Routine inspection·July 15, 2025

Licensing Program Analysts (LPAs) Becky Mann and Renese Howell-Small made an unannounced visit to the facility. The purpose of the visit was to conduct a required comprehensive annual inspection. LPA Mann and Howell-Small met with Administrator Milagros Azaula. The facility is an Residential Facility for the Elderly (RCFE). The current census is five (5) residents. The facility is a five (5) bedroom, two (2) bathroom home with a kitchen/dining area, living room, laundry area and a garage. LPAs was accompanied by Milagros Azuala, Administrator 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). LPAs observed no obstructions to indoor and outdoor passageways. The facility is maintained at a comfortable temperature of 78 degrees Fahrenheit. LPAs inspected resident bedrooms; they are equipped with required furniture such as: beds, mattresses, lamps and storage space with sufficient lightning. LPAs observed that bathrooms were clean, and appliances were operating appropriately. LPAs observed grab bars and non-skid mat in the resident bathrooms. LPAs tested the hot water temperatures in the bathroom to be between 109 and 111 degrees Fahrenheit. The facility is equipped with operating smoke detectors, carbon monoxide alarms and charged fire extinguisher. Posters such as personal rights, the CCLD complaint poster, Ombudsman poster and the disaster plan were posted in a common area. There was a designated storage space for resident/staff files. There is a cabinet with the resident’s medications locked. Food Service : Seven (7) days non-perishable and two (2) days perishable food supply observed at the facility. Care & Supervision: The facility has an administrator present in the facility. The facility has sufficient staff 24 hours, 7 days a week. Record Review: LPA reviewed three (3) resident files for admission agreements, updated physician reports, pre-placement appraisal (LIC603) and needs and services plans (LIC625). The files were complete with updated physician’s reports, admissions agreements, needs and services plan and preplacement appraisals. LPAs reviewed three (3) staff files for First Aid/CPR certification, criminal record clearance, trainings, and health screenings with negative tuberculosis (TB) result. LPAs observed that two (2) out of three (3) staff do not have current trainings for the year of 2025. Technical violation issued. Three (3) resident medications were audited. Based on LPAs observation and record reviews, staff did not update Resident #1 (R1) and Resident #2 (R2) Medication Administration Record (MAR) after dispensing their medications per R1 and R2 physician's order. Deficiency cited. Based on the observations made during today’s visit, deficiencies were cited per Title 22, Division 6, Chapter 8 of the California Code of Regulations. An exit interview was conducted, and this report (LIC809), LIC809D forms, LIC9102 and Appeal Rights were discussed and provided to Administrator Milagros Azaula.