Routine inspection·January 21, 2026

On 01/21/2029 at approximately 1:45PM, Licensing Program Analyst (LPA) Ali Deniz arrived unannounced to conduct 1-Year Required visit of this licensed Residential Care Facility for The Elderly (RCFE). LPA was greeted by Administrator, Chuluunchimeg Young. Facility has an approved fire clearance and capacity for 1 ambulatory, 4 non-ambulatory, and 1 bedridden resident and has an approved hospice waiver for 2 individuals. Upon arrival, LPA was informed that there were 2 residents in care and 1 staff member on-site. Facility is a 1 story building with 4 Resident bedrooms, 3 bathrooms, and common spaces. At approximately 2:05PM, LPA reviewed the Facility's Staff Roster and found that all staff on-site were background cleared and associated to the facility per regulation. At approximately 02:15PM, LPA toured the building and grounds which was found to be clean and in good repair. LPA observed all walkways and exits to be unobstructed. All notices that are required to be posted have been posted. LPA observed activity supplies for resident use. The amount of fresh and nonperishable foods is within regulation. Facility kitchen, refrigerators and freezers were clean, and food was stored properly. LPA recommended to keep toxins separate from kitchen utensils. Toxins are stored in a locked kitchen cabinets under the sink and cabinets in the laundry room. Water temperature measured 109.6 degrees F and 107.4 which is within regulation between 105- and 120-degrees F at faucets accessible to residents. Fire extinguishers were bought new on 01/04/2025 and has not been inspected since. Gauge was on green zone (Technical advice given). Carbon Monoxide detectors were present and in order. There was enough lighting in all common areas, resident rooms, and hallways. Medication is centrally stored and secure. Continued on LIC809-C page... Continued from LIC809 page... At approximately 3:10PM, LPA reviewed 2 resident records and found 2 of 2 residents did have current physician's reports, care plans, signed admission agreements, and physician's orders on file. 1 out of 2 residents did not have signed personal rights (Technical Advice given). At approximately 3:25PM, LPA reviewed 2 staff records. 2 of 2 records did contain documentation of completed training records as required. Evidence of first aid and CPR training were current and/or renewed at the time of the visit. 1 out of 2 staff did not have health screening available for review (Technical Advice Given). At approximately 4:30PM, LPA reviewed the facility emergency disaster plan. The plan outlines evacuation routes, which are shown on facility sketch and has alternative meeting locations. Facility has supplies enough to operate for more than 72 hours in an emergency. Facility conducted and documented a disaster drill on 01/20/2025. Administrator stated that they will get it done quarterly and will conduct a new drill as soon as possible and will submit copy of the proof to CCL (See LIC809D page).LPA was presented with proof of current CPR & 1 st Aid certification for staff. Administrator Certificate is for Chuluunchimeg Young #7014580740 expires on 1/16/2028. Updated copies of the following documents were requested for facility file and are to be submitted to CCL within 10 days of this visit: LIC 308 Designation of Facility Responsibilities LIC 500 Personnel Summary LIC 9020 Register of Facility Resident’s Copy of Updated Certificate of Liability Insurance Deficiencies are cited from the California Code of Regulations (CCRs), and/or the Health and Safety Code. Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment. Exit interview conducted. Copy of report, LIC-809D, Plan of Corrections, and Appeal Rights discussed and provided to Administrator. Signature on form confirms receipt of documents.