Routine inspection·December 5, 2025

On December 5, 2025, Licensing Program Analyst (LPA) Garlli Tat conducted an unannounced visit to the facility for the purpose of a required annual inspection. LPA explained the purpose for the visit and was greeted and granted entry by staff on duty. During the visit, facility administrator (AD) Jundith Que was present during the visit and assisted with the inspection. For this visit, there are three staff members on duty, two of which are background cleared and associated. The PUB475 ‘See Something, Say Something’ poster was observed to be located in the front entrance. LPA observed the Administrator's Certificate for Jundith Que, which expires on May 29, 2026. The facility is a Residential Care facility for the Elderly (RCFE) licensed for six residents, six of which may be non-ambulatory, one of which may be bedridden, and a hospice waiver for six. LPA toured the interior and exterior portions of the facility with AD. For this visit, there are a total of one non-ambulatory and four ambulatory residents in care, one of which is on hospice, and none are bedridden. The facility is a single story home. There are a total of four bedrooms, two of which are private resident bedrooms, and two are shared bedrooms. LPA toured each bedroom with the AD and observed that bedrooms were provided with furniture in good repair, clean linens, adequate storage space, and free of any hazards. Smoke and carbon monoxide detectors as well as auditory exit alarms were tested and operational. There are a total of three full bathrooms. Continued on LIC 809-C. Bathrooms were observed to be in good repair, toilets and faucets were operational and showers were equipped with grab bars and non-skid floor mats. Water temperature in the bathrooms were measured to be between 116.9 and 117.8 degrees Fahrenheit. Facility met the minimum two-day perishable and seven-day non-perishable food supplies. Sharp items and knives were locked in a kitchen cabinet and inaccessible to residents in care. Fire extinguisher was charged, mounted and located in the kitchen. Fire extinguisher had a purchase date of July 15, 2025. LPA observed the emergency disaster and evacuation plan, which is posted in the dining room. LPA observed the facility conducted their last emergency disaster drill on November 6, 2025. Facility had back-up emergency food and water supplies, located in the dining room. LPA observed that the First Aid kit had all the required components. Medications were observed to be locked in a pantry in the dining room, inaccessible to residents in care. Chemicals were observed to be locked underneath the bathroom sink. LPA observed the detached two car garage is kept locked and inaccessible to residents in care. The garage is used for storage and for housing vehicles. For the exterior portion, LPA observed patio furniture under shading, and the grounds were free of any hazards or obstructions. There are two exit gates in the backyard that can be opened in case of an emergency. No bodies of water were observed. During this visit, five resident files and three staff files were reviewed. One staff is background cleared, but not associated with the facility. LPA reviewed residents’ medication and medication records and two resident interviews were conducted. Based on today's observations, there are two deficiencies being cited per Title 22 of the California Code of Regulations. A Technical Advisory was issued at the time of the visit. A Civil Penalty was assessed. An exit interview was conducted with Jundith Que. This report was reviewed with the Licensee and a copy was provided at the end of the visit. Appeal Rights were reviewed.