Routine inspection·October 26, 2025

Licensing Program Analyst (LPA) Raquel Hernandez made an unannounced visit to the facility. The purpose of the visit was to conduct a required comprehensive annual inspection. LPA Hernandez met with House Manager Maria Delia Alpez. The capacity is (12) current census is (11). The facility is a nine (9) bedroom, nine (9) bathroom home with a kitchen/dining area, living room and attached garage. The facility is Residential Care Facility for the Elderly (RCFE). LPA Hernandez was accompanied by House Manager Maria Delia Alpez 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 of 72 degrees. LPA Hernandez inspected resident bedrooms; they are equipped with required furniture such as: mattresses, nightstands, storage space, and sufficient lighting. LPA observed water to be of white color in (2) residents restrooms. LPA observed in Resident #8 (R8) to not have any hot water as hot water faucet on bathroom sink does not turn on. Deficiency will be issued. LPA Hernandez observed sufficient furniture and lighting throughout the facility. 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 CCL complaint poster, labor laws, 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. There is a Medicine cabinet with the resident’s medications locked. Food Service: More than seven (7) days’ supply of Non-perishable foods and more than two (2) days’ supply of perishable food supply were observed and sufficient for the number of residents in care. Care & Supervision: The facility has sufficient number of staff to provide care and supervision to the residents in care. Record Review: LPA Hernandez reviewed eight (8) resident files for admission agreements, updated physician reports, pre-placement appraisals and needs and services plans. LPA observed no updated physician report for Resident #8 (R8). Deficiency will be issued. LPA observed no reappraisals for Resident #1 (R1), Resident #2 (R2), Resident #4 (R4), Resident #7 (R7) and Resident #8 (R8). LPA observed no needs and services plan for R1 or R8. Deficiency will be issued. Additionally, LPA observed for Resident #6 (R6) a full bed rail with no doctor order or on hospice care. Deficiency will be issued. LPA discovered the facility is providing care for three (3) bedridden residents which are not approved per the facility's license. Deficiency issued with civil penalty. LPA observed Resident #1 (R1) does not have a restricted health care plan. Deficiency will be issued. LPA observed five (5) residents medications. LPA observed for all (5) residents medication to not be documented properly on Medication Administration Record (MAR). Deficiency will be issued. LPA observed missing medications that are documented on MAR but not on resident's centrally stored medication log. Deficiency will be issued. LPA observed for Resident #5 medication to be removed from original container and put into a different container. Deficiency will be issued. Based on the observations made during today’s visit, deficiencies were cited per Title 22, Division 6, of the California Code of Regulations. An exit interview was conducted, and this report (LIC809) (LIC809D) and (LIC421IM) was discussed and provided to House Manager Maria Delia Alpez.