Routine inspection·November 17, 2025

Licensing Program Analyst (LPA) Marisela Garcia-Centeno conducted an unannounced Required Annual Inspection. The facility file was reviewed prior to the visit. Upon arrival, LPA identified herself and was granted entry by Caregiver Lizbeth Caudillo. LPA met with Administrator Karina Lopez and explained the purpose of the visit. It was noted that Caregiver Caudillo had a current criminal record clearance; however, she was not associated with this facility. According to the facility license, the facility is approved for a maximum capacity of six (6) elderly residents ages 60 and above, all of whom may be non-ambulatory, and has a hospice waiver for up to four (4) residents. During today’s inspection, six (6) residents were in care, all non-ambulatory. The facility does not have a secured perimeter or delayed-egress doors. LPA Garcia-Centeno, accompanied by Caregiver Caudillo, toured the interior and exterior of the facility, including resident bedrooms. The facility was clean, well-maintained, and free of obstruction or slip hazards. Resident bedrooms contained required furnishings, and all doors, toilets, and showers were operational. Adequate linens and hygiene supplies were available. The facility provided sufficient space and equipment for dining, laundry, visitation, meetings, and activities. The facility’s internal temperature, refrigerator, and freezer were within regulatory ranges. Hot water temperature in the resident-accessible kitchen faucet measured 110 degrees, which is within regulatory limits. The facility maintained at least two (2) days of perishable food and seven (7) days of non-perishable food, all properly stored. Cooking and dining equipment were present. No sharp objects, toxic chemicals, fireplaces, or open-faced heaters were accessible to residents. (continue at LIC809C) (continue from LIC809) Medications were properly labeled and stored in locked areas. Confidential resident and staff records were secured. No pools or bodies of water were observed. Per the Administrator, no firearms or ammunition are kept on the premises. Smoke alarms, carbon monoxide detectors, emergency lighting, and the facility telephone were operational. Fire extinguishers were serviced within the last 12 months on October 22, 2025. The first aid kit was complete and accessible. Required licensing postings were observed. Emergency drills were conducted in August 2025 and again this morning, November 17, 2025. LPA interviewed staff and residents and reviewed staff and resident files. No licensing concerns were identified through interviews. Resident files contained required documentation. Staff files included proof of current first aid training. The Administrator provided proof of current business liability insurance. Civil penalties in the amount of $900 were assessed for violations and are documented on the attached LIC 421. A plan of correction was developed in coordination with Administrator Karina Lopez. An exit interview was conducted with Administrator Karina Lopez. She was provided copies of this report, LIC 809D Deficiencies, LIC 421 Civil Penalty, and Licensee/Appeal Rights (LIC 9058, 03/22).