Routine inspection·August 28, 2025

Licensing Program Analyst (LPA) Marcella Tarin conducted an unannounced annual inspection and met with Licensee Josephine and Jesus Arcilla, and ADM Minerva Velasco. LPA stated the purpose of the visit. The facility has two buildings (Blossom Home and Wisteria Place) and a licensed capacity of 48. LPA toured the interior and exterior of both Blossom Home and Wisteria Place with ADM and Licensee to include the kitchen, resident rooms, dining room, bathrooms, back and front of the facility. LPA observed a facility pantry near the facility storage garage. LPA observed all exit and passageways were free and clear of obstruction. During exterior inspection of Wisteria Place, LPA observed wood rot on the roof corner located outside of the living room exit door. Licensee states the facility will repair the wood rot by 10/31/2025 and submit a letter to include the repair timeline to the Department by 8/29/2025. LPA toured the 2 kitchen areas in Blossom Home and Wisteria Place and observed a perishable food supply of at least two days and a non-perishable food supply of at least seven days. LPA observed refrigerator and freezer temperatures in 5 refrigerators maintained at Title 22 87555 General Food Service Requirements . LPA observed the medication storage area, knives storage area, and cleaning product storage area as locked and inaccessible to clients in care. Page 1 of 2 The facility was equipped with smoke and carbon monoxide detectors, which were last inspected by a third party vendor on 6/17/2025. Fire extinguishers were last serviced on 9/17/2024. The facility emergency drill log was reviewed. The facility's last drill was on 6/26/2025. Posters observed in Blossom Home and Wisteria Home to include the licensing complaint poster, ombudsman poster, and facility license. LPA toured 25 resident bedrooms. All 25 resident rooms have a bed, functioning lights, dresser/table, bedding and space for personal belongings. LPA toured 7 resident bathrooms. All 7 bathrooms had hand soap, paper towels, functioning lights, and trash bins. 1 out of 7 resident bathroom water temperatures were measured with a range of 105 F to 120 F. 1 out of 7 resident bathrooms water temperatures was below 105 F. A Technical Assistance was issued, see LIC 9102 for more information. LPA reviewed 5 resident records. LPA reviewed 5 resident’s Centrally Stored Medication and Destruction Records (CSMDR’s). LPAs reviewed 5 staff records. No deficiencies were cited during today's visit per California Code of Regulations Title 22. An exit interview was conducted with Licensee Josephine Arcilla and a signed copy of this report was provided.