Routine inspection·August 7, 2025

On 08/07/2025 unannounced annual inspection was made to this facility by Licensing Program Analyst (LPA) Sommer Hayes. The LPA identified themselves and the purpose of the visit and asked to speak to the Designated Facility Administrator (DFA). LPA was met by the Designated Facility Administrator, Ann Taguinod and a brief interview followed. LPA was allowed entry into the facility that is licensed to serve a total capacity of 5 residents. The current census is 4. LPA Hayes toured the facility with the DFA, Ann Taguinod. The kitchen was accessible to residents and clean and sanitary. The LPA observed 7 days of non-perishable and 2 days of perishable food supplies. There is enough clean plates, cups and bowls and cutlery to meet capacity. Opened packages in the refrigerator were dated appropriately. Staff were observed assisting residents with activities of daily living (ADLs), cleaning the home, cooking and engaging with resident in care. Residents were observed sleeping, watching television, and in their bedrooms. Water temperature measured 106.3 degrees F within regulation between 105- and 120-degrees F at in the bathroom accessible to residents. Fire extinguishers inspected were charged on 04/25 by River City Fire. A dual smoke detector/carbon monoxide monitor in hallway was tested and working. There was enough lighting in all common areas, resident rooms, and hallways. Continued on 809-C Two first aid kits were observed containing a first aid manual, tweezers, scissors, gauze and Band-Aids. LPA Hayes reviewed 4 resident files and 3 staff records during this visit. Medication was centrally stored and secured. The medication administration record (MAR) was reviewed and found to be complete with accurate documentation of administered medications provided to residents. LPA Hayes observed the backyard of the facility to be clean and free of hazards. There was a shaded area for residents to enjoy. Fencing was in good repair. There was patio furniture, flowers, a garden and a walking path for residents. There were no bodies of water. The facility living room was clean and free of obstruction. The temperature reading was 73 degrees Fahrenheit per Title 22 regulations. The seating is efficient for the number of residents in this facility. This facility is being LPA Hayes requested the following annual documents for the facility file: LIC 500 Personnel Report, LIC 308 Designation of Responsibility, LIC 610 Emergency Disaster Plan, LIC 999 Facility Sketch, Copy of Liability Insurance. Per California Code of Regulations (CCR) - Title 22, 2 deficiencies are being cited. An exit interview was held, and a copy of the report was provided to Designated Facility Administrator, Ann Taguinod.