Routine inspection·January 23, 2026

Licensing Program Analyst (LPA) Becky Mann conducted an unannounced required 1-year visit to the facility. LPA met with Delfina Rebollar, Administrator and discussed the purpose of the visit. The facility is Residential Care Facility for the Elderly (RCFE). Licensed capacity of 6 with a current census of 4. LPA conducted an overall inspection of the facility, 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 inspected resident bedrooms; they are equipped with the required furniture such as beds, mattresses, night stands, storage space, and sufficient lighting. Bathrooms are clean and appliances were operating appropriately. LPA observed sufficient furniture and lighting throughout the facility. The hot water temperature tested between 105 and 108 degrees Fahrenheit. 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. All the sharps are locked. There was a designated area for resident/staff files. Overall, the facility is clean, in good repair, and operating in a safe condition for residents in care. Administrator was unable to provide proof of Liability Insurance, deficiency issued. Food Service: Non-perishable and perishable food supply is sufficient for the number of residents. Facility has a variety of food available for residents. Dishes, cups, and utensils were also stored properly. Care & Supervision: Facility has sufficient care staff for coverage 24 hours a day, 7 days a week. Record Review: LPA reviewed two (2) resident files for admission agreements, updated physician reports, and needs and services plans. Resident files are maintained and up to date. LPA reviewed two (2) residents medications. Medications are labeled and administered as prescribed. Medications are kept locked and inaccessible to residents in care. LPA also reviewed two (2) staff files for First Aid/CPR certification, criminal record clearance, trainings, and health screenings. Facility staff records are up to date. Based on the observations made during today’s visit, one (1) deficiency were cited per Title 22, Division 6, of the California Code of Regulations. An exit interview was conducted, and this report LIC809, LIC809C and LIC809D was discussed and provided to Administrator Delfina Rebollar.