Routine inspection·April 24, 2026

On 4/24/2026 Licensing Program Analyst (LPA) LaVette Farlow arrived unannounced to conduct the required comprehensive annual inspection to the facility. LPA was greeted and granted access into the facility by Administrator, Carina Davis and introduced self and stated purpose of the visit. During the visit LPA was escorted by Carina on a tour and the following information was observed: The facility has 5 bedrooms, 1 of the 5 rooms is for staff, 3 bathrooms, kitchen, dining area, family room, living room, lock laundry area, attached garage, and backyard. LPA completed a walk through of facility, review of records, and conducted a random audit of the medication. 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 76 degrees Fahrenheit. LPA inspected client bedrooms; they are equipped with required furniture such as: mattresses, night stands, storage space, and sufficient lighting. LPA inspected client bathrooms; bathrooms were clean and appliances were found functional. LPA observed that facility has a sufficient supply of hygiene items for residents in care. Water temperatures tested at 113.5, 111.0, and 109.5 degrees Fahrenheit. The facility is equipped with operational smoke detectors, carbon monoxide alarms and charged fire extinguisher. LPA observed poster on display for personal rights, and disaster plans were posted in a common area. Cleaning supplies, toxins, sharps, and other dangerous items were kept in secure cabinets, inaccessible to residents. There was a designated storage space for client/staff files. Medications and first aid kit were in secure cabinets and inaccessible to residents. There are no firearms or ammunition in the facility. Overall, the facility is clean, in good repair, and operating in safe conditions. Food Service : LPA observed that the facility has a sufficient supply of perishable and non-perishable items. The facility has sufficient supply of dishes, cups, and utensils were also stored properly. Emergency food and water were observed. Yards/Outside: LPA observed one shaded patio, a side gate with self-latching handle on the left side of the house that leads into the backyard. All outdoor pathways were free of obstructions. LPA observed a garden with fresh fruit and vegetables in the backyard. Record Review: LPA reviewed Administrator and 3 staff files for First Aid/CPR certification, criminal record clearance, training, health screenings and TB test. LPA observed that 3 staff were missing a health screening, but everyone had TB test results available. A Technical Violation issue. LPA reviewed 3 residents files for admissions agreements, pre-admissions appraisals, physician's reports, needs and service plans. Personnel records and residents file appeared to be complete and in order. LPA observed 3 out of 3 resident were missing a needs and service plan. A Technical Violation issued. LPA conducted an audit of the resident MARs and Centrally Stored Medication log. LPA observed that 1 out of 3 residents had one medication missing from the residents MARs. A Deficiency Cited. One (1) deficiency and two (2) Technical Violation issued during this visit per Title 22, chapter 6 California Code of Regulation. An exit interview was conducted where this report LIC809, LIC809C, LIC809D, LIC9102TV and Appeals Rights were discussed and copies were provided to Administrator, Carina Davis.