Routine inspection·November 4, 2025

On November 4, 2025, at 8:00 AM, 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 was greeted and met with Interim Executive Director (ED) Sam de Guzman. The facility is licensed to operate for eighty-five (85) nonambulatory residents of which eight (8) may be bedridden and have a hospice waiver for twenty (20) residents. The facility is a two-story structure and consists of the following: sixty-three (63) resident bedrooms, six (6) offices, sixty-eight (68) bathrooms, living area, two dining areas, beauty salon, TV room, kitchen, bistro, two activity rooms, theater room, lounge, parking garage, and outdoor seating area. LPA Kim toured inside and outside of the physical plant. There were no bodies of water or obstructions 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. The Resident’s rooms were inspected: Resident Room 112, Resident Room 125, Resident Room 153, Resident Room 201, Resident Room 216, Resident Room 229, Resident Room 231, Resident Room 240, and Resident Room 255. Bathrooms were found to be within Title 22 regulations and were clean and operational. The water temperature measured 115.3 degrees F to 117.5 degrees F. A comfortable temperature of 73 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, 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. Emergency food, emergency water, and emergency supplies were stored in the parking garage. The facility has fourteen (14) fire extinguishers that were charged, mounted throughout the facility, and serviced on October 29, 2025. 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). All mandated inspection control posters were posted. The smoke detectors and carbon monoxide detectors were inspected by CAL Building systems on December 6, 2024. Sprinkler system was inspected and tested by Cal Building Systems on December 6, 2024. A working telephone (714-738-3656) and internet capable devices for teleconferencing purposes remain available. Emergency drill logs were last conducted on October 23, 2025, and are conducted monthly. LPA observed the facility had current Evidence of Liability Insurance effective May 1, 2025, to May 1, 2026. LPA Kim conducted an audit of eight (8) resident files (R1-R8), six (6) staff files (S1-S6), and medication and medication administration record. LPA observed R1’s diagnosed with dementia with a physician’s report dated October 11, 2024, and R2’s diagnosed with dementia with a physician’s report dated November 2, 2024. LPA Kim conducted interviews with six (6) staff and five (5) residents. A Technical Violation was assessed during the visit in regard to R1 being diagnosed with dementia with a medical assessment dated October 11, 2024, and R2 being diagnosed with dementia with a medical assessment dated November 2, 2024. An exit interview was conducted, LIC811, LIC9102, and a copy of this report was provided to Interim Executive Director Sam De Guzman.