Routine inspection·September 16, 2025

Licensing Program Analyst (LPA) Maria (Mita) Partoza, conducted an unannounced Required 1 Year visit, was greeted by staff Ray Lomero and Daniel Mabunay. Administrator Gladys Smart came after 15 minutes. LPA met with administrator Gladys Smart and stated the purpose of the visit. The facility is licensed to serve 60 and over. The facility is licensed for 6 bedridden/total care clients and hospice care. The facility currently has 4 staff and 6 residents. At 1:15 pm. LPA toured the exterior and interior of the facility. LPA observed emergency exits are clear from obstruction. LPA observed a swimming pool with a 5 foot perimeter fence with locked gates. The backyard patio is free from debris. LPA toured the facility kitchen and observed at least 2 days of perishable food and at least 7 days of nonperishable food. Sharps and medications were locked in secured areas. LPA observed additional food supply. The refrigerator temperature is at 32 degree F and the freezer temperature is at 0 degree F. The water temperature measured at 105.2 to 105.7 degree F. LPA observed the kitchen to be organized and sanitary. During inspection, LPA observed 4 out of 6 residents were not in their bedroom, 2 out of 6 were in the bedroom and asleep. LPA attempted to interview 4 out of 6 residents. page 1 of 2 LPA observed 5 resident bedroom, 1 Out of 5 bedroom is shared. 5 Out of 5 resident room were equipped with ample storage, bed were covered with bed linens. The resident bedrooms were equipped with hospital beds. LPA observed fire water sprinklers throughout the house. Hallways were observed to be free from obstruction. LPA observed smoke and carbon monoxide detectors in good working condition. The Laundry area was secured. LPA observed that chemical and cleaning supply cabinet were locked and not accessible to residents in care. The staff room is used as a storage for overflow of supplies and as a break room. The facility is equipped with Fire extinguisher inspected on 06//17/2025. LPA reviewed the facility's record and the last disaster drill training for earth quake and fire drill training was provided to staff and resident on 09/03/2025. LPA requested copies of updated LIC 500 Personnel report, liability insurance, LIC 308 designated administrator, plan of operation, emergency and disaster plan and dementia care plan. LPA reviewed 3 Out of 6 resident record such as but not limited to care plan and centrally stored medications and destruction record (CSMDR). LPA reviewed 2 out of 4 staff record, including but not limited background clearance and training. No deficiencies were cited during today's visit based on California Code of Regulations (CCR) Title 22. An exit interview was conducted with administrator, Gladys Smart and a copy of the report was provided. End of Report page 2 of 2