Routine inspection·April 6, 2026

Licensing Program Analyst (LPA) Alviso conducted a Required -1 Year visit, on 4/6/26 at approximately 9:40am, and met with Administrator Erika Molina who arrived from licensee's other licensed home. LPA observed a total of two (2) caregivers on duty. Facility's /Administrator Tilly Molina was contacted by staff, it was their day off, but the Administrator arrived to meet with the LPA. Facility has an approved dementia plan of operation. There is an approved hospice waiver for four(4) residents. Facility has a required infection control plan. Facility has a required emergency disaster plan. Fire clearance is approved for six (6) non-ambulatory, which includes one(1) bedridden, any resident room may be used for the bedridden clearance. LPA reviewed six (6) resident files. All files were complete. LPA reviewed five (5) staff files. All staff have required First Aid certification, and CPR certification. All staff have required criminal record clearance. All staff have annual training. Staff that handle and assist with medications have the required medication training. LPA toured the facility with Administrator Tilly. All exits were free and clear of obstruction. All walkways were clear for resident's use, for visitor's, and for staff. The facility has a hard wired smoke alarm system which worked appropriately during the inspection. All fire extinguishers were serviced and tagged. Facility carbon monoxide detector (s) as required. Continued on LIC809C... LPA observed sufficient furnishings for residents in care. All bathrooms had grab bars as required, and the roll-in-shower had non-slip mat/flooring for residents use. Facility had sufficient lighting in common areas, bathrooms, resident rooms, and hallways for resident use. Facility had sufficient food supply for residents in care. All cleaners/disinfectants were locked up and inaccessible to residents in care. All medications were locked up and inaccessible to residents in care. The facility was at a comfortable temperature during the inspection. Sufficient supply of linens, paper products, hygiene products, and personal protective equipment (PPE). Facility had emergency supplies, including food and water. LPA reviewed emergency disaster quarterly drills binder; Facility completed all required quarterly drill in 2025, and the first quarterly drill was completed on 3/28/2026, for this year. LPA is requesting the following documents be updated and submitted by 5/6/26: LIC308 - Designation of Administrator Responsibility LIC500 - Personnel Report LIC610E- Emergency Disaster Plan (ensure to review and update as needed/required-no changes submit copy of review page) If changes submit plan copy Infection Control Plan (ensure to review and update as needed/required- no changes submit copy of review page)- If changes submit plan copy LIC400- Handling of Client Cash Resources (include copy of surety bond if handling cash) Current Liability Insurance Resident Roster Copy of current Administrator Certificate There are no deficiencies cited during today's inspection.