Routine inspection·September 4, 2025

On 9/04/2025 at 1:00 PM, Licensing Program Analysts (LPAs) Eldin Serrano and Edith Conchas made an unannounced visit to the facility. The purpose of the visit was to conduct a required comprehensive annual inspection LPAs met with Administrator Letitia Isai and was granted entry to the facility. At the time of the visit there were two (2) staff present, and two (2) residents present. The facility is a four (4) 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 four (4) non-ambulatory and two (2) hospice care waiver residents and the current census is two (2) residents. LPAs was accompanied by Staff #1 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 84 degrees Fahrenheit. LPAs 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 observed sufficient furniture and lighting throughout the facility. LPAs measured and observed the water temperatures in the bathroom to be at 114 degrees Fahrenheit. The facility is equipped with operating smoke detectors and carbon monoxide alarms. Fire extinguishers were also observed at the facility. Posters such as personal rights, the CCLD complaint poster, and the emergency disaster number were posted in a common area. ***Continuation in LIC809C *** LPAs observe that the facility did not have the Infection Control Plan (LIC9282), Emergency/Disaster Plan (LIC610E) ready for review during the visit. Citation issued. Cleaning supplies, toxins, sharps, and other dangerous items were kept inaccessible to residents in care. There is a Medicine cabinet with the resident’s medications locked. LPAs observed complete first aid kit and first aid book at the facility. 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. Care & Supervision: The facility has an Administrator present in the facility with enough hours to appropriately manage the facility. The facility has sufficient number of staff to provide care and supervision to the residents in care. Record Review: LPAs reviewed two (2) resident files for admission agreements, updated physician reports, pre-placement appraisals and needs and services plans. LPAs observed resident files reviewed were complete. LPAs reviewed two (2) staff files for First Aid/CPR certification, criminal record clearance, trainings, and health screenings. Based on the observations made during today’s visit, two (2) deficiencies 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 Administrator Letitia Isai.