Routine inspection·March 6, 2026

Licensing Program Analyst (LPA) Magda Malcore made an unannounced visit to the facility to conduct a required comprehensive annual inspection. LPA met with Staff, Janette Mabutas, and discussed the purpose for the visit. The facility is a Residential Care Facility for Elderly (RCFE) with a license capacity of (6), and a current census of (4). LPA conducted a general inspection of facility, which included, but was not limited to, the following: Operation/Physical Plant: Indoor and outdoor passageways were kept free of obstruction. The facility has no swimming pools or similar bodies of water. The facility has sufficient indoor and outdoor space for resident activities. Outdoor activity space is enclosed with a latching gate. The facility is maintained at a temperature of 72 degrees Fahrenheit. Resident bedrooms were furnished with beds, night stands, chairs, bed linen and lighting. Resident bathrooms were maintained clean and fixtures were operating properly. The hot water temperatures in the bathrooms measured at 114 degrees Fahrenheit. The facility is equipped with operating smoke/carbon monoxide alarms, fully charged fire extinguisher, laundry equipment, door signal, emergency supplies/water and telephone service. The facility has posted in a common area Community Care Licensing complaint poster, Ombudsman poster, Resident Personal Rights, facility license, facility sketch, food menu, "oxygen in use" signs, emergency plan and telephone numbers. The facility has a designated area for resident and staff files. In a non-private bathroom located near resident room #2, LPA observed cleaning supplies stored in unlocked and left unattended. Food Service: Kitchen and dining areas were maintained cleaned. Non-perishable and perishable food supply was sufficient for number of residents in care. Cups, plates, and utensils were sufficient for residents in care. **continued on LIC809-C** Health Related Services: The facility maintains a first aid kit with manual and medications were centrally stored in a locked area. LPA audited medications for three (3) residents. LPA observed hand written, altered prescription labels on two (2) prescribed medications for resident #1 (R1). Staff stated the there was a recent order change to the medication dosage and they altered the label to reflect the new dosage. LPA observed a medication supplement for R1 not stored in it's original container. Staff stated that resident's spouse had brought the medication to them in gum container. LPA observed the supplement was listed under medications in R1's Hospice Plan of Care. Record Review: Three (3) resident files were reviewed for admissions agreements, physician’s reports, appraisals, needs and services plans. LPA observed Resident #2 (R2) who was admitted to the facility in October 2025, did not have a hospice care plan maintained at the facility for review. Three (3) staff files were reviewed for First Aid/CPR certifications, criminal record clearances, training, and health screenings. Files were complete. The facility has available an infection control plan, emergency/disaster plan, client registry, and liability insurance for review. During today's visit, deficiencies were cited per Title 22, Division 6, of the California Code of Regulations. An exit interview was conducted where this report was discussed and a copy provided with appeal rights to Staff Mabutas.