Routine inspection·May 20, 2025

Licensing Program Analyst (LPA) Carmen Lopez conducted an unannounced required Annual Inspection. The facility file was reviewed prior to the visit. LPA Lopez identified herself, was granted entry by caregiver Jonathan Luciano. LPA discussed the purpose of the visit with caregiver Luciano. Licensee Paulo Ordinanza 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 of which 6 may be bedridden in at any given time at the facility site. The facility is approved for 2 hospice residents. During today’s inspection, the facility’s current census is five (5) residents living at the facility. There were 4 residents present at the facility site during the inspection. LPA, accompanied by caregiver Luciano, toured the interior and exterior of the facility, and inspected each room. The facility was in clean, sanitary and in good repair. Pathways were free of obstruction and slip hazards. Resident 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, at 72.1 degrees Fahrenheit (F). Hot water temperature at taps accessible to clients were also compliant: kitchen sink measured hot water at 108.5 degrees F; sink in restroom #1 delivered hot water at 113.4 degrees F; and sink in restroom #2 delivered hot water at 109.8 degrees F. [CONTINUED ON LIC 809-C] [CONTINUED FROM LIC 809] 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 all safely stored. There were no toxic chemicals or poisons accessible to residents. Medications were properly labeled, as required, and stored in locked cabinet that LPA inspected. The facility-maintained medication logs which LPA reviewed. No pools or bodies of water on the premises. Per licensee, no firearms or ammunition are kept at the facility. Carbon monoxide detectors, emergency lighting, and facility telephone were all working. Fire extinguisher was present (01) and serviced within the last 12 months. First aid kits were completed and readily accessible. LPA spoke with staff and residents, and reviewed staff and resident records. During today’s visit there were 4 residents on the facility premise. LPA conversations 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. There were deficiencies observed and cited and a technical advisory provided to the facility during today's annual inspection and can be found on the LIC809-D and LIC9102TA page of this report. An exit interview was conducted with Licensee Paulo Ordinanza 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. LPA requested Licensee Ordinanza to submit a current copy of their Designation of Administrative Responsibility LIC 308, Personnel Report LIC 500, and Emergency Disaster Plan LIC 610-E, to the licensing office within 10 business days. Forms are available at www.ccld.ca.gov . LPA also requested to have their Plan of Operation updated and submitted to the licensing office.