Routine inspection·August 6, 2025

On 08/06/25, an 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 a caregiver. The Administrator, Michael Jankowski and Designated Facility Administrator (DFA) Mary Rose Jankowski arrived shortly after, and a brief interview followed. LPA was allowed entry into the facility that is licensed to serve a total capacity of 6 residents. The current census is 5. This facility is licensed for 6 non-ambulatory residents and a hospice waiver granted for 6. A fire drill was held on 03/15/25 for 10.5 minutes. The drill included 2 staff and 4 residents. LPA observed there was no time noted on the log for fire drills. LPA toured the facility with the Administrator, Michael Jankowski and DFA with Mary “Rose” Jankowski. The kitchen was accessible to residents and clean and sanitary. The LPA observed 7 days of non-perishable food supplies and observed 2 days of perishable food supplies. LPA Hayes also observed a delivery of food during this visit. There were enough clean plates, cups and bowls and cutlery to meet capacity. The garage was not accessible to residents. LPA observed the storage of incontinence supplies, washer and dryer and a small storage with a door. Inside LPA observed more incontinence supplies. The facility living room was clean and free of obstruction. The room temperature reading was 73 degrees Fahrenheit which fell within the Title 22 regulations of 68-85 degrees Fahrenheit. The seating is efficient for the number of residents in this facility. Continued on 809-C There was a fire extinguisher (last serviced 01/2025 by River City Fire), smoke and carbon monoxide detectors, and central heating and air in the facility. LPA observed the centrally stored medications area to be locked and making medication inaccessible to residents. The Medication Administration Record (MAR) was reviewed. LPA reviewed 5 resident records and 2 staff records. LPA observed the residents’ bedrooms. Bedrooms were clean and furnished with beds, bed sheets, bed comforters, lighting, a chest of drawers. LPA observed the backyard of the facility. There was a shaded area with seating for residents to enjoy. Fencing was in good repair. There were no bodies of water. Per California Code of Regulations, Title 22, 0 deficiencies were observed during today’s visit. Exit interview was conducted. A copy of this report was provided to the Administrator, Michael Jankowski and Mary “Rose” Jankowski.