Routine inspection·December 12, 2025

On December 12, 2025, at 12:45 PM, Licensing Program Analyst (LPA) Edward Kim conducted an unannounced required 1-Year annual visit using the CARE Inspection Tool. Upon arrival at the facility, LPA Kim met with Caregiver (CG) Reynoldo Avena. LPA Kim spoke with Administrator (ADMIN) Kristen Viana over the phone and explained the purpose of the visit. ADMIN Viana stated that CG Avena could sign on behalf of the facility The facility is licensed to operate for six (6) non-ambulatory and have a hospice waiver for three (3) residents. The facility is a single-story building located in a residential neighborhood. It consists of the following: five (5) resident bedrooms, one (1) staff bedroom, three (3) bathrooms, living area, dining area, kitchen, attached 2-car garage, and an outside covered patio area. LPA Kim toured indoor and outdoor of the physical plant with CG Avena. There are no obstructions or bodies of water 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. All bedrooms were inspected: Resident Room 1, Resident Room 2, Resident Room 3, Resident Room 4, and Resident Room 5. Bathrooms were found to be within Title 22 regulations and were clean and operational. The water temperature measured between 118.2 degrees F and 118.5 degrees F. A comfortable temperature of 67 degrees F was maintained in the facility. Evaluation Report Continues on LIC 809-C LPA Kim observed the facility to be sanitary and appropriately furnished at the time of visit. Storage areas for personal hygiene, and sharps objects were stored and not accessible to residents. LPA observed the following cleaning supplies were placed in an unlocked cabinet under the sink: a bottle of Great Value Ultra Dish Liquid detergent and Ortho Home Defense Indoor Insect Killer spray bottle. Facility immediately removed and placed the items in the garage that is locked. The kitchen was inspected and there is a two-day supply of perishable and seven-day supply of non-perishable food available and maintained properly. Emergency food, water, and supplies are stored in the garage. The facility has one (2) fire extinguishers that were charged and were serviced on February 1, 2025. All smoke/carbon monoxide detectors were operable. During the visit, LPA Kim observed the facility's infection control practices, plan of operation, and screening protocols for visitors, staff, and residents. LPA observed the facility has a 30-day supply of Personal Protective Equipment (PPE). The facility conducted a Fire/Safety Drill quarterly and was last conducted on October 16, 2025. A working telephone (714-378-1289) remains available. First Aid Kit contained all the necessary elements. LPA conducted an audit of resident files (R1-R5), staff files (S1-S3) and medication and medication administration record. During the tour of the facility, LPA observed facility had kept medication in an unlocked cabinet in the dining room. Facility immediately placed the unlocked medication in a locked medication cabinet. LPA Kim conducted interviews with 2 residents and 2 staff. Deficiencies were cited during this visit as per Title 22 Division 6 Chapter 8 of the California Code of Regulations. LPA observed medication that was stored in an unlocked cabinet in the dining room. LPA observed a bottle of Great Value Dish Liquid detergent and Ortho Home Defense indoor insect killer spray bottle were placed in an unlocked cabinet under the sink. An exit interview was conducted, and a copy of this report and appeal rights were provided to Caregiver Reynoldo Avena.