Routine inspection·May 8, 2026

Licensing Program Analyst (LPA) Raquel Hernandez made an unannounced visit to the facility. The purpose of the visit was to conduct a required comprehensive annual inspection. LPA Hernandez met with Administrator Jesus Correa. The capacity is (6) current census is (4). The facility is a six (6) bedroom, two and a half (2 1/2) bathroom home with a kitchen/dining area, living room and attached garage. The facility is Residential Care Facility for the Elderly (RCFE). LPA Hernandez was accompanied by Administrator Jesus Correa 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. LPA Hernandez inspected resident 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 Hernandez observed sufficient furniture and lighting throughout the facility. The facility is equipped with operating smoke detectors and carbon monoxide alarms. Posters such as personal rights, the CCL complaint poster, labor laws, and the disaster plan were posted in a common area. There was a designated storage space for resident/staff files. There is a Medicine cabinet with the resident’s medications locked. LPA observed scissors, knives, and chemicals kept unlocked accessible to residents in care. Deficiency will be issued. Food Service: More than seven (7) days’ supply of Non-perishable foods and more than two (2) days’ supply of perishable food supply were observed and sufficient for the number of residents in care. Care & Supervision: The facility has sufficient number of staff to provide care and supervision to the residents in care. **Continuation on LIC809-C** Record Review: LPA Hernandez reviewed two (2) resident files for admission agreements, updated physician reports, pre-placement appraisals and needs and services plans. LPA observed two (2) residents medications. LPA observed no updated centrally stored medication log for Resident #1 (R1) and Resident #2 (R2). Deficiency will be issued. LPA observed no reapprasial's for Resident #1 (R1) and Resident #2 (R2). Deficiency will be issued. Additionally, LPA observed no needs and services plan for R1 and R2. Deficiency will be issued. LPA Hernandez reviewed two (2) staff files for First Aid/CPR certification, criminal record clearance, trainings, and health screenings with Tuberculosis (TB) test result. No issues were observed. Based on the observations made during today’s visit, deficiencies were cited per Title 22, Division 6, of the California Code of Regulations. An exit interview was conducted, and this report (LIC809) was discussed and provided to Administrator Jesus Correa.