Routine inspection·August 29, 2025

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 Karin Vaughn. LPA began inspection with introduction, visit purpose and provided the facility Manager with LPA identification and business card. Resident record review began- Five (5) 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. Employee records review began- Three (3) records were reviewed. LPA reviewed employee record for first aid certification, fingerprint clearance, personnel/job application, health screening and TB test results, criminal record statement, employee rights, 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 current 06/02/2027. Physical Plant and Safety of Environment/Operational Requirements- LPA toured the facility inside and outside. The kitchen area has been under repairs since the end of May and is expected to be completed end of September. The home is maintained at a comfortable temperature for the clients. Lighting is sufficient for safety and comfort. Water temperature measured 130.0 degrees F with warnings labels posted. Laundry facilities and a locked cabinet is present for storing laundry soap and other chemicals in the garage. (Continued on Page 2) (Continued from LIC809, Page 1) All outdoor and indoor passageways are free of obstruction. A locked area is provided for medications inside the laundry room and sharp objects have been temporary moved to the garage. LPA verified there is a telephone working at this location. This home does have a pool and is locked at all times with fencing that is more than 5 ft. high around the perimeter of the pool. Food Service- Food supply meets the of one week supply of nonperishable and 2-day supply of perishables food on hand. Due to the repairs of the kitchen, food supplies are housed inside the garage and staff rooms. 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. Smoke detectors and carbon monoxide detectors were tested and found to be operational. Fire extinguishers are tested or replaced annually and were last done so on 6/27/2025. The facility conducting emergency disaster drills quarterly and last done on 7/1/2025. Corporation is active and in good standing. Based on the information received during this visit today, one (1) deficiency is being cited per Title 22, Division 6 of The California Code of Regulations. This report, LIC809D, LIC809G and Appeal Rights was reviewed with Karin Vaughn at the time of the exit interview.