Routine inspection·September 10, 2025

Licensing Program Analyst (LPA) Celine Rodriguez conducted an unannounced required visit to the facility for the purpose of conducting the required annual inspection. LPA Rodriguez explained reason for visit and was greeted and granted entry by staff on duty. During the visit, staff on duty contacted facility administrator (AD) Elsa Roman about visit. For this visit, there are 2 staff members on duty, of which are background cleared and associated. The PUB475 "See Something, Say Something" poster was observed to be posted in the living room. LPA observed the Administrator's Certificate for Elsa Roman which expires on 6/23/2026. LPA toured the interior and exterior portions of the facility with staff on duty (S1). The facility is a one level structure and is licensed for 6 non-ambulatory residents, of which 0 may be bedridden and 2 may be on hospice. For this visit, there are a total of 6 residents in care, of which 1 is on hospice and 0 bedridden. There are a total of 6 resident bedrooms, of which all 6 are private resident rooms. LPA toured each bedroom in the facility and observed that bedrooms were provided with furniture in good repair, clean linens, adequate storage space, and kept free of tripping hazards. Smoke and carbon monoxide detector and auditory exit alarms were tested and operational. There are a total of 2 restrooms, of which were observed to be in good repair, toilets were operational, and grab bars and non-skid floor mats were provided. Water temperature was measured to be at 115.8 degrees Fahrenheit. Facility met the minimum two-day perishable and seven-day non-perishable food supplies. Sharp items and knives were locked and inaccessible to residents in care. Fire extinguisher was charged, mounted and located in the kitchen. Fire extinguishers were dated and tagged for the date of 2025. LPA observed the emergency disaster and evacuation plan, which is posted at in the living room. Facility had back-up emergency food and water supply, located in the kitchen and in the garage. LPA observed that First Aid Kit had all the required components. Medications and toxins were also observed to be locked and inaccessible to residents in care. For the exterior portion, LPA observed patio furniture under shading, and the grounds were free of any hazards. There are 2 gates in the backyard, which were self-closing and self-latching. No bodies of water were observed. For today's visit no deficiencies were issued per Title 22 Division 6 of the California Code of Regulations. No citations were issued. An exit interview was conducted with AD Roman. A copy of this report was provided and explained.