Routine inspection·November 20, 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 Administrator (AD) Ida Marie Valencia and explained the reason for the visit. Administrator (AD) Victoria Valencia arrived shortly to assist with the visit. Facility is licensed for six, four may be non-ambulatory and one may be bedridden in Bedroom #2, with a hospice waiver for two. Currently there are four residents, of which there are none on hospice during today's visit. LPA Tea reviewed four resident files and two staff files. Resident files and staff files contained all the required documentation. AD Ida Valencia’s administrator certificate expires on March 5, 2027. AD Victoria Valencia’s administrator certificate expires on October 31, 2027. LPA Tea along with AD Ida Valencia toured the facility. LPA toured the physical plant, checked food service, and the first aid kit. The facility is a one-story home with four resident bedrooms, two half bathrooms, living room, kitchen, dining area, enclosed front yard, back yard and an attached car garage. There is an Additional Dwelling Unit (ADU) where Administrator Valencia lives in. 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 between 110.3 F to 114.9 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. (Annual inspection continued on LIC809-C) 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 a kitchen drawer. LPA also observed toxin substances to be secured and locked and inaccessible to clients underneath the kitchen sick and in the garage where residents have no access to. The fire extinguisher in the hallway is fully charged with a service date of July 11, 2025. The facility’s last disaster drill was conducted on October 25, 2025. LPA toured the outside grounds and there is ample seating with shade in the front yard and back yard. There are gates on both sides of the facility that are self-latching and operational. LPA observed emergency supplies, food and water in the garage. Activities that the residents enjoy are playing games and musical therapy. The administrator likes to take the residents out on outings like going to the beach, shopping, and getting something to eat. Or they will just go on a drive and visit the other facilities and interact with the other residents. At the time of the visit, LPA observed residents listening to music. LPA then reviewed medication storage and administration. Medications are stored in a locked cabinet in the kitchen. Medications are being administered per physicians order. P&I funds were accounted for and there were no discrepancies. 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