Routine inspection·August 25, 2025

Licensing Program Analyst (LPA) Dang Nguyen conducted an unannounced visit to conduct a Required Annual Inspection. The facility file was reviewed prior to the visit. LPA was welcomed by, identified himself to, and discussed the purpose of the visit with Caregiver Margarita "Marga" Ciruela. LPA then met with Licensees Mevyl Deguzman and Aries Deguzman, who arrived shortly after. According to the facility’s license, the facility has a maximum capacity for six (6) residents, of whom all may be ambulatory or non-ambulatory, but none may be bedridden. Per LPA observation, LIC602 Physician’s Reports, and staff interviews: During today’s inspection, there were a total of six (6) residents in care, of whom all were non-ambulatory. The facility’s license does not include endorsements for delayed-egress doors or secured perimeters, and none of these were present. LPA, accompanied by Licensee’s staff, toured the interior and exterior of the facility and inspected all common areas and resident bedrooms. LPA interviewed multiple residents and multiple staff. LPA reviewed care records for all residents and personnel records for all active staff. The facility was clean, sanitary, and in good repair. Pathways were free of obstruction and slip hazards. Resident bedrooms contained the required furnishings. Doors, windows and screens, toilets, and showers were working. Extra linens and hygiene supplies were present. The facility had sufficient space and equipment to facilitate dining, laundry, visitation, meetings, and resident activities. [CONTINUED ON LIC 809-C] [CONTINUED FROM LIC 809] The facility’s ambient internal temperature was complaint at 74 F. Where tested, hot water temperature at taps accessible to residents were all compliant: Kitchen Sink was 110.1 F, Bathroom #1 Sink was 109.2 F, and Bathroom #2 Sink was 109.4 F. Appliances to preserve perishable food were also compliant in temperature. There was at least two (2) days of perishable food, and at least seven (7) days non-perishable food present, all safely stored. Cooking/dining equipment and utensils were present. There were no sharp objects, toxic chemicals/poisons, or open-faced heaters accessible to residents. Medications were labeled, as required, and stored in locked areas. Confidential records were stored in locked areas. Required licensing postings were observed in visible areas of the facility. Carbon monoxide detector, smoke detectors, night lights, emergency lighting, and facility telephone were all working. The facility’s fire extinguisher had been serviced within the last twelve (12) months. The facility’s fireplace was screened, as required. No pools/bodies of water were observed on the premises. Per the Licensee, no firearms or ammunition are kept at the facility. Fire/disaster drills were performed at required intervals. There were reserve supplies of Personal Protective Equipment (PPE). Staff were trained on the both facility's written LIC610E Emergency Disaster Plan and PPE within the last twelve (12) months, as required. Licensee presented proof of current business liability insurance. During records review, LPA observed, and manager interview confirmed: Licensee did not maintain written proof that 3 of 6 staff (S1, S2, and S3) had current/active First Aid Training. (Regulation requires all care staff to have first aid training from “persons qualified by such agencies as the American Red Cross.”) [See LIC811 Confidential Names List for a description of select person identifiers used in this report.] One (1) deficiency was cited per California Code of Regulations, Title 22 (refer to the LIC809-D page). A Plan of Correction was jointly developed with the Licensee. LPA also issued two (2) Technical Violations (TV), regarding a videoconferencing device dedicated for resident use and regarding knob protectors for the kitchen range (refer to the LIC9102-TV pages). An exit interview was conducted with Licensees Mevyl Deguzman and Aries Deguzman, to whom a copy of this report, the LIC 809-D page, the LIC9102-TV pages, and the LIC811 Confidential Names List, and the Licensee/Appeal Rights (LIC9058 03/22) were provided during today’s visit.