Routine inspection·December 2, 2025

On December 2, 2025, 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 introduced self and was granted entry into the facility by staff, after stating the purpose of the visit. Administrator (AD) Aurora Tecson arrived at the facility and remained to assist during the visit. Administrator Aurora Tecson has an administrator certificate that expires on July 2, 2027. The facility is licensed to operate for six (6) non-ambulatory residents where one (1) may be bedridden in Room #1, with a hospice waiver for two (2) residents. The facility is a one-story house with four (4) resident bedrooms, two (2) bathrooms, living room, dining room, kitchen, an attached 2 car garage, and an outdoor covered seating area. During the visit, LPA toured inside and outside of the physical plant with staff. 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. Bathrooms were clean and operational with water temperatures measured between 116.7 degrees F to 117.8 degrees F. LPA 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 seven-day supply of non-perishable food available and maintained properly. LPA observed at least ten expired perishable items stored in the kitchen refrigerator. A deficiency is being cited. CONTINUE TO LIC809-C..... LPA toured the backyard and observed a shaded seating area with a table and chairs for residents to sit outside. The smoke detectors and carbon monoxide detectors were operable. Emergency safety drills were last conducted on September 22, 2025, and are conducted quarterly. First aid kit is maintained and contains all the necessary elements. A working telephone (657)231-9389 remains available, however, the facility does not have a device that can be used for video teleconference purposes. Emergency food, emergency water, and emergency supplies were stored in the kitchen. The facility has one (1) fire extinguisher that was charged, mounted, and last serviced on October 6, 2025. Liability Insurance is effective June 12, 2025, and expires on June 12, 2026. LPA conducted an audit of five (5) resident files (R1-R5), five (5) staff files (S1-S5), and medication and medication administration review. Resident and staff interviews were conducted. A record review revealed one (1) out five (5) staff are not associated to the facility. A CIVIL PENALTY WAS ASSESSED. Based on observations and record review, deficiencies are being cited during today’s inspection visit. An exit interview was conducted, and a copy of this report, LIC809-D, LIC421BG, and appeals rights were provided to Administrator Aurora Tecson at exit.