Routine inspection·May 21, 2025

Licensing Program Analyst (LPA) Michael Tea conducted an unannounced visit. The purpose of today’s visit was to conduct the Annual Required inspection. At around 1:30 PM, LPA Tea was greeted and granted entry into the facility by Licensee (LE) Kevin Dinh and explained the reason for the visit. Facility is licensed for six non-ambulatory residents, with an approved hospice waiver for six, and one maybe bedridden in Room #3. Currently there are no residents in care during today's visit. The licensee hopes to have residents for the facility during this year once the facility is approved for the Assisted Living Waiver (ALW) program. LPA Tea along with the LE Dinh toured the facility. LPA toured the physical plant, checked the first aid kit. The facility is a one-story home that consists of four resident bedrooms, two private, two shared, two full bathrooms, living room, family room, dining area, kitchen and garage. LPA observed smoke detectors/carbon monoxide in common areas and bedrooms to be 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. The grab bars were secure, and shower was free of mold/mildew. Water temperature measured around 107.9 Fahrenheit 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 dressing, bandages, tweezers, thermometer, and scissors. Kitchen was inspected. Kitchen appliances are operational during today's visit. Sharps are locked and stored in a secured drawer in the kitchen. LPA also observed toxin substances inaccessible to residents in care, locked and secured underneath the sink. The fire extinguisher is fully charged in the kitchen area. LPA toured the outside grounds and there is ample seating with shade. Backyard has a nice garden with different plants and fruit trees. There are two exit gates that are self-latching and operational on both sides of the house. Continuation of the annual report on LIC809-C Emergency food is in a closet by the front entry way. Emergency water is in the garage and the emergency supplies are in the medication closet. No resident files were reviewed, and interviews were not conducted as there are no residents living at the facility. There were no health and safety concerns observed during today's visit. 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. This report was reviewed with Licensee Kevin Dinh and a copy of this report LIC809, 809-C was read and provided to the facility