Routine inspection·July 29, 2025

On July 29, 2025, at 2:00pm, 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 Administrator (AD) Fregil Jimenez and Administrator (AD) Camille Santos later joined the inspection. LPA stated the purpose of the visit and requested Resident/Staff rosters and Personnel Record. The facility is licensed to operate for six (6) non-ambulatory residents, of which one (1) may be bedridden, and has a hospice waiver for two (2) residents. The facility is a single-story building located in a residential neighborhood. It consists of the following: four (4) resident bedrooms, one (1) staff bedroom, two (2) bathrooms, two living room areas, dining area, kitchen, an outdoor covered seating area, and an attached two car garage. LPA Bentley toured inside and outside of the physical plant with AD Pascual. There are no obstructions on the premises. There is a large, covered fish tank in the front living room. 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. Bathrooms were found to be clean and operational. The water temperature measured 130.1 degrees F to 130.4 degrees F and a deficiency is being cited. CONTINUE ON LIC809-C... LPA Bentley observed the facility to be sanitary and appropriately furnished at the time of visit. Storage areas for personal hygiene, cleaning supplies, toxins, and sharps objects were stored and not accessible to residents. 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. During the visit, LPA Bentley observed all mandated inspection control posters were posted. A comfortable temperature of 76 degrees F was maintained in the facility. The smoke detectors and carbon monoxide detectors were operable. A working telephone (714-968-6042) remains available, and the facility has a device that can be used for video teleconference purposes. Emergency food, emergency water, and emergency supplies were stored in the garage. The facility has four (4) fire extinguishers that were charged, mounted, and serviced on May 29, 2025. Liability Insurance is effective November 21, 2024, and expires on November 21, 2025. Emergency safety drills were last conducted on June 20, 2025, and conducted quarterly. First aid kit is maintained and contains all the necessary elements. LPA Bentley conducted an audit of five (5) resident files (R1-R5), four (4) staff files (S1-S4), and a medication and medication administration review. LPA Bentley conducted two (2) staff interviews and five (5) resident interviews. During tour LPA Resident 1 (R1) bedroom with AD Santos and AD Jimenez and observed multiple medications unsecured on tray table, near R1 bed. LPA observed AD Santos remove and secure R1 medication Based on observations, interviews and record reviews, deficiencies are being cited during this visit 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 and appeal rights were provided to Administrators Camille Santos and Fregil Jimenez at the end of the visit..