Routine inspection·November 4, 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 8:00 AM, LPA Tea was greeted and granted entry into the facility by caregiver staff and explained the reason for the visit. Administrator (AD) Jimmy Briones arrived shortly to assist with the visit. Facility is licensed for six non-ambulatory residents with a hospice waiver for six. Currently there are six residents, of which four are on hospice during today's visit. LPA Tea reviewed six resident files and two staff files. Resident files and staff files contained all the required documentation. The administrator certificate expires on December 18, 2025, AD Briones completed all course work for renewal and is currently pending renewal. LPA Tea along with AD Briones toured the facility. LPA toured the physical plant, checked food service, and the first aid kit. The facility is a one-story home with five resident bedrooms, two bathrooms, living room, family room, kitchen, dining area, laundry area, backyard and an attached car garage. LPA observed smoke detectors/carbon monoxide in common areas and bedrooms are 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, grab bars were secure and shower was free of mold/mildew. The water temperature measured around 112.2 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, and 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. Perishable and non-perishable food supply were checked and adequately stocked at time of visit. LPA observed sharps locked and secured in drawers. LPA (Annual inspection continued on LIC809-C) also observed toxin substances to be secured and locked and inaccessible to clients in the laundry area and in the locked storage shed in the backyard. The fire extinguisher in the dining area is fully charged with a service date of April 9, 2025. The facility’s last disaster drill was conducted on September 4, 2025. LPA toured the outside grounds and there is ample seating with shade and there is a gate on the right side of the facility that is self-latching and operational. LPA observed emergency supplies, food and water in the garage. Activities are based on resident’s personal preference or health condition. Some residents read. Some residents go walking. At the time of the visit, LPA observed residents watching television. LPA then reviewed medication storage and administration. Medications are stored in a locked cabinet in the family room. Medications are being administered per physicians order. LPA interviewed residents regarding their quality of care and spoke to staff present regarding care provided. 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 the facility and a copy of this report LIC809, 809-C, LIC858, LIC859 was read and provided to the facility.