Routine inspection·March 27, 2026

Licensing Program Analyst (LPA) Raquel Hernandez made an unannounced visit to the facility. The purpose of the visit was to conduct a required comprehensive annual inspection. LPA met with Caregiver Nenita Gorospe and was granted entry to the facility. The facility is a (5) bedroom (2) bathroom home and, with a kitchen/dining area, living room, attached garage. LPA was accompanied by Administrator Jerome Alim to conduct a general overall inspection, which included, but was not limited to, the following: Physical Plant: The facility is operating in the capacity approved by Community Care Licensing (CCL). There are no obstructions to indoor and outdoor passageways. The facility is maintained at a comfortable temperature. LPA inspected client bedrooms; they are equipped with required furniture such as: mattresses, nightstands, storage space, and sufficient lighting; bathrooms were clean, and appliances were operating appropriately. LPA observed sufficient furniture and lighting throughout the facility. The facility is equipped with operating smoke detectors and carbon monoxide alarms. Posters such as personal rights, the CCL complaint poster, and the disaster plan were posted in a common area. There was a designated office that stored resident/staff files. Overall, the facility is clean, in good repair, and operating in safe conditions for clients in care. Food Service: Non-perishable and perishable food supply is sufficient for number of clients in care. Facility has a variety of food available for clients. Dishes, cups, and utensils were also stored properly. Care & Supervision: Facility has sufficient care staff for coverage 24 hours a day, 7 days a week. Record Review: LPA reviewed (3) resident files for admission agreements, updated physician reports, and needs and services plans. LPA observed incomplete Appraisal/Needs and Services Plan for Resident #1 (R1) and and Resident #3 (R3). Deficiency will be issued. Additionally, LPA observed no Reappraisal forms for R1 and R3. Deficiency will be issued. A previous licensing report was issued on 03/27/2025 giving notice of the same violation. Because you have been cited for repeating the same violation within 12 months, the following civil penalty shall be assessed until the violation is corrected. An immediate civil penalty of $250 is hereby assessed for the date of 03/27/2026. LPA reviewed (3) resident medications. LPA observed PRN medication for Resident #2 (R2) and Resident #3 (R3) to not be documented properly on Medication Administration Record (MAR). Deficiency will be issued. Additionally, LPA observed (2) medications not labeled or prescribed by a physician in Resident #3 (R3) medications. Deficiency will be issued. LPA also reviewed (2) staff files for First Aid/CPR certification, criminal record clearance, trainings, and health screenings. No issues observed. Per record review, LPA observed facility accepted (4) hospice residents when facility is only licensed for (2). Deficiency will be issued. Based on the observations made during today’s visit, deficiencies were cited per Title 22, Division 6, of the California Code of Regulations. An exit interview was conducted, and this report (LIC809), (LIC809D), and LIC421IM was discussed and provided to Administrator Jerome Alim. Along with copy of appeal rights.