Routine inspection·December 26, 2025

Licensing Program Analyst (LPA) Manuel Monter conducted an unannounced annual inspection visit, and met with Administrator Wennie Concepcion . During the visit, LPA observed 1 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, restrooms and resident bedrooms. There was no obstruction to block the walkways. The staff area of the facility was also inspected. The front yard and backyard were inspected. While touring the facility living room, LPA noted a medication bottle on the coffee table, accessible to residents in care. LPA observed the medication container had medication tablets. ADM stated that medication belongs to her family member and must have forgotten it on the coffee table. While touring the facility bathroom closest to the backyard, LPA observed a container of Comet Cleaner, next to the toilet, accessible to residents in care. 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 110 degrees F in resident bathrooms. Page 1 Out of 2. Fire extinguisher was serviced in July 31, 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 October 10, 2025. LPA reviewed facility records for 2 staff and 1 residents. LPA noted R1's Needs and services plan is dated October 31, 2024. ADM stated she did complete an updated care plan, but stated she sent it to the family for signature and doesn't have a copy for LPA to review. LPA reviewed 1 resident medications and centrally stored medication records. Deficiencies are being cited during today's visit. See LIC809-D This report was reviewed with Administrator Wennie Concepcion and a copy of the signed report was provided. Appeal rights were provided. Page 2 Out of 2. END OF REPORT.