Routine inspection·April 1, 2026

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 Caregiver, Lailani Pineda and was granted entry to the facility. Caregiver Lailani notified the administrator of my arrival. LPA was accompanied by Gina Cayanan to conduct a general overall inspection, which included, but was not limited to, the following: The facility has 5 bedrooms, 2 1/2 bathrooms, 1 staff bedroom, kitchen, dining area, living room, laundry area, garage and backyard. LPA completed a walk through of facility, review of records and medication audit. Physical Plant: The facility is operating in the capacity approved by Community Care Licensing (CCL). LPA observed no obstructions to indoor and outdoor passageways. The facility is maintained at a comfortable temperature of 73 Degrees Fahrenheit. LPA inspected resident bedrooms; they are equipped with required furniture such as: mattresses, night stands, storage space, chairs and sufficient lighting. LPA inspected resident bathrooms; bathrooms were clean and appliances were found functional. Water temperatures tested at 108.5 and 106.2 Degrees Fahrenheit. The facility has operational smoke detector or carbon monoxide alarms. The facility has charged fire extinguisher. LPA observed the facility has a first aid kit, and first aid book, all component available and accounted for. ***LIC809 continued*** LPA reviewed 3 out of 3 staff files and all 3 files were complete. LPA reviewed staff files for Criminal Background Clearance, Health Screening Report, TB test and test results, required training, and CPR/First Aid. LPA reviewed and audited 2 out of 2 residents files for Admission Agreement, Physicians Report, and Needs and Service Plan. LPA observed 1 out of 2 residents was missing a current Physician report. The last documented report was dated 4/6/2024. A Deficiency cited. At approximately 4:30 PM, LPA conducted a Medication audit. During the course of the audit LPA observed medication that was discontinued still being stored with dispensed medication. Medication that has been dispensed missing initials. Medications not accurately logged on the medication MARs sheet. This was PRN and daily prescribed medications. A Deficiency cited. LPA conducted a review of the facility file: Liability Insurance, Emergency Disaster Plan, Infection Control Plan, Resident Roster (LIC9020) Personnel Roster (LIC500). The facility did not have the Infection Control Plan (LIC9282) or manual for review. A Technical Violation issued. LPA observed the facility did not have a current Liability Insurance policy. Licensee stated they were in the process of negotiating the price. A Deficiency cited. LPA observed that the facility is conducting quarterly emergency drills. During this visit three (3) deficiencies and one (1) technical violations, were cited per title 22, chapter 6 of the California Code of regulation. An exit interview was conducted where this report LIC809, LIC809C, LIC809D, LIC9102TV, and appeal rights were discussed and copies were provided to Licensee Gina Cayanan.