Routine inspection·July 18, 2025

On 7/18/2025, Licensing Program Analyst(LPA) John Calandra arrived at the facility to conduct the Annual 1-year required inspection. LPA Calandra was greeted by Emma Advincula, Caregiver and explained the purpose of the visit. Administrator, Cyndi Advincula arrived later during the visit. LPA Calandra toured the physical plant. This is a one-story building with 8 bedrooms, 2 bathrooms, living room, kitchen, and dining room. All bedrooms had the required furniture and sufficient lighting. All bathrooms had anti-skid floor mats and grab bars. No accessible bodies of water or hazards were observed. The fire extinguisher was fully charged. The smoke detector and carbon monoxide detector were observed to be in working order. Per interview with Administrator, Cyndi Advincula, the facility's smoke alarms and carbon monoxide detectors are connected directly to the fire department. The first aid kit contained the required items such as sterile dressings, bandages, adhesive tape, scissors, tweezers, thermometers, antiseptic solution and guide. The facility's hot water temperature was measured within the 105-120 degrees Fahrenheit. The facility had 7 days of non-perishables and 2 days of perishables on hand. No food was expired. All sharp objects, detergents, poisons, and soap were observed to be locked and in-accessible to persons in care. LPA reviewed 5 resident records and 6 staff files. All staff files were observed to be complete but resident files were missing documents. During review of resident files, LPA observed that resident, R1 had been diagnosed with Dementia but had not had a reappraisal since 2023. Furthermore, LPA observed during file review that all resident records were missing both the Functional Capabilities Assessment and the Pre-Admissions Appraisal. Type B citations were provided for these violations. A review of Centrally Stored Medications showed that all medications were properly labeled and that dosages and times of day were recorded by the facility. During today's inspection LPA received the following documents: Liability insurance LPA has requested the facility send a copy of their LIC 500: Personnel Summary Report by Friday, July 25th. Deficiencies are cited under the California Code of Regulations, Title 22. Failure to correct the deficiencies by the 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 left at the facility.