Post-licensing visit·January 30, 2026

At approximately 11:50 AM, Licensing Program Analyst (LPA) Magdaleno arrived unannounced to conduct a Post Licensing inspection and was greeted by staff. Administrator Grace Larcena was called and arrived at approximately 12:15 PM. Facility is a Residential Care Facility for the Elderly (RCFE) with two (2) residents in care. Facility has a Dementia Care Plan, a Hospice waiver for six (6), with zero (0) Hospice residents currently in care, and is approved for four (4) non-ambulatory residents in rooms 3 and 4 only. 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 12:20 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 2/25. Smoke and Carbon Monoxide detectors were inspected 10/25. Administrator adjusted water temperature to 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. LPA observed supplies for both indoor and outdoor activities including a piano, board games, art supplies, and miniature golf green. Facility has an internet access device and internet available to residents in care. Updated facility phone number was acquired during this visit. Continued LIC809C... Continued from LIC809... Facility conducts quarterly disaster drills, and the most recent drill was conducted 10/25. LPA reviewed emergency disaster plan which was last updated 10/25. LPA observed a supply of PPE, emergency supplies, a first aid kit, and flashlights. At approximately 12:55 PM LPA conducted review of two (2) staff records. All required documentation present. At approximately 1:05 PM LPA conducted a review of two (2) resident records. All required documentation present. At approximately 1:20 PM LPA and Administrator conducted a spot check of medication and medication records. Medication is centrally stored and locked. Grace Larcena Administrator Certificate 6069070740 expires 5/7/2027. All fees are current as of this time. Updated copies of the following documents were gathered during this visit : Liability Insurance No deficiencies cited. Exit interview conducted with Administrator, whose signature on form confirms receipt.