Routine inspection·January 14, 2026

Licensing Program Analyst (LPA) Maria (Mita) Partoza conducted an unannounced annual required inspection and met with administrator Belinda Devano and stated the purpose of the visit. The facility is licensed for adults 60+; 6 non-ambulatory, 1 maybe bedridden, and hospice waiver for 5. LPA observed 6 residents and 2 staff present 6 out 6 residents present at the facility 3 out of 5 were in their bedroom and 3 out of 6 were in the living room watching TV. 5 out of 6 resident was interviewed by LPA. LPA toured the facility, including common areas, resident rooms, dining, kitchen, 3 bathrooms, outdoor area and storage area. Indoor temperature was within acceptable range of 70°F. The kitchen was sanitary and organized; knives and chemicals were locked. Food supply met requirements (2 days perishable, 7 days non-perishable). Kitchen water temperature measured at 107.9°F. Bathroom water temperature ranged from 109.9°F to 111.0°F. Bathrooms had grab bars and non-skid mats; resident rooms had adequate storage. Medications were locked and inaccessible to residents; first aid kit was complete. Outdoor areas were free of hazards; laundry appliances were functional, and cleaning supplies were secured. Fire, smoke, and carbon monoxide systems were operational; hallways were clear and well-lit. The facility has motion sensors to alert any movements in the hallways at night time. LPA observed a storage shed at the back of the property that is used to store dry goods and a portion was converted as a activity place for residents to use. page 1 of 2 see LIC 809C LPA reviewed 5 resident and 3 staff records, including medication logs, admission agreements, care plans, personal and incidentals, health screenings, and training. All staff have required clearances, certifications and training required for residents that are in the facility. The facility conducts fire and earthquake drill quarterly for each shift. Last drill practice training was on 01/02/2026. The facility is equipped with fire pull alarm system and 1 fire extinguisher were inspected on 05/29/2025. No deficiencies were cited during today's visit based on the California Code of Regulations (CCR) Title 22. An exit interview was conducted with administrator Belinda Devano and a copy of the report was provided. end of report page 2 of 2