Routine inspection·September 22, 2025

At approximately 9:45 AM, Licensing Program Analyst (LPA) Elias Magdaleno arrived unannounced to conduct a required 1-year annual inspection and was greeted by staff. Licensee Paulino Buna arrived shortly after. Administrator Maria Buna arrived at end of inspection to sign report. 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) and hospice exceptions for two (2), with four (4) Hospice residents currently in care, and is approved for all non-ambulatory residents. At approximately 10:00 AM, LPA initiated a tour of the facility with Licensee 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 9/25. Smoke and Carbon Monoxide detectors were tested and found operational by third party on 9/25. Water temperature measured 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. Continued LIC809C... Continued from LIC809... LPA observed one (1) locked garage in the backyard which LPA inspected and found the contents to consist of additional canned foods and two (2) freezers with frozen food. Secondary room in garage was inspected and found to contain extra resident supplies, Licensee stated room was only used for additional storage. Facility has an internet access device and internet available to residents in care, and the phone was tested and operational during today's inspection. Facility conducts disaster drill every three (3) months with the most recent drill conducted on 9/25. LPA observed emergency disaster plan which was last updated 11/24. LPA observed a supply of PPE, emergency supplies, a first aid kit, and flashlights. At approximately 10:40 AM LPA conducted a review of three (3) resident records. All required documentation present. At approximately 11:00 AM LPA conducted review of three (3) staff records. All required documentation present. At approximately 11:30 AM LPA and caregiver conducted a spot check of medication and medication records. Medication is centrally stored and locked. Maria Buna Administrator Certificate 7026374740 expires 11/21/2025. All fees are current as of this time. Updated copies of the following documents shall be submitted to CCL within 30 days of this visit : LIC308 - Designation of Responsibility LIC400 - Affidavit Regarding Client Cash Resources No deficiencies cited. Exit interview conducted with Administrator, whose signature on form confirms receipt.