Routine inspection·August 7, 2025

On 8/7/2025, Licensing Program Analyst (LPA) Cynthia Tamayo arrived unannounced to conduct a Required 1 Year inspection visit. LPA met with staff Karishma Devi (S2) and Administrator Sanjeeta Prasad (S1) whom arrived a bit later and explained the purpose of this visit. An entrance interview was conducted. Administrator current certification is current. This facility is licensed to serve six (6) non-ambulatory of which all may be bedridden. Hospice approved for (2).Current census is 6. LPA toured the facility with S1 and S2. LPA toured the physical plant including but not limited to the common area, kitchen, dining area, resident bedrooms; resident bathrooms, garage, laundry area, and outside courtyards of the facility to ensure compliance with Title 22 regulations. LPA observed the facility is clean and in good repair. LPA observed required furniture and lighting throughout the facility. LPA observed two day perishables and seven day non-perishables. The hot water temperature was measured initially at 134.1*F. S1 stated the water heater was replaced recently. S1 readjusted the water heater and the final water temperature was at 130.1 within the required range of 105-120*F. S1 stated they will keep a water temperature log and periodically check the temperature is within Title 22 regulation. The temperature inside the facility measured at 77*F which was within the required range of 68-85*F. 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. Smoke and carbon monoxide detector(s) in the facility were in good repair. Continued on 809-C PA requested resident and staff files for review. LPA reviewed (3) staff files and (4) resident files, including criminal record clearances. A review of staff records indicates that all facility staff or other individuals who require caregiver background checks are fingerprint cleared and associated to the facility. LPA verified staff training for staff file reviews. LPA observed that the garage is currently undergoing construction for two additional bedrooms. As per the licensee, they are still in the process of converting the garage with two additional bedrooms. The emergency exit in the garage remains unchanged and observed to be unobstructed. LIC200 and LIC 999 was received. The following forms were requested by 8/15/25: LIC 308 Designation of Administrative Responsibility After several attempts troubleshoot FAS, it was determined that FAS was "not responding" when LPA tried to print reports..Although LPA was able to capture signatures on FAS, LPA was not able to print a physical copy of these reports due to technical issues with FAS. As a result of this annual visit two(2) deficiencies were cited (See LIC809D). An exit interview was conducted with S1and a copy of these LIC 809 reports, LIC 809-D page, and Appeals rights were provided to the facility via email