Routine inspection·November 4, 2025

On 11/4/2025 at 12:05 PM, Licensing Program Analyst (LPA) Eldin Serrano made an unannounced visit to the facility. The purpose of the visit was to conduct a required comprehensive annual inspection LPA met with Caregiver Maria Ventress and was granted entry to the facility. At the time of the visit there was one (1) staff present, and one (1) resident present. The facility is a three (3) bedrooms, two (2) bathroom home with a kitchen/dining area, living room/activity room. The facility is Residential Care Facility for the Elderly (RCFE). The facility is licensed for a capacity of six (6) of which five (5) can be non-ambulatory, two (2) hospice care waiver and one (1)bedridden and the current census is one (1) resident. LPA was accompanied by a staff 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 Division (CCLD). There are no obstructions to indoor and outdoor passageways. The facility is maintained at a comfortable temperature of 74 degrees Fahrenheit. LPA inspected resident bedrooms; they are equipped with the 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 bathroom to be at 117.8 degrees Fahrenheit. The facility is equipped with operating smoke detectors alarms. LPA observed that the facility does not have the carbon monoxide detector. Citation issued. Fire extinguisher was also observed at the facility. Posters such as personal rights, the CCLD complaint poster, and the emergency contact number were posted in a common area. ***Continuation in LIC809C *** Cleaning supplies, toxins, and other dangerous items were kept inaccessible to residents in care. There was a designated storage space for resident/staff files. There is a Medicine closet that is locked inaccessible to residents in care. LPA observed first aid kit at the facility. LPA observed that the facility does not have the first aid manual. Technical violation issued. LPA observed that the knives were in the kitchen drawer not locked. Citation issued. Yards/Outside : Two shaded patio, one (1) side gate with self-latching handle on the left side of the house that leads into the backyard, attached two (2) car garage observed. All outdoor pathways were free of obstructions. Food Service: Seven (7) days’ supply of Non-perishable foods and two (2) days’ supply of perishable food supply were observed and sufficient for the number of residents in care. LPA observed that the facility have the 72 hour emergency food and water. Care & Supervision: The facility has sufficient number of staff to provide care and supervision to the residents in care. Record Review: LPA reviewed one (1) resident files for admission agreements, updated physician reports, pre-placement appraisals and needs and services plans. LPA observed resident #1 (R1) does not have the physician report, pre-placement appraisal and needs and services plan. Citation issued. LPA reviewed two (2) staff files for First Aid/CPR certification, criminal record clearance, trainings, and health screenings. LPA observed that staff#2 (S2) does not have a health screening report that showed the chest x-ray results and S2 does not have an updated CPR/first aid training. Citation issued. Based on the observations made during today’s visit, seven (7) deficiencies and one technical violation were cited per Title 22, Division 6, of the California Code of Regulations. An exit interview was conducted, and this report LIC809, LIC809D forms, and Appeal Rights were discussed and provided to caregiver Maria Ventress.