Routine inspection·September 10, 2025

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 House Manager Marco Pascaran and was granted entry to the facility. Licensed capacity is (6) current census (2). LPA was accompanied by House Manager Marco Pascaran 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 resident bedrooms; they are equipped with required furniture such as: mattresses, night stands, storage space, and sufficient lighting; bathrooms were clean, and appliances were operating appropriately. LPA tested water temperature to test at 106 degrees Fahrenheit. 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. Cleaning supplies, toxins, sharps, and other dangerous items were kept inaccessible to clients in care. There was a designated office for resident/staff files. Overall, the facility is clean, in good repair, and operating in safe conditions for residents in care. 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 (2) resident files for admission agreements, updated physician reports, pre-placement appraisals and needs and services plans. LPA observed no updated physician report for Resident #1 (R1). Technical Violation will be issued. LPA observed no reappraisal being conducted for (2) residents in care. Technical violation was issued. House Manager stated a reappraisal will be sent to LPA. LPA observed facility does not have a Plan of Operation in place. Deficiency will be issued. Additionally, LPA observed facility does not have a dementia care plan and has (1) resident diagnosed with dementia. Deficiency will be issued. LPA reviewed (1) resident medications. No issues were observed. Additionally, LPA also reviewed (3) staff files for First Aid/CPR certification, criminal record clearance, training's, and health screenings. No issues were observed. Based on the observations made during today’s visit, (2) deficiencies and (2) technical violation were cited/issued per Title 22, Division 6, of the California Code of Regulations. An exit interview was conducted, and this report (LIC809), (LIC809D), (LIC9102TV) and copy of appeal rights were discussed and provided to House Manager Marco Pascaran.