Routine inspection·June 6, 2025

Licensing Program Analyst (LPA) William Vanegas made an unannounced inspection for the purposes of conducting an annual inspection. Upon arrival LPA Vanegas was greeted and granted entry by Care Giver (CG) Martin Jose. LPA Vanegas began to set up equipment, began a tour of the facility, and observed the following. This is a one storied home with four bedrooms, two bathrooms, and a one car detached garage. LPA Vanegas observed the kitchen area to be clean and free of any mildew. LPA Vanegas observed a refrigerator, microwave, dishwasher, gas stove, washer, and dryer. All appliances appeared to be in good repair, and tested to be operational. LPA Vanegas observed a two day supply of perishable food, and a seven day supply of non-perishable food, along with a sufficient amount of emergency water. LPA Vanegas observed all resident rooms to be clean and free of any debris. LPA Vanegas observed the bedrooms to have all required furnishings such as a bed, clean linens in good repair; meaning no strains or tares, chest drawer, a reading lamp, and enough storage space to store personal belongings. LPA Vanegas observed resident bathrooms to have all required furnishings such as grab bars, shower chair, and slip resistant floor matts. LPA Vanegas observed bathroom water faucets and toilets to be operational, and in good repair. Water tested between 119.8 and 125.3 degrees. LPA Vanegas observed all fire extinguishers to be fully charged and up to date. LPA Vanegas observed all smoke detectors and carbon monoxide detectors to be in good repair and operational. CONTINUED ON LIC809C LPA Vanegas observed first aid kit to have all required items such as adhesive tape, tweezers, scissors, bandages, a thermometer, and a first aid manual. LPA Vanegas observed the backyard to be big enough to participate in outdoor activities upon resident request. LPA Vanegas observed there to be an outdoor shadded sitting area, and no obstructions along the exit routes. LPA Vanegas observed side doors to be self latching and unlocked. LPA Vanegas reviewed four resident files, and four staff files. All files (Staff and Resident) had all required documents and annual training was completed for all staff. LPA Vanegas reviewed medication administration record (MAR), and resident medications. Per LPA review all medications are being documented correctly and administered per physicians orders. Based on observations made during today's inspection no deficiencies will be cited per title 22 chapter 8 division 6 of the California Code of Regulations. An exit interview was conducted with Administrator Alexander Arias and a copy of this report was provided to the facility.