Routine inspection·June 11, 2025

On June 11, 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 Caregiver (CG) Leticia Bitas. Administrator (AD) Elvie Ringor met with LPA and was present during the visit. AD Elvie Ringor has an administrator certificate with an expiration date of September 5, 2026. The facility is a single level structure, licensed for six (6) non-ambulatory residents, of which one (1) may be bedridden and has a hospice waiver for six (6) residents. The home consists of the following: Four (4) resident bedrooms, one (1) staff bedrooms, three (3) bathrooms, a living room area, dining room area, kitchen, outdoor shaded seating area, and an attached two car garage. There are three residents on census, all present during today’s visit. LPA obtained copies of pertinent documents, including facility records, clients/staff rosters, Personnel Record (LIC500), and clients/staff records. During the visit, LPA Bentley toured the interior and exterior of the physical plant with AD Ringor and the following was observed: There were no bodies of water or obstructions on the premises. All rooms were inspected. Beds and bedding supplies were in good condition, adequate lighting was provided, storage for each resident’s personal belongings was observed. Bed linens, comforters, and bath towels were adequately stocked at the time of visit. CONTINUE TO LIC809-C PAGE Bathrooms were found to be clean and operational. The water temperatures in three bathrooms measured 106.1 degrees F and 114.9 degrees F. A comfortable temperature of 74 degrees F was maintained throughout the facility. LPA Bentley observed the facility to be sanitary and appropriately furnished at the time of visit. Storage areas for cleaning supplies, toxins, and sharps objects were stored and locked. The kitchen was inspected and there is a two-day supply of perishable and seven-day supply of non-perishable food available. There is a two car garage with two refrigerators and additional supply of perishable items. The washer and dryer were observed to be in working condition. Facility has emergency food supply and water supply. The backyard was clean and free of clutter and debris. A shaded patio area with tables and chairs was observed. Emergency safety drills was last conducted on July 15, 2019 and a deficiency is being cited. First aid kit is maintained and contains all the necessary elements. Smoke and carbon monoxide alarms were tested and observed operational. The facility has two (2) fire extinguishers that are fully charged in the kitchen and garage, with a last service date of October 22, 2024. A working telephone (714-600-7269) remains available. Liability Insurance is effective June 30, 2024 through June 30, 2025 and licensee also provided documentation for Liability Insurance is effective June 30, 2025 through June 30, 2026. LPA Bentley conducted an audit of three (3) resident files (R1-R3) and four (4) staff files (S1-S4). A review of the Medication and Medication Administration Record (MAR) was conducted. LPA observed annual training missing for three out of four staff files. Upon review of Resident #1 (R1) centrally stored medication list and medication box, four refills are not present in facility. Licensee stated refills were requested on June 9, 2025 but have not been delivered. Interviews were conducted with three (3) residents and two (2) staff. Based on today’s observations, deficiencies are being cited as per Title 22 Division 6 Chapter 8 of the California Code of Regulations. An exit interview was conducted, and a copy of this report, deficiency pages, and appeal rights were provided to Administrator Elvie Ringor.