Routine inspection·November 17, 2025

Licensing Program Analyst (LPA) Marcella Tarin conducted an unannounced annual inspection and met with Administrator (ADM) Michelle Bayquen. LPA stated the purpose of the visit. ADM states the facility has 2 residents. LPA observed 1 resident and 1 staff. LPA toured the interior and exterior of the facility with ADM to include the kitchen, resident rooms, dining room, bathrooms, back and front of the facility. All exit and passageways were free and clear of obstruction. LPA toured the kitchen area and observed a perishable food supply of at least two days and a non-perishable food supply of at least seven days. LPA observed the kitchen cabinets and drawers to have dark areas around the handles, and spider webs hanging from light fixtures and overhead cabinets. LPA observed the chemicals and knives storage areas were not locked and accessible to residents. The facility was equipped with smoke and carbon monoxide detectors. All smoke detectors functioned properly when tested by ADM. Fire extinguishers were last serviced on 8/13/2025. ADM stated she did not have documentation of fire drills. LPA inspected 2 resident bathrooms. LPA observed the bathrooms did not have hand-soap and paper towels. LPA advised ADM to ensure resident bathrooms have hand-soap and paper towels. LPA observed dark stains in the resident showers, and brown staining on the sinks and around the toilets. LPA also observed cobwebs throughout the bathroom ceilings. Page 1 of 2 LPA toured 2 resident rooms. LPA observed Resident Room #1 to have papers, clothing, beddings, and medications on the ground. LPA also observed a catheter bag with unknown liquid in an uncovered trash bin. Based on review of R1's physician's report, R1 cannot administer his/her own medications. In Resident Room #2 LPA observed 2 measuring cups on a dresser, with one cup containing brown liquid, and the other cup containing blue liquid with a dead inside inside. Staff S1 stated he/she did not know what the liquids were in the cups. ADM removed the cups with unknown liquids during inspection. Throughout the facility, LPA observed dark staining on the walls, cabinets, flooring of all rooms, bathrooms, kitchen and doorways. LPA advised ADM to ensure staff are cleaning to maintain sanitary conditions for residents, visitors and staff. LPA reviewed 2 resident records. LPA reviewed 2 resident’s Centrally Stored Medication and Destruction Records (CSMDR’s). LPA reviewed 3 staff records. 2 Out of 3 staff were associated and fingerprint cleared to the facility. Staff S1 is not associated to the facility. LPA reviewed S1's name in Guardian and S1 is not fingerprint cleared. S1 stated he/she has not done his/her fingerprints (LiveScan). LPA advised ADM to have S1 fingerprinted and associated to the facility, and S1 cannot work at the facility until he/she has obtained a background fingerprint clearance and is associated to the facility. Deficiencies are being cited per California Code of Regulations, Title 22. See LIC809-D. A civil penalty is being assessed for the amount of $500 ($100 per day x 5 days = $500) for S1 working in the facility without receiving a criminal record background clearance. See LIC421BG. LPA also recommended ADM to Community Care Licensing Division's Technical Support Program (TSP). LPA provided ADM with a TSP pamphlet. Deficiencies were cited during today's visit per California Code of Regulations Title 22. An exit interview was conducted with Administrator Michelle Bayquen and a signed copy of this report and appeals rights were provided.