Routine inspection·August 28, 2025

On August 28, 2025, Licensing Program Analyst (LPA) Murial Han conducted an unannounced annual inspection. LPA met with caregiver, Alvin Gomez and explained the purpose of today's visit. LPA toured the facility inside out and inspected the living room, dining area, kitchen, bedrooms, bathrooms, and backyard. The facility has 4 residents and all of them are in private rooms. Furniture and furnishings were observed to be sufficient. Food supplies were sufficient of 2- days perishables and 7- days of non-perishables. Toilet, hand washing and bathing areas were observed clean and in operating condition. Showers were observed equipped with grab bars but non slip- resistant mats. Facility exits are equipped with audible alarms. Comfortable temperature is maintained and lighting is sufficient for comfort. Bed sheets, linens, and towels were observed to be sufficient and able to meet the needs of the residents at this time. Central storage for medications, sharps and chemicals were observed to be locked and inaccessible to residents in care. Hot water temperature in the kitchen and bathroom were measured at 105-115 degrees Fahrenheit. Fire extinguishers were checked. During the facility tour, LPA observed the same storage room in the garage that was observed during the annual inspection last year on 8/6/2024. As the time, the administrator submitted a plan of correction indicating that the facility would be collaborating with the Foster City Building Code Enforcement and the Local Fire Marshall on the steps to legalizing the unit. The Foster City Building Code Enforcer conducted an inspection and deemed the storage room as un-permitted altercation and advised the administrator/licensee to follow-up with the Local Fire Marshal. During the process of collaborating with the Local Fire Marshal and the Foster City Building Code Enforcement, the administrator/licensee reported to LPA that he has not been provided with clear instructions on how to legalizing the storage unit. Therefore, on January 23, 2025, the administrator/licensee informed LPA that the storage room would be demolished in a week. However, during today's visit, LPA observed the same storage unit in the garage. A review of (3) resident files was conducted and noted on the LIC 858. A review of (2) staff files was conducted and noted on the LIC 859. During today's visit, LPA was not able to review S2 and R4's files as the caregiver reported that the administrator/licensee has the files and he is in the process of updating the them. The following documents were requested submitted to CCL by 9/2/2025: - Liability Insurance and Administrator Certification. Based on observation, deficiency is cited under California Code of Regulations, Title, 22 cited on the LIC 809D. Failure to correct the deficiencies may result in civil penalties. This report is reviewed and discussed with the caregiver. A copy of this report and the appeal rights were provided.