Routine inspection·August 28, 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. Administrator (AD) Jessica Villanueva arrived shortly to assist with the visit. Facility is licensed for 6 non-ambulatory residents, with a hospice waiver for six. Currently there are three residents, of which one is on hospice during today's visit. LPA Tea reviewed three resident files and two staff files. Resident files and staff files contained all the required documentation. Administrator certificate expires on May 1, 2027. LPA Tea along with the Administrator toured the facility at 9:41 AM. LPA toured the physical plant, checked food service, and the first aid kit. The facility is a single-story home that consists of 3 resident bedrooms, 1 caregiver room, 1 1/2 bathrooms, living room, dining room, kitchen, sunroom and attached garage. LPA observed smoke detectors/carbon monoxide in common areas and bedrooms and are operational. 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 around 107.6 F 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. The kitchen has been recently renovated from the last annual visit. Perishable and non-perishable food supply was checked and adequately stocked at time of visit. LPA observed sharps locked in a kitchen drawer. LPA also observed toxin substances to be locked and inaccessible to clients (Annul Inspection continued on LIC809-C) underneath the kitchen sink. The fire extinguisher in the kitchen was fully charged. Kitchen appliances are operational during today's visit. 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 kitchen pantry and the garage. Facility provides activities based on resident interests and physical condition. The residents watch television, do puzzles, and read books. At the time of the annual visit, LPA observed residents eating and watching TV. LPA reviewed medication storage and administration. Medications are stored in a locked cabinet in the office area. 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 Administrator Jessica Villanueva and a copy of these reports were given to the facility along with a copy of the LIC858; 859.