Routine inspection·August 29, 2025

Licensing Program Analyst (LPA) Manuel Monter conducted an unannounced annual inspection visit, and met with Administrator Ann Marie Zarraga . 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, 2 restrooms and 3 residents bedrooms. The staff area of the facility was also inspected. The front yard and backyard were inspected. There was no obstruction to block the walkways. LPA observed a locked storage shed in the backyard of the facility being used as a storage space. 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 118 degrees F in resident bathrooms. Fire extinguisher was serviced in August 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 July 21, 2025. The facility's emergency and disaster plan was last reviewed on August 29, 2025. Page 1 Out of 2. LPA reviewed facility records for 3 staff and 3 residents. Staff S1's health screening doesn't have the identifying information for the physician who did the health screening. LPA requested to reviewed staff S2's health screening. ADM did not provide LPA with a copy of S2's health screening. ADM stated S2 would get an updated, by next week. LPA reviewed 3 resident medications and centrally stored medication records. LPA reviewed 3 resident P&I records. Deficiencies cited during today's visit. This report was reviewed with Administrator Ann Marie Zarraga and a copy of the signed report was provided. Appeal Rights were provided Page 2 Out of 2. END OF REPORT.