Routine inspection·January 5, 2026

On 1/5/2026, Licensing Program Analyst(LPA) John Calandra arrived at the facility to conduct the 1-year required Annual Inspection. LPA Calandra was greeted by Fernando Induct, Caregiver/temporary House Manager and explained the purpose of the visit. Licensee's Husband, Henry Chang arrived later during the visit. LPA toured the physical plant. This is a 2-story house with 7 bedrooms, 4 bathrooms, a kitchen, office, living room, dining room, garage, and Foyer. All bedrooms had the required furniture and sufficient lighting. All bathrooms had the required non-skid flooring and grab bars. The facility's fire alarm was observed to be in working order. The facility's fire extinguishers were observed to be fully charged and last checked on 10/29/2025 . The facility had the required 7 days of non perishables and 2 days of perishables on site. No food was expired. The facility's first aid kit had the required items. LPA reviewed 5 resident files and 6 staff files. During record review, missing documents were observed. This facility does not handle cash resources for residents. A review of Centrally Stored Medications indicated that medications for residents were properly labeled with instructions on dosage and times of day and matched the Centrally Stored Medication Records(CSMR) kept at the facility. During the tour of the physical plant, LPA observed that soap, detergent, poisons, and sharp objects such as knives and scissors were not locked up and in-accessible to persons in care. A Type A citation was issued for not ensuring that sharp objects were locked up. A Type A citation was also provided for not ensuring soap, detergent, and poisons were locked up and in-accessible to persons in care. During record review of staff files, LPA observed that S1 did not have a TB exam prior to employment. A Type B citation was provided for this deficiency. In addition, LPA asked for a copy of the Licensee's Liability Insurance but one could not be provided during the inspection. A Type B citation was provided for this deficiency. During the tour of the physical plant, LPA could not locate the facility's carbon monoxide detector. LPA asked Licensee but they could not locate it. A Type B citation was provided for this deficiency. In addition, during the tour of the physical plant, LPA observed that the facility's faucets in bathrooms did not deliver hot water between the required temperature of 105-120 and were not in good repair. Two Type B citations were issued for these deficiencies. During record review, LPA observed that the Licensee had not documented the number of hours of trainings on subjects such as Dementia. In addition, LPA observed that none of the staff had active CPR and First Aid Training. Per conversation with the Licensee, a CPR and First Aid training had been conducted recently but the active certificates for staff could not be located at the time of the inspection. Type B citations were issued for these deficiencies. In addition, during record review, LPA observed that Licensee had not provided 8 hours of Dementia care training and four hours of training which shall be specific to postural supports, hospice care, and restricted health conditions. A Type B citation was provided for this deficiency. During the tour of the physical plant, LPA observed that Licensee was storing food supplies with soap, detergent, and poisons. A Type B citation was provided for this deficiency. During record review, LPA observed that Licensee had not recorded the date and time of each contact with physicians and the physicians directions when assisting residents with self-administration of PRNs. A Type B citation was provided for this deficiency. In addition, during record review, LPA observed that the Licensee had not ensured that the date and time the PRN medication was taken, the dosage taken, and the resident's response shall be documented and maintained in the resident's facility record. During record review, LPA observed that Pre-Admission appraisals had not been completed for R1 and R2 prior to admission. A Type B citation was provided for this deficiency. During record review, LPA observed that Licensee did not ensure that quarterly emergency drills were completed. A Type B citation was issued for this deficiency. In addition, during record review, LPA observed that R3 was missing an Appraisal of Needs and Services. A Type B citation was provided for this deficiency. LPA requested the following documents be sent to the Department by 1/16/2026: - Control of Property(Property tax statement or Deed) - Current Liability Insurance - Up to date LIC 500(Personnel Summary Report) - Administrator's Certificate Deficiencies are cited under the California Code of Regulations. Failure to correct the deficiencies by the POC due date may result in Civil Penalties. An exit interview was conducted. This report was reviewed with facility representative and a copy of the report along with Appeal Rights provided.