Routine inspection·July 22, 2025

At approximately 12:50 PM, Licensing Program Analyst (LPA) Elias Magdaleno arrived unannounced to conduct a required 1-year annual inspection and was greeted by staff. Administrator Imee Villegas was contacted and arrived at approximately 1:10 PM. Facility is a Residential Care Facility for the Elderly (RCFE) with five (5) residents in care. Facility has a Dementia Care Plan, a Hospice waiver for two (2), with two(2) Hospice residents currently in care and is approved for all non-ambulatory residents. At approximately 1:20 PM, LPA initiated a tour of the facility with Administrator and observed the following: Facility is a one (1) story home, was a comfortable temperature, and passageways were free from obstructions. Fire extinguishers were last inspected 6/25. Smoke and Carbon Monoxide detectors were tested and operational during inspection. Water temperature measured 107.4- and 106.3 degrees F, which is within the allowable range of 105 to 120 degrees F per Title 22 regulations. LPA observed a supply of clean linens, hygiene, incontinent care, and paper products available for residents. Residents' bedrooms were inspected and observed to have all the appropriate furnishings as outlined in Title 22 regulations. Cabinets containing cleaning supplies and other items that could pose a risk were locked. LPA observed at least a two (2) day supply of perishable and seven (7) day supply of non-perishable food, as well as an emergency water supply. Food was found to be stored in a safe manner with open items covered. There is a shaded seating area in the backyard with outdoor space for activities. Facility has an internet access devise and internet available to clients in care, and the phone was observed operational during today's inspection. LPA observed staff regularly checking on residents and fulfilling their care requests. Continued LIC809C... Continued from LIC809... Facility conducts monthly disaster drills, and the most recent drill was conducted 6/25. LPA observed facility's infection control plan and emergency disaster plan which was last updated 4/25. LPA observed a supply of PPE, emergency supplies, a first aid kit, and flashlights. At approximately 1:50 PM LPA conducted a review of five (5) resident records. All required documentation present. At approximately 2:15 PM LPA conducted review of two (2) staff records. All required documentation present. At approximately 2:30 PM LPA and caregiver conducted a spot check of medication and medication records. Medication is centrally stored and locked. Imee Villegas Administrator Certificate 7009121740 expires 6/9/2026. Updated copies of the following documents shall be submitted to CCL within 30 days of this visit : Liability Insurance LIC500 - Personnel Report LIC308 - Designation of Responsibility LIC400 - Affidavit Regarding Client Cash Resources LIC610E - Emergency Disaster Plan No deficiencies cited. Exit interview conducted with Administrator, whose signature on form confirms receipt.