Routine inspection·July 17, 2025

Licensing Program Analyst (LPA) Marcela Yanez conducted an unannounced Required 1 Year visit and met with Elizabeth Bautista, Administrator. LPA announced the purpose of the visit. LPA observed 2 staff and 4 residents, 1 resident is currently hospitalized. 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. LPA observed perishable food supply of at least two days and a non-perishable food supply of at least seven days. LPA observed a garage with laundry area and separate pantry for residents and staff food storage. LPA observed a staff lounge area for staff to use on breaks and lunches. LPA toured 4 resident bedrooms. Each bedroom had available bedding and clothing storage areas as well as functioning lights. ADM tested the smoke detector in the hallway and found to function properly when tested. The facility has a pull fire alarm last serviced on 05/16/25 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 118-119 degrees F. Page 1 of 2 Page 2 of 2 LPA toured the outside area and found the exits to be clear of obstructions. LPA observed fire extinguisher was last serviced on 03/15/2024. LPA reviewed Fire and Earthquake log. The Facility last disaster drill was last conducted on 05/30/25 LPA reviewed resident records for 3 out of 4 residents.. LPA reviewed 3 staff records. ADM and LPA reviewed Centrally Stored Medication Record for 3 residents. During visit LPA observed R1 medication record was not update from 01/16/25 which poses an immediate health and safety risk for resident in care. ADM did not report R1s refusal of medication to the department within 7 days of occurrence. ADM stated resident has been refusing medication (Tam) since it was prescribed on 03/28/25. Deficiencies were cited as per California Code of Regulations Title 22. This report was reviewed with Elizabeth Bautista and a copy of this report and appeal rights were provided.