Routine inspection·January 15, 2026

On 01/15/2025 at 09:30 AM, Licensing Program Analyst (LPA) Beena Singh made an unannounced visit to the facility. The purpose of the visit was to conduct a required comprehensive annual inspection. LPA Singh met with Staff-Carmencita fajardo and was granted entry to the facility. Facility manager Juana Hamed Shalaby arrived during the visit. At the time of the visit there were two (2) staff present, and twenty-three (22) residents present. The facility is a fourteen (14) bedroom, four (4) bathroom home with a kitchen/dining area, living room/activity room. The facility is Residential Care Facility for the Elderly (RCFE). The facility is licensed for a capacity of twenty-five (25) non-ambulatory residents and approved for six (6) hospice waiver. The current census is twenty-three (22) residents. LPA Singh was accompanied by Staff-Carmencita Fajardo 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 of 73 degrees Fahrenheit. LPA Singh inspected resident bedrooms; they are equipped with required furniture such as: mattresses, night stands and wall lamps, storage space, and sufficient lighting; bathrooms were remodelled and clean, and appliances were operating appropriately. LPA Singh observed sufficient furniture and lighting throughout the facility. LPA Singh measured and observed the water temperatures in the bathroom to be at 112 degrees Fahrenheit. The facility is equipped with operating smoke detectors and carbon monoxide alarms. Fire extinguishers were also observed at the facility. Posters such as personal rights, the CCL complaint poster, Ombudsman poster, labor laws, and the disaster plan were posted in a common area. ***Continuation in LIC809C ** During the tour of the facility, LPA Singh observed cleaning supplies, toxins, sharps, and other dangerous items were kept locked, inaccessible to residents in care. There was a designated storage space for resident/staff files. There is a Medicine Cabinet for the residents with the resident’s medications locked. LPA Singh observed the complete first aid kit and first aid book at the facility. Food Service: More than seven (7) days’ supply of Non-perishable foods and more than two (2) days’ supply of perishable food supply were observed and sufficient for the number of residents in care. Care & Supervision: The facility has an Administrator present in the facility with appropriate and enough hours to appropriately manage the facility. The facility has sufficient number of staff to provide care and supervision to the residents in care. Record Review: LPA Singh reviewed five (5) resident files for admission agreements, updated physician reports, pre-placement appraisals and needs and services plans. LPA Singh observed resident files reviewed were complete. LPA Singh reviewed two (2) staff files for First Aid/CPR certification, criminal record clearance, Dementia and other training, and health screenings. Last Fire drill completed on 11/15/2025 and Earthquake drill on 11/09/2025. Medications/Medication Administration Record (MAR) for five (5) residents and P&I were audited for three (3) residents, LPA Singh observed no issue. Liability insurance is valid from 09/2025 to 09/2026. Based on the observations made during today’s visit, no deficiencies were cited per Title 22, Division 6, of the California Code of Regulations. An exit interview was conducted, and this report (LIC809),LIC 809C were discussed and provided to Facility manager Juana Hamed Shalaby.