Routine inspection·June 13, 2025

Licensing Program Analyst (LPA) Iby Strong conducted an unannounced Required Annual Inspection. The facility file was reviewed prior to the visit. LPA was welcomed by, identified herself to, and discussed the purpose of the visit with Administrator Linda Cruz. According to the facility’s license, the facility has a maximum capacity of six residents, of whom all may be non-ambulatory and six may be bedridden. LPA toured the interior and exterior of the facility and inspected each room. The facility was 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. The facility had sufficient space and equipment to facilitate dining, laundry, visitation, meetings, and resident activities. Cooking/dining equipment and utensils were present. There were no toxic chemicals/poisons accessible to residents. Medications were observed to be pre-poured in cups for the following two days, with incorrect dates marked. Medication administration records for today's morning was not filled in. No pool or body of water is present. Per Linda, no firearms or ammunition are kept at the facility. Carbon monoxide detectors, emergency lighting, and facility telephone were all working. Fire extinguisher were present. First aid kit was complete and readily accessible. Resident records reviewed had required documentation. Five out six resident's needs and services plans were complete but not signed by resident or responsible party. Staff records reviewed did contain required documentation Two technical violations were issued today for records and one deficiency was cited per California Code of Regulations. An exit interview was conducted with Administrator, to whom a copy of this report and the Licensee/Appeal Rights (LIC9058 03/22), LIC809 D and LIC9102 x2 were provided to.