Routine inspection·March 10, 2026

Licensing Program Analyst (LPA) Alviso, conducted a Required - 1 Yeari Inspection, on 3/10/26 at approximately 9:20am, and met with Licensee/Administrator Sheila Sumabat. LPA observed two (2) caregivers, Rosie and Fely, on duty. There are currently six (6) residents in care. Facility has a dementia plan of operation. There is an approved hospice waiver for four (4) residents. The facility has a required infection control plan. The facility has a required emergency & disaster plan. Per review of records, fire/emergency drills are being conducted quarterly with staff as required. Fire clearance is approved for six (6) non-ambulatory. Facility has smoke alarms, and a carbon monoxide detector, all were working properly during the inspection. Fire extinguishers were serviced and tagged as required. LPA reviewed six (6) resident files. Files were complete, including medication records. All medications were locked, and centrally stored as required by regulation. LPA reviewed five (5) staff files. All staff have criminal record clearance as required. All staff have first aid certification and CPR certification. LPA reviewed staff training; Staff were current in annual training hours per regulation and H&S Code. All staff had current medication training as required. LPA toured the facility with the Administrator, Sheila. Hot water was measured at 116.5 degrees Fahrenheit. All exits were free and clear of any obstructions. Facility had sufficient linens, furnishings, paper products, cleaners/disinfectants, personal protective equipment (PPE) for staff/resident use, and supply of hygiene products for residents in care. Continued on LIC809C.. Facility had sufficient lighting in bathrooms, resident rooms, hallways, and all common areas for residents in care. The home was observed to be at a comfortable temperature during the inspection. The food supply was sufficient, observed a large variety of meats in the freezer, fruits on the kitchen counter and in storage, vegetables, bread/rolls, grains, milk, cheese, eggs, juice, water, and variety of food perishable and non-perishable items. LPA is requesting the following documents be updated and submitted by 4/10/26: 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 (s) No deficiencies cited today. Exit interview conducted with Administrator/Licensee Sheila Sumabat.