Routine inspection·November 18, 2025

Licensing Program Analyst (LPA) Arian Golbakhsh conducted an unannounced, required Annual Inspection. The facility file and personnel report was reviewed prior to the visit. LPA was welcomed by, identified themselves to, and discussed the purpose of the visit to caregiver Jorge Barajas. LPA spoke with Administrator Todd Brooks over the phone, and they arrived later during the visit. The facility's license shows a maximum capacity of six (6) residents, five (5) being non-ambulatory and one (1) being bedridden. Bedridden may only reside in bedroom #1 or #4. Additionally, the facility is approved for two (2) hospice waivers. During today’s inspection there were five (5) residents in care. LPA and Administrator Brooks toured the interior and exterior 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, screens, toilets, and showers were in working order. Hot water temperature at taps accessible to clients were all compliant: kitchen sink was 114.6F. 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 client activities. The facility contained at least two (2) days of perishable food, and at least seven (7) days non-perishable food, all safely stored. Cooking, dining equipment, and utensils were present. Knives were locked and inaccessible to residents in care. [Continued on LIC 809-C] [Continued from LIC 809] No toxic chemicals or poisons were accessible to clients.  Medications were labeled, as required, and stored in locked areas. No pools or bodies of water exist on the premises. Per Administrator Brooks, no firearms or ammunition are kept at the facility. Smoke and carbon monoxide detectors, emergency lighting, and facility telephone were all in working order. Fire extinguisher was purchased within the last 12 months. First aid kit was complete and readily accessible. Required licensing postings were observed in visible areas of the facility. Due to time constraints, LPA was unable to conduct file review and interviews with staff and residents. LPA will return for a continuation visit at a future unannounced date to complete the inspection. Upon review of the personnel report, LPA noted that an employee currently working (identified as S1) was not associated to the facility. LPA was able to verify the employee had an eligible background clearance and associated to sister facilities, just not this one. A Type A citation was issued during the visit per California Code of Regulations, Title 22, Division 6 on the attached LIC 809-D form. In addition, a Civil Penalty is being assessed for Zero Tolerance Violations regarding Criminal Record Clearances and are noted on the attached LIC 421BG form in the total amount of $500.00. Licensee was able to associate S1 to to facility during LPA's visit. One deficiency was cited during the inspection. Administrator Brooks expressed disagreement with the citation issued and refused to sign today's report (LIC 809 and LIC 809-C) and attachments (LIC 809-D and LIC 421BG). Administrator Brooks stated they will not sign as they believe the citation does not fall under the definition of a Type A citation. LPA explained that signing today's report does not necessarily mean they agree with the citation, and that it is rather acknowledgement of LPA providing documentation of the visit and documentation of Administrator Brooks' receipt of today's report. Administrator Brooks stated they understood and maintained their refusal to sign. Administrator Brooks stated they did not feel it appropriate to sign a document for a partially completed Annual Inspection visit. LPA provided Administrator Brooks a copy of today's report and attachments as well as a copy of the Licensee/Appeal Rights (LIC 9058).