Routine inspection·June 30, 2025

On 6/30/2025, Licensing Program Analyst (LPA) Tobola conducted an unannounced Annual Required – 1 yr. inspection for this facility and was greeted by Caregiver, Luz Madraga. Administrator, Sarah Chu was contacted and arrived later in the visit. The facility currently provides care for 5 residents none of which with a diagnosis of dementia. LPA continued with a tour of the facility with staff, facility found to be clean and at a comfortable temperature with all exits free from obstruction. Resident’s bedrooms, common areas, kitchen & food storage areas were inspected. Fire Extinguishers located throughout the facility were found to be charged. Smoke and carbon monoxide detectors were present. LPA also observed two new carbon monoxide detectors that the Licensee will be installing on both facility floors. Emergency disaster plan is reviewed and completed. There was a sufficient supply of both perishable and nonperishable foods as required by Title 22 Regulations, with food stored in the kitchen refrigerator found to have appropriate coverings, enough for residents in care. There was a supply of hygiene products and paper products available for residents. Resident's bedroom have lighting & appropriate furnishings and bedding items. Restrooms for resident use were equipped with non-slip mats, grab bars and kept in good condition. There is a large outdoor patio equipped with appropriate shading for resident use. Medications are stored in designated cabinets in the kitchen and were found to be secured. Continued onto LIC809-C Upon spot review of medications, LPA found that the facility has centrally store medication records updated and in order. LPA conducted a sample file review for residents and found all items to be current. Upon a sample review of staff files LPA found that all caregiver staff have health screening records on file and training records on track for completion. LPA found that 2 of 3 staff require updated 1st aid certification but are scheduled to complete training. Technical Violation issued. Lastly, during the inspection, LPA observed several mediations belonging to staff found in an unsecured drawer. The items were immediately removed and stored in staff bedroom. Deficiency cleared at the time of visit. Sarah Chu's Administrator Certificate 6076000740 is valid through 2/26/2027. LPA requested the following documents be sent to CCL by COB 7/14/2025: LIC 308 Designated Facility Responsibility LIC 500 Personnel Summary LIC 610 Emergency Disaster Plan Deficiency cited from the California Code of Regulations, Title 22, Division 6 of California Regulation. Appeal rights given. Failure to correct the deficiency and/or repeat deficiencies within a 12-month period may result in civil penalties.