Routine inspection·September 24, 2025

On 9/24/2025, Licensing Program Analyst, Arvin Villanueva (LPA), arrived at this facility unannounced to conduct the annual inspection visit. LPA initially met with staff on duty, Hirut Taye and stated the purpose of the visit. The administrator, Vivek Sharma, was notified and arrived shortly after. This visit was conducted concurrently with post-licensing today. Overview : Facility is a one-story home located in a residential neighborhood. Facility is licensed to serve up to 6 elderly residents, up to 6 may be non-ambulatory, 1 can be bedridden in room #6 on the facility sketch. Facility has a hospice waiver for 2. Initial Observation: Present during this visit were 5 residents with 1 staff on duty. LPA observed required posters and facility license at the entrance. Room temperature was at 74 degrees Fahrenheit upon arrival. Physical Inspection : Areas inspected include, but not limited to, the kitchen, resident bedrooms, resident bathrooms, living and dining room and outdoor areas. LPA inspected 3 resident bedrooms. Bedroom #6 is currently vacant. LPA measured the hot water temperature in the 1 of the bathrooms to be at 111 degrees Fahrenheit. Bathrooms were observed to be in good repair, equipped with grab bars and non-skid flooring. Fire extinguisher was observed in the living room area and was last inspected on 8/29/2025. Smoke and carbon monoxide detectors were observed throughout. LPA observed centrally stored medications, toxins, and sharp objects were kept locked and inaccessible to residents in care. In the livingroom area, LPA observed the fireplace not screened. Per licensee, they do not utilize the fireplace. LPA also observed a cane was placed at the bottom of the sliding exit door. In the kitchen area, LPA observed sufficient seven day non-perishable and two day perishable food supplies. Pantry was observed to be fully stocked with non-perishable food items. Proper storage of food items were observed. Kitchen refrigerator and freezer were maintained at regulatory temperature. Outdoor area was inspected. LPA observed a covered patio with outdoor furniture for resident use. LPA observed a table obstructing the emergency walkway on the right side of the facility. Advisory was provided to remove the table. Record Reviews: Review of 5 of 5 resident files was conducted, include review of Admission Agreement, Physician Reports, Needs and Services Plan, Centrally Stored Medication Record and Ambulatory Status. Advisory was provided to licensee to obtain PRN authorization for each residents in care. Medication review of 2 residents, include review of physician orders for over-the-counter medications. Facility utilizes an electronic MAR for routine and PRN medications. Review of 3 staff files, include review of background clearance, First Aid/CPR certificate, Health Screen, Initial and Ongoing Training. No issues were noted at this time. LPA also reviewed fire drill/disaster drill records; facility conducts quarterly drill. LPA was provided a copy of current Liability Insurance Certificate, LIC500 and updated Dementia Care Plan during this visit. The updated LIC 308 will be provided via email. Interviews: LPA interviewed 1 staff. Per the California Code of Regulations, Title 22, Division 6, Chapter 8, deficiencies were cited. Exit interview was conducted with Vivek Sharma. A copy of the report was provided upon exit.