Routine inspection·March 26, 2026

Licensing Program Analyst (LPA) Yolanda Delgado arrived unannounced to conduct an annual inspection. Upon arrival LPA was greeted by facility staff and granted entry by Junell Evanglista. LPA began inspection with introduction, visit purpose and provided the facility caregiver with LPA identification and business card. Resident record review began- Two (2) records were reviewed. LPA reviewed for admission agreement, medical assessment and TB test results, consent forms, identification and emergency information, appraisal needs and service plans, centrally stored medication/destruction records, safeguard for personal property/valuables, and personal rights notification. This facility is meeting documentation requirements. LPA began review of employee records- Two (2) records were reviewed. LPA reviewed employee record for first aid certification, fingerprint clearance, personnel/job application-1 missing, health screening-1 missing and TB test results, training verification, and current administrator certification. CPR and requirements have been met. The facility employs enough staff to maintain cleanliness and meet the needs of the clients in care. Administrator certification is present and expires 6/5/2027. Physical Plant and Safety of Environment/Operational Requirements- LPA toured the facility inside and outside. The home is maintained at a comfortable temperature for the clients. Lighting is sufficient for safety and comfort. Water temperature measured 109.0 degrees F. Laundry facilities and a locked cabinet is present for storing laundry soap and other chemicals in the garage. All outdoor and indoor passageways are free of obstruction. A locked area is provided for medications and sharp objects. LPA verified there is a telephone working at this location. (Continued on next page) (Continued from Page 1) Food Service- Food supply meets the requirement of one week supply of nonperishable and 2 day supply of perishables food on hand. A menu is posted, foods are dated to assure safety. Food prep areas are clean and organized. LPA made observation throughout the inspection process to assess if the facility remains in conformity with the State Fire Marshall regulations. The facility has not exceeded its capacity limitation and the structure remains unchanged according to the approved floor plan however a resident that is designated as bedridden was not in approved bedroom according to the fire safety inspection. Smoke detectors and carbon monoxide detectors were tested and found to be operational. Fire extinguisher was not tested or replaced annually and were last done so on 02/4/2025. The facility is conducting emergency disaster drills monthly and done on 2/28/2026. Based on the information received during this visit today, there are seven (7) deficiencies is being cited with Civil Penalties of $1,000 being issued per Title 22, Division 6 of The California Code of Regulations. This report, LIC809D, LIC421IM and Appeal Rights was reviewed with Junell Evangelista and a copy provided at the time of the exit interview.