Routine inspection·October 1, 2025

On 10/01/25 Licensing Program Analyst (LPA) Javina George made an unannounced visit to the facility to conduct a 1 year required visit. LPA was greeted and granted entry by Destiny Quijada, Activities Director, where LPA explained the purpose of the visit. The facility has an approved fire clearance for ten (10) residents that are bedridden with an approved hospice waiver for (15). The administrator was not at the facility at the time the inspection was conducted. Below are the observations made during today's visit: The facility was observed to be clean, with the passageways being from of obstructions. The food supply was sufficient as there was a 2 day supply of perishable food items and a 7 day supply of non perishable food items. The chemicals, and other hazardous items were observed to be locked and inaccessible to residents in care. The resident bedrooms were observed to have the required furniture such as bed, chair, chest of drawers,night stands and light. The bathrooms were observed to have grab bars, with pull cords and the signal system was tested and observed to be operable, in addition residents are provided with pendants . The hot water temperature was tested in randomly selected resident bathrooms and found to be within regulatory limits of 113.8 degrees Fahrenheit. The medications are stored in a locked medication room inside medication carts. The fire extinguishers were last serviced 05/18/25. The last emergency disaster drill was conducted on 09/15/25. There are no known guns or ammunition on the premises. There are no pools or bodies of water observed at the facility. The facility annual fees were observed to have been paid. The facility is in possession of valid liability insurance that expires on 04/20/26, and the governing body was observed to be in good standing. Records review: Per the Guardian personnel roster all staff present at the facility were observed to have obtained criminal record clearance and to be associated to the facility. The Executive Director Jennifer was observed to have a valid administrator's certification with a certificate that expires on 03/21/27, as well as CPR certification that expires on 11/06/25. However a records review of four (4) staff files revealed the files are incomplete, as there are records missing such as criminal record statement, proof of 20 hours of completed training and health screening report. Additionally LPA observed for there to not be proof of valid CPR certification. Deficiency cited. Resident files were observed to have updated medical assessments, appraisals and admissions agreements. The facility is to submit an updated emergency disaster plan LIC610E, by 5pm on 10/6/25. Based on today's inspection the deficiencies are being cited in accordance with the California Code of Regulations (Title 22, Division 6, Chapter 8). on the attached 809D. An immediate civil penalty of $250 is being assessed due to a repeated violation within a 12 month period. An exit interview was conducted and a copy of this report, LIC809D, LIC421FC, LIC9098-Proof of Corrections form, and appeal rights were reviewed and provided to Destiny Quijada, Activities Director.