Routine inspection·October 23, 2025

Licensing Program Analyst (LPA) Paola Guerrero 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 Ronald Dayo and was granted entry to the facility. At the time of the visit there was two (2) staff present, and four (4) residents present. The facility is a five (5) bedroom, three (3), bathroom home, with a kitchen/dining area, living room, with an attached garage. The facility is a Residential Care Facility for Elderly (RCFE) Licensed capacity is (6) current census (4). LPA was accompanied by Facility caregiver, 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. During inspection LPA observed facility main exterior door to have double lock LPA did no observe fire clearance or CCL approval to be in file. The facility is maintained at a comfortable temperature. LPA inspected resident’s bedrooms; they are equipped with required furniture such as: mattresses, nightstands, storage space, and sufficient lighting; bathrooms were clean, and appliances were operating appropriately. During room inspections LPA observed cameras to be in residents rooms. LPA observed one (1) out of (4) written consents to be in file. LPA will be issuing deficiency. LPA observed sufficient furniture and lighting throughout the facility. The facility is equipped with operating smoke detectors and carbon monoxide alarms. LPA observed an in-ground pool in the backyard; the perimeter of pool is gated however, LPA observed that pool gate did not have a lock. LPA will be issuing deficiency. 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 kitchen cabinets 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. 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 four (4) resident files for admission agreements, updated physician reports, and needs and services plans. LPA also reviewed two (2) staff files for First Aid/CPR certification, criminal record clearance, training, and health screenings. Medications were audited at random and appeared to be dispensed appropriately by staff members. Based on the observations made during today’s visit, facility has been issued two (2) deficiencies, cited per Title 22, division 6, chapter, article 6, is being cited on the attached LIC 9099 D. An exit interview was conducted, and this report (LIC809) was discussed and provided to Facility Caregiver Ronald Dayo.