Routine inspection·August 19, 2025

Licensing Program Analyst (LPA) LaVette Farlow conducted an unannounced visit to the facility. The purpose of the visit was to complete the required comprehensive annual inspection. LPA met with Facility Caregiver Helena Lapalonga and was granted entry to the facility. At the time of the visit there was two (2) staff present, and one (1) residents present. One resident was in the hospital and two resident were at InnoVage facility. The facility is a six (6) bedroom, three (3), bathroom home, with a kitchen/dining area, living room, with a laundry room and covered patio with sufficient amount of chairs for residents in care. The facility is a Residential Care Facility for Elderly (RCFE) Licensed capacity is (6) current census (4). LPA was accompanied by Facility Caregiver, to conduct a general overall inspection, which included, but was not limited to, the following: Physical Plant: The facility is operating in the capacity approved by Community Care Licensing (CCL). There are no obstructions to indoor and outdoor passageways. The facility is maintained at a comfortable temperature of 68 degrees F. LPA inspected resident’s bedrooms; they are equipped with required furniture such as: mattresses, nightstands, storage space, and sufficient lighting; bathrooms were clean, and appliances were operating appropriately. LPA observed sufficient furniture and lighting throughout the facility. LPA measured and observed the water temperatures in the bathrooms to be 111.2 and 105.2 degrees F. The facility is equipped with operating smoke detectors and carbon monoxide alarms. Posters such as personal rights, the CCL complaint poster, and the disaster plan were posted in a common area. Cleaning supplies, toxins, sharps, and other dangerous items were kept inaccessible to residents in care. There was a designated storage space for resident/staff files. Medications are kept inside medication closet inaccessible to residents in care. Overall, the facility is clean, in good repair, and operating in safe conditions for residents in care. Food Service: Non-perishable and perishable food supply is sufficient for number of residents in care. Care & Supervision: Facility has sufficient care staff for coverage 24 hours a day, 7 days a week. All staff members working in the facility have criminal record clearance through the department. Record Review: LPA reviewed two (2) resident files for admission agreements, updated physician reports, and needs and services plans. LPA also reviewed two (2) staff files for First Aid/CPR certification, criminal record clearance, training, and health screenings. Medications were audited at random and 1 out of 2 residents MARS did not have a PRN medication logged on the medication chart. A deficiency was cited. Based on the observations made during today’s visit, one deficiencies were cited per Title 22, Division 6, of the California Code of Regulations. An exit interview was conducted, and this report LIC809, LIC809C, LIC809D was discussed and provided to Licensee Jasbindar Singh.