Routine inspection·December 4, 2025

Licensing Program Analyst (LPA) Simi Rai conducted an unannounced Required 1 Year visit. LPA Rai met with Caregiver, Cynthia Gacias and stated the purpose of today's visit. LPA Rai spoke with Licensee/Administrator Leliani Cortes over the phone and obtained verbal permission for Caregiver, Cynthia Gacias to sign today's report on her behalf. LPA Rai observed 3 staff and 6 residents at the facility. During visit, LPA Rai toured the inside and outside of the facility . When touring the outside area of the facility, the exits were cleared of obstruction. LPA Rai observed screen doors in good repair. LPA Rai toured the facility kitchen and observed food supply of at least 2 days of perishable food and at least 7 days of nonperishable food. Sharps and medications were locked in secured areas. LPA observed additional food supply areas and secured areas for cleaning supplies and laundry detergents. LPA Rai toured the facility to include resident rooms, staff room, living room, dining room, kitchen and bathroom. Resident bedrooms had available bedding, drawers, and functioning lights.  The facility bathroom had available soap, paper towels, and trash cans with lids, including mounted dish soap. Fire extinguisher was observed and inspected on 12/29/2024. The facility staff could not provide disaster drill log for 2025. LPA Rai reviewed facility records for 2 staff and 2 residents. 2 Out of 2 staff files did not contain training documentation for 2025. Resident R1's medication #1 was not written on the Centrally Stored Medication Log. Staff S1-S2 stated R1 was administered the medication per physician's orders. LPA Rai reviewed resident medications and central stored medication records. Continuation on LIC 809-D, Page 1 of 2. Page 2 of 2. Deficiencies were cited from California Code of Regulations, Title 22 during today’s visit, see LIC 809-D. A civil penalty is being assessed for the amount of $250 for a repeat violation for HSC 1569.695(c). A previous licensing report issued on 12/21/2024 cited the same deficiency. Please see LIC421FC. Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment. This report, including today's cited deficiencies, was reviewed with Licensee/Administrator Lelani Cortes and a copy of the report was provided. Licensee/Administrator agreed and understood the POC. Appeal Rights was provided. LIC 858 and LIC 859 were provided.