Routine inspection·September 16, 2025

On 9/16/2025, Licensing Program Analyst, Arvin Villanueva (LPA) arrived unannounced at this facility to conduct their annual inspection visit. LPA met with Licensee/Administrator Lea Vicio (S1), and stated the purpose of the visit. Overview : Facility is a one-story home located in a residential neighborhood. Facility is licensed to serve up to 6 elderly residents, ages 60 and above. Facility has a fire clearance to obtain/retain up to 4// non-ambulatory residents. Facility is also vendored by Alta California Regional Center (ACRC). No approved hospice waiver at this time. Initial Observation: Upon arriva, LPA did not observe any residents during this visit. Per interview with S1, residents were out in the community. LPA observed required posters and facility license at the entrance. Room temperature was at 75 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 4 resident bedrooms and were observed to be equipped with the required furniture and sufficient lighting throughout. LPA measured the hot water temperature in the 1 of 2 bathrooms to be at 118 degrees Fahrenheit. Both resident bathrooms were observed to be in clean and good repair at this time. Fireplace was observed to be screened. Living areas and hallways were observed to be clear of obstructions. {809-1} Fire extinguisher was observed in the kitchen area and was last inspected on 11/8/24. Smoke and carbon monoxide detectors were observed throughout, tested and found operable at this time. LPA observed centrally stored medications, toxins, and sharp objects were kept locked and inaccessible to residents in care. 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. Extra canned food supplies were observed in the garage area. Proper storage of food items were observed. Kitchen refrigerator and freezer were maintained at regulatory temperature. Outdoor area was inspected. LPA observed outdoor furniture for resident use. Ramps were observed to be in good repair at this time. Emergency walkways were observed to be unobstructed. Location of shut off valves (electric, gas, water) were identified. Record Reviews: Review of 3 of 3 resident files (R1, R2, R3) was conducted, include review of Admission Agreement, Physician Reports, Needs and Services Plan, Centrally Stored Medication Record and Ambulatory Status. No issues were noted at this time. Medication review of 2 residents (R1, R3) include review of physician orders for over-the-counter medications. Resident cash was also reviewed for 2 residents (R4, R5). S1 counted the money on hand. No issues were noted at this time. Review of 3 staff files (S1, S2, S3) 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 monthly drill. First Aid kit was reviewed to be completed. LPA was provided a copy of current Liability Insurance Certificate, LIC500 and Surety Bond during this visit. Interviews: LPA interviewed 1 staff. No resident in care during this visit. Per the California Code of Regulations, Title 22, Division 6, Chapter 8, no deficiencies were cited. Exit interview was conducted with S1. A copy of the report was provided upon exit. {809-2}