Routine inspection·September 17, 2025

Licensing Program Analyst (LPA) David Marrufo conducted an unannounced Required 1 Year visit and met with Administrator (ADM) Bhupinder Kaur. During visit, LPA toured the facility inside and out. LPA toured the kitchen area and observed there to be locked drawers for sharp objects and cleaning supplies. LPA observed the kitchen refrigerator, two refrigerators in the garage, a freezer in the garage, and the pantry area. LPA observed there to be a perishable food supply of at least two days and a non-perishable food supply of at least seven days. LPA observed the first aid kit and found it to be complete. LPA observed two out of two bathrooms. Each bathroom had working lights and available soap and paper towels. The showers had shower chairs and grab bars. LPA observed the bathroom sink water temperatures to be 115 F to 117 F. LPA toured three out of three resident bedrooms. Each bedroom had working lights and available bedding and clothing storage areas. LPA tested the facility carbon monoxide detector and the smoke detectors in the facility hallways and bedrooms. The carbon monoxide detector and smoke detectors functioned properly when tested. See LIC809-C page for more information. Page 1 of 2. LPA toured the outside area and found the exterior exits to be complete. LPA reviewed six out of six resident records, including Centrally Stored Medication and Destruction Records, and found them to be complete. LPA reviewed two out of two resident Personal and Incidental Money Logs and found them to be complete. LPA reviewed four staff records and found them to be complete. The Emergency Disaster Drill Log indicates the last drill was conducted on 09/08/2025. No deficiencies were cited as per California Code of Regulations Title 22. During visit, LPA Marrufo obtained copies of the following forms: LIC500 Personnel Report Surety Bond LIC308 Designation of Administrative Responsibility LIC610 Emergency Disaster Plan Liability Insurance LIC400 Affidavit Regarding Client/Resident Cash Resources This report was reviewed with ADM Bhupinder Kaur and a copy of this report was provided. Page 2 of 2. END REPORT