Routine inspection·February 14, 2025

Licensing Program Analyst (LPA) Marcela Yanez conducted an unannounced Required 1 Year visit and met with Lilian Sacun, Administrator/Licensee (ADM/LIC). LPA announced the purpose of the visit. LPA observed 2 staff and 5 residents. During visit, LPA toured the facility inside and out. LPA toured the garage area and observed food storage areas and locked cabinets for cleaning supplies. LPA observed the kitchen area and observed locked cabinets for medications, sharp objects, and cleaning supplies. During tour LPA observed a bottle of Cleaning Spray (Photo Taken) in unlocked cabinet under sink accessible to residents in care. S1 removed Cleaning Spray and placed it in locked closet. LPA observed perishable food supply of at least two days and a non-perishable food supply of at least seven days. Refrigerator temperature was measured with thermometer at 37 degrees and freezer at 0 degrees F. LPA observed Posters, ADM certificate and License posted in the facility as well as and Residents Rights. LPA toured 4 resident bedrooms. Each bedroom had available bedding and clothing storage areas as well as functioning lights. While touring resident bedroom LPA observed a medication Inhaler and Eye Drops and and Over the Counter medication belonging to a resident R3 accessible to residents in care. S1 removed medication and placed it in Centrally Stored Medication Closet. Page 1 of 2 page 2 of 2 LPA toured two out of two resident bathrooms. Each bathroom had available soap and paper towels and functioning lights. The water temperatures in the bathroom sinks measured with thermometer at 116-120 degrees F. ADM tested the smoke detector in the hallway and found the smoke detector to function properly when tested. Facility has a Fire Pull Alarm which was serviced 09/2024. LPA toured the outside area and found the exits to be clear of obstructions. LPA observed fire extinguisher was last purchased on 07/12/2024. LPA reviewed Fire and Earthquake log and last disaster drill was conducted on 01/31/2025 LPA reviewed resident records for 3 residents. LPA reviewed 3 staff records. LPA reviewed Centrally Stored Medication for 3 residents with S1. Deficiency was cited as per California Code of Regulations Title 22. This report was reviewed with ADM/LIC and a copy of this report and appeal rights were provided.