Routine inspection·September 3, 2025

Licensing Program Analyst (LPA) Manuel Monter conducted an unannounced annual inspection visit, and met with Administrator (ADM) Joseph Anthony Oliva. During the visit, LPA observed 6 residents and 2 staff. LPA explained the purpose of the visit. LPA toured the facility inside out with ADM which included the Living room, kitchen, dining room, 3 restrooms and 6 residents bedrooms. The staff area of the facility was also inspected. The front yard and backyard were inspected. There was no obstruction to block the walkways. During the tour of the backyard, LPA noted some clutter alongside the backyard of the facility. LPA also noted some clutter in the inside of the facility as well. LPA advised ADM to de-clutter both the inside and outside of the facility. Two-day perishable food supplies and seven day nonperishable food supplies were observed. LPA observed the medication storage area, knives storage area, and cleaning product storage area as locked and inaccessible to residents in care. Room temperature was at 75 degrees F, and hot water temperature was measured at 114 degrees F in resident bathrooms. Fire extinguisher was serviced in May 9, 2025. The facility was equipped with smoke and carbon monoxide detectors. Smoke detectors was tested by ADM, and were functional. LPA observed facility first aid kit and facility fire/earthquake drill log. The facility's last drill was on July 9, 2025. The facility's emergency and disaster plan was last reviewed on October 22, 2024. Page 1 Out of 2. LPA reviewed facility records for 3 staff and 3 residents. LPA reviewed 3 resident medications and centrally stored medication records. LPA reviewed resident records. Based on a review, R1-R3's Needs and services plans are not updated and are over 12 months old. ADM stated he has not updated R1-R3's Needs and services plans. A deficiency is cited during today's visit. A technical violation was cited. This report was reviewed with Administrator Joseph Anthony Oliva and a copy of the signed report was provided. Page 2 Out of 2.