Routine inspection·March 20, 2026

On 3/20/26, Licensing Program Analyst (LPA) Cynthia Tamayo arrived at this facility unannounced to conduct a required annual visit. Upon arrival, LPA met with Care staff Rasela Changkwan (S2) and explained the purpose of today’s visit. S2 called the Administrator, Maria Gloria Dulay (S1), and informed them of LPA’s presence. S1 arrived around 11:00AM. This Residential Care Facility for the Elderly facility is a single story building licensed to serve 6 non-ambulatory adults within age range of 60 and over, with a hospice waiver for six. The census is 4 residents and two staff, S2 and Roman Murallo (S3). LPA Tamayo inspected the physical plant including but not limited to the common area, kitchen, dining area, resident bedrooms, bathrooms, laundry room and outside courtyards of the facility to ensure compliance with Title 22 regulations. LPA Tamayo observed the facility to be free of odor, clean and in good repair. There are no bodies of water present. LPA toured the physical plant and observed the following: KITCHEN : Appliances and fixtures were clean and functional. LPA observed seven day non-perishable and two-day perishable food supplies. Meals are prepared by the Staff. Knives and other sharps are locked inaccessible in a drawer. Kitchen and house cleaning supplies are stored in a locked cabinet. LPA observed a weekly menu to be posted. COMMON AREAS: Common areas include the Living Room and Dining Room. All furniture was observed to be clean and in good condition, with enough seating for clients in care. There was space to accommodate both indoor and outdoor activities. LPA noted an Activity Calendar in the living room area and activities stored in the in the dining room area. The dining area was set up to celebrate resident 1’s (R1’s) birthday (R1). Continued on 809-C. INFECTION CONTROL/EMERGENCY DISASTER PLAN: During today’s visit, the LPA reviewed the facility's infection control plan as well as the facility's emergency disaster plan. The facility’s policies and procedures as it pertains to infection control are within regulation. Both documents were observed to be complete and recently updated. Emergency disaster drill is conducted quarterly per regulation. EXTERIOR : Exterior passageways were clean and clear of any obstructions. There is a backyard patio area for client and visitor use with furniture observed to be in good condition. There are no exterior gates. BEDROOMS : LPA inspected facility bedrooms. The facility has five (4) total client bedrooms and (1) staff bedroom. All bedrooms were observed to contain furniture, bedding and linens within regulation. Extra linens are stored in the hallway cabinet. Client bedrooms had no visible hazards or inconsistencies observed. BATHROOMS : There are three bathrooms. All bathrooms were observed to be clean and sanitary, and supplied with paper towels. Water temperature was tested and measured at 121.1 degrees F in the kitchen and 105 degrees Fahrenheit in resident bathroom sink, which is not within the required regulation, S2 adjusted the water temperature during this visit to ensure water temperature is within 105 to 120 degrees Fahrenheit. Grab bars and non-slip mat were observed to be stable and in good repair at this time. MEDICATION REVIEW: LPA reviewed medications which are centrally stored in a locked cabinet in the common area near the facility entrance. LPA observed the centrally stored medications area to be locked and inaccessible to residents. LPA observed the fire extinguisher(s) and first aid kits were up to date. Fire drills are completed monthly. LPA observed smoke and carbon monoxide detector(s) in the facility were in good repair. All emergency exits were clear from obstructions. LPA requested client and staff files for review. LPA reviewed 6 resident files and 3 staff files, including criminal record clearances. A review of staff records indicates that all facility staff or other individuals who require caregiver background checks are fingerprinted and associated to the facility. Administrator holds certification Administrator Certificate # 7001763740 and expires on 11/10/2027. The following documents were requested to be sent to the Regional Office: (1) LIC 308 Designation of Administrative Responsibility (2) Insurance verification (3) LIC 610 Current Emergency Disaster Plan (4) Surety Bond (5) LIC 500 Current Personnel Report As a result of this annual visit, the facility is in compliance with Title 22 Regulation no deficiencies were cited. An exit interview was conducted with the Licensee, and a copy of these LIC 809 reports were left at the facility.