Routine inspection·December 18, 2025

Licensing Program Analyst (LPA) Amy Rodgers conducted an unannounced required Annual Inspection. The facility background information was reviewed prior to the visit. LPA Rodgers identified herself, was granted entry by caregiver Blanca Garcia. Facility Manager Elda Acosta later arrived and joined the visit. According to the facility’s license, there may be a maximum of six (6) residents all of whom may be non-ambulatory in at any given time at the facility site. They may have one (1) bedridden resident in bedroom #2 and the facility is approved for a hospice waiver for 1 resident. LPA, accompanied by caregiver Garcia and facility manager Acosta, toured the interior and exterior sections of the facility, and inspected each room. The facility was clean, sanitary and in good repair. Pathways were free of obstruction and slip hazards. Client bedrooms contained the required furnishings. Doors, windows, toilets, and showers were in working order. Extra linens and hygiene supplies were present, as well as Personal Protective Equipment. The facility had sufficient space and equipment to facilitate dining, laundry, visitation, meetings, and activities. The facility’s ambient internal temperature was comfortable and compliant.. Hot water temperature at taps accessible to clients were also compliant. There was at least 2 days of perishable food, and at least 7 days non-perishable food present. Cooking/dining equipment and utensils were present and stored. Sharps were not safely stored in a locked or inaccessible area but facility manager placed a lock on the cabinet door during the inspection. There were no toxic chemicals or poisons accessible to residents. LPA found that medications were properly labeled, as required, and stored in a locked area. The facility maintained medication logs which LPA reviewed. [CONTINUED ON LIC 809-C] (Continued form LIC802) No pools or bodies of water on the facility premises. Per facility manager Elda Acosta, no firearms or ammunition are kept at the facility. Carbon monoxide detectors, emergency lighting, and facility telephone were all working. Fire extinguisher(s) were present (01) and serviced within the last 12 months. First aid kit(s) were readily accessible. LPA interviewed staff and residents, and reviewed staff and resident records. LPA interviews did not raise any licensing concerns. The files which LPA reviewed contained required documents. Confidential records were stored in a locked area. Required licensing postings were observed in a visible area of the facility. During today’s visit there were 4 residents on the facility premise. The department observed Resident #1, #2, and #3 beds to have full bed rails with no doctors orders and the Residents #1,#2, and #3 were not on hospice. Facility manager Elda Acosta removed the bed rails during the visit. Upon entry into the facility the the Department noted a latch device on the inside of the front door that would prevent immediate exit form the facility. Photos were taken and Facility Manager Elda Acosta removed the locking device during the visit. There were deficiencies observed and cited during today's annual inspection and may be found on the LIC809-D page. LPA requested facility manager Acosta to remove the full bedrails as well as the delayed egress device from the front door during the visit. Acosta explained they may be submitting a prohibited exception waiver for 3 of 4 residents in care to CCLD. Forms are available at www.ccld.ca.gov . An exit interview was conducted with facility manager Elda Acosta to whom a copy of this report along with the Licensee/Appeal Rights (LIC9058 03/22) were provided at the conclusion of the visit. The signature below confirms the documents were received.