Routine inspection·March 7, 2026

On 03/07/2026, Licensing Program Analyst (LPA) Arielle Pascua arrived unannounced to this facility to conduct an annual visit. LPA Pascua was greeted by Facility Designated Representative (FDR), Allan Jose and JJ Jose and explained the purpose of the visit. Current census was 5. Upon arrival LPA Pascua observed 2 residents leaving the facility for a weekend outing. This facility is licensed to serve residents who at 60 and older, 4 out 6 residents may be non-ambulatory but cannot reside in the middle bedroom. This facility also has a dementia plan on file and has a hospice waiver for 2 residents. This facility is also vendorized by Valley Mountain Regional Center to accept and retain Level 7 residents. There is current 1 resident on hospice, 1 resident obtaining home health services. LPA Pascua reviewed 5 resident files and 5 staff files. LPA Pascua provided technical assistance to FDR Jose regarding dementia regulations, physicians reports, needs and services plans, and administrator certification. A tour of the facility was conducted. Fire extinguisher located by the back door appeared to have been serviced 07/29/2025 by Jorgenson Co and is in compliance. The kitchen area was toured. LPA Pascua observed a sufficient seven days of non-perishable as well as two days worth of perishable food supplies in the main kitchen. Additional perishable supplies were identified in an additional refrigerator located in the garage. Knives and additional cleaning supplies were locked and made inaccessible to the residents at this time. LPA Pascua observed a locked centralized stored medication cabinet located in the kitchen. Along with facility staff, the LPA observed, reviewed, and compared resident medication with the medication dispensing logs. First Aid Kit was present and contained all of the required components. Common areas were toured. Living room, dining area and all other areas intended for resident use were in compliance and good repair. A washer and dryer were also identified. Laundry detergent, bleach, and all other cleaning supplies were observed to be locked and made inaccessible to the residents at this time. A tour of the garage was conducted. Additional storage for supplies were stored in cabinets. A tour of the bathrooms was conducted. Hot water temperature was measured and observed to be within the required range of 105-120 degrees. Grab bars were present and in good repair. A tour of the resident bedrooms was conducted. Resident furniture was observed to be sufficient to meet the resident needs at this time. The exterior of the physical plant was toured. LPA Pascua observed several wood planks hanging from the fence and a large concrete block that has been broken due to the surrounding tree. LPA Pascua also observed several broken window screens. The following forms and documents were requested to be updated and submitted into CCL. -LIC 308 -LIC 400 -LIC 500 -LIC 610 The following deficiencies were observed and cited on the following LIC 809-D pursuant to Title 22 Rules and Regulations, Health and Safety Codes. Appeal rights were reviewed and a copy was printed and given to the facility designated Administrator at this time.