Routine inspection·November 5, 2025

Licensing Program Analyst’s (LPA) Janet Ngallo conducted an unannounced Required Annual Inspection. The facility file was reviewed prior to the visit. LPA was welcomed by, identified themselves to, and discussed the purpose of the visit with caregive r Natalia Lazcano. A dministrator Julie Norris later arrived to meet with LPA. According to the facility’s license, the facility has a maximum capacity of six (6) residents, all of whom can be non-ambulatory. During today’s inspection, there were a total of residents in care. LPA, accompanied by caregiver Natalia , 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. 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. Hot water temperature was compliant at 110 F, 109 F, and 109 F. There was at least 2 days of perishable food, and at least 7 days non-perishable food present, all safely stored. Cooking/dining equipment and utensils were present. There were no sharp objects, toxic chemicals/poisons, fireplaces, or open-faced heaters accessible to clients. Medications were labeled, as required, and stored in locked areas. [CONTINUED ON LIC 809-C] [CONTINUED FROM LIC 809] No pools or bodies of water were observed on the premises. Per administrator no firearms or ammunition are kept at the facility. Smoke alarms, carbon monoxide detectors, emergency lighting, and facility telephone were all working. Fire extinguisher(s) were present. First aid kit(s) were complete and readily accessible. Required licensing postings were observed in visible areas of the facility. LPA interviewed staff and reviewed staff and client records/files. LPA interviews did not raise any licensing concerns. The files which LPA reviewed contained required documents. Confidential records were stored in locked areas. During the facility tour, LPA observed medications being stored in small paper cups outside of the resident's medication containers. An interview with Staff #1 (S1) revealed that S1 transfers medications into the paper containers for when they leave their shift so that the other caregiver can easily administer medications to residents. S1 stated the facility is using a new Medication Administration Record (MAR) system called Alcomy. These medications were not stored in the original medication packages. LPA explained to the administrator and caregivers that medications must not be transferred into different containers in this way and in accordance with licensing guidelines must stay in their original packaging. A deficiency was cited per California Code of Regulations, Title 22 (refer to the attached LIC 809-D page). A Plan of Correction was jointly developed with the Licensee. An exit interview was conducted with caregiver Natalia Lazcano to whom a copy of this report and the Licensee/Appeal Rights (LIC9058 03/22) were provided.