Routine inspection·November 16, 2025

Licensing Program Analyst (LPA) Mary Rico made an unannounced visit to the facility. The purpose of the visit was to conduct a required comprehensive annual inspection LPA met with Administrator/Licensee Marilou Panaligan and granted entry to the facility. Licensed capacity is (6) current census (6). LPA was accompanied by Administrator/Licensee Marilou Panaligan 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). The facility is maintained at a comfortable temperature. 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. During facility tour, LPA Rico observed boxes and furniture blocking emergency exit for bedridden room. In addition, LPA observed the facility kitchen floor and cabinets dirty. LPA requested the facility to be deep clean, de- clutter and organize. Residents’ personal hygiene was not labeled. Lose toothbrushes were mixed with other residents items. Staff were unable to tell which personal items belong to what resident. LPA requested emergency food, water and supplies to be placed in a storage box to be made available. Furthermore, LPA Rico observed the facility had five out of the six residents with full bed rails. During record review the five residents did not have a physician order nor hospice care plan indicating they require full bed rails. Food Service: Non-perishable and perishable food supply is sufficient for number of residents in care. Facility has a variety of food available for residents. 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 (6) resident file for admission agreements, updated physician reports, and needs and services plans. The licensee stated that R1 and R2 are part of hospice. Both residents did not have a hospice care plan nor completed hospice binder. During medication audit, LPA Rico observed staff had falsely all residents’ medication by documenting medications days in advance.. Blood Pressure for R3 and R4 was also falsely and documented days in advance. LPA observed lose medication in bin, and medications not locked away. Medication did not include starting day and end day. Furthermore, R3 medication was transfer to a Monday through Sunday container. In addition, R3 PRN medication was documented but the date/time and resident’s response were missing. LPA also reviewed (3) staff files for First Aid/CPR certification, criminal record clearance, training, and health screening.Facility did not have their emergency drills updated. Last Emergency drill was conducted in September 30, 2024. Based on the observations made during today’s visit, (11) deficiencies were cited per Title 22, Division 6, of the California Code of Regulations. An exit interview was conducted, and this report (LIC809) was discussed and provided to Administrator/Licensee Marilou Panaligan. Along with a copy of Appeal Rights