Routine inspection·April 2, 2025

On April 2, 2025, Licensing Program Analyst(LPA) Murial Han conducted an unannounced annual inspection. LPA was greeted by caregiver, Emily Soriano. LPA explained the purpose of the visit. Facility supervisor, Moddie Andaya and licensee, Wilhelm Ick arrived shortly thereafter and assisted with the inspection. LPA toured facility and grounds. No accessible bodies of water. LPA toured inside and outside including all of resident rooms, common areas, and kitchen area. The indoor and outdoor passageways were free of obstruction. Comfortable temperature is maintained and lighting is sufficient for comfort. LPA observed 5 resident rooms. Rooms were spacious and included all required furnishings. Bathrooms were observed to be clean; equipped with paper towels, soap, grab bars, and non-skid mats. Hot water temperature in the kitchen, and bathroom was measured at 105- 107 degrees F. 2 days for perishables and & 7 days non-perishable were observed to be present. The facility is approved for 2 hospice and 1 bedridden; during today's visit, there are 5 resident and 3 of which are on hospice care. Medications, toxins, chemicals were observed to be locked and inaccessible to residents in care. Emergency drills were reviewed. Facility is equipped with smoke detectors and carbon monoxide detectors. Fire extinguisher was last inspected on 10/21/2024. A review of (5) resident files was conducted and noted on the LIC 858. A review of (3) staff files was conducted and noted on the LIC 859. 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 administrator and supervisor. A copy is provided and the appeal rights.