of which one may be bedridden in room #4. The facility has a hospice waiver for six and one resident is currently on hospice. During the visit LPA toured the kitchen and observed the refrigerator had more than two days of perishable items and the pantry and freezers had seven days of non-perishable items. LPA observed sharps and knives secured with medications. Hazardous chemicals were secured in the garage. All appliances were in working order and the facility was clean with no odors detected. LPA inspected the smoke and carbon monoxide detectors and all detectors were operational. Two fire extinguishers were charged and serviced on July 31, 2025. A fire drill was conducted on January 13, 2026. The facility temperature was 76 degrees Fahrenheit. LPA tested hot water temperatures in three of three resident bathrooms. Bathrooms had grab bars and non-skid mats. The hot water temperature ranged between 113.5 to 116.7 degrees Fahrenheit. Resident bedrooms were clean with the required linens and furnishings. LPA toured the exterior of the property and observed the exterior gate was self-latching and all pathways were clear of obstructions (Continued on LIC 809-C) (Continued from LIC 9099) LPA observed medication storage and reviewed the centrally stored medications. Per review medications are being given as prescribed. The First Aid Kit had all the required elements. The facility has a First Aid manual book was on-site. LPA reviewed three of three staff training and fingerprint records and conducted a complete review of resident records. Annual staff training records were not observed in staff files and a deficiency will be given. LPA interviewed alert residents regarding their quality of care and spoke to staff present regarding care provided. LPA confirmed that administrator has a current administrator certificate which expires on January 21, 2027. A Legionnaires' Disease Fact Sheet for Assisted Living Facility Administrators was provided to AD. The following deficiencies are being cited per Title 22 Division 6 of the California Code of Regulations. An exit interview was conducted with Ahl Agustin, Administrator (AD) and a copy of this report was given to the facility along with a copy of the LIC 858, LIC 859; LIC 809-D and Appeal Rights.