Routine inspection·November 12, 2025

On November 12, 2025 at 9:45 AM Licensing Program Analyst (LPA) LaVette Farlow made an unannounced visit to the facility. The purpose of the visit was to conduct a required comprehensive annual inspection. LPA met with Facility Caregiver Gerardo Alfonso and was granted entry to the facility. Gerardo notified the Administrator Alaina Hendrick of LPA's arrival. At the time of the visit there was two (2) staff present, and five (5) residents present. The facility is a two story six (6) bedroom, five (5), bathroom are for residents and the second story room is for staff, with a kitchen/dining area, living room, and attached garage. The facility is a Residential Care Facility for Elderly (RCFE) Licensed capacity is (6) current census (5). LPA was accompanied by Facility Caregiver, Gerardo and Administrator, Alaina 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 72 degrees Fahrenheit. LPA inspected resident’s bedrooms; they are equipped with required furniture such as: mattresses, night stands, storage space, and sufficient lighting; bathrooms were clean, and appliances were operating appropriately. LPA observed the hallway bathroom was missing it's door. Caregiver and Administrator informed LPA that the door was removed due to lock repair and a hole in the door. Administrator stated the repairs should be completed within the next 48 hours. A technical advisory noted. LPA observed sufficient furniture and lighting throughout the facility. LPA measured and observed the water temperatures in the bathrooms/kitchen to be 110.6 and 111.2, 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. There was a designated storage space for resident/staff files. Medications are kept inside medication closet inaccessible to residents in care. Overall, the facility is clean, in good repair, and operating in safe conditions for residents in care. Food Service: Non-perishable and perishable food supply is sufficient for number of residents in care. LPA observed emergency food supply and water for residents and staff. Care & Supervision: Facility has sufficient care staff for coverage 24 hours a day, 7 days a week. All staff members working in the facility have criminal record clearance through the department. Record Review: LPA reviewed three (3) resident files for admission agreements, updated physician reports, and needs and services plans. LPA observed that three (3) out of three (3) residents file were missing a annual Needs and Service Plan. A deficiency cited. LPA also reviewed three (3) staff files for First Aid/CPR certification, criminal record clearance, training, and health screenings. LPA observed staff file were maintained. Medications were audited at random. LPA reviewed three (3) residents medication log. Two (2) out of three (3) residents centrally stored medication were incomplete. The centrally stored medication log for the month of November was missing medication that was issued in January, August, and October and the facility was not maintaining a MARS log for PRN medications. Deficiencies cited. Based on the observations made during today’s visit, two (2) deficiency were cite and one (1) technical advisory was issued, per Title 22, Division 6, of the California Code of Regulations. An exit interview was conducted, and this report (LIC809), (LIC809C), (LIC809D) and appeal rights was discussed and provided to Facility Administrator Alaina Hendrick.