Routine inspection·August 5, 2025

On 08/26/2024, Licensing Program Analyst (LPA) Hansen conducted an unannounced Annual Required – 1 yr. inspection visit for this facility and met with Administrator, Chris Cardenas. Facility is 2 story with all 8 resident bedrooms on first floor. Facility approved/cleared for 8 non-ambulatory, and three (3) bedridden, with a hospice waiver approved for three (3). There are currently eight (8) residents in care, (7) seven with dementia diagnosis and two (2) on Hospice. At approximately 11:50am, LPA and Administrator toured the building and grounds. All door alarm systems were observed to be in functioning order. The facility was found to be at a comfortable temperature. LPA observed a 2 day supply of perishable and 7 day supply of non-perishable food. Refrigerated food was found to be stored in a safe manner being labeled and dated. All rooms were equipped with lighting, nightstand, and chest of drawers. All rooms were in good repair. Extra hygiene products and linens were available. Water temperature in sinks accessible to residents in care measured between 108.1 degrees F and 113.9 degrees F in 8 sinks, within Title 22 range of 105 to 120 degrees F. All shower floors have slip-resistant mats as required by Title 22 regulations. Fire extinguishers were last inspected 4/1/2025. Smoke/Carbon Monoxide detectors located throughout the facility were tested and operational. Toxins, sharps and other items that could pose a threat if available to residents were located in the carport, laundry room and next to the kitchen sink and found to be secured. LPA conducted spot medication count and found all prescription medication to be centrally stored and inaccessible to residents in care. Continue on LIC809-C Continue from LIC809 At approximately 1:00 pm, LPA conducted a review of five (5) resident records. Reviewed files had the required documentation. At approximately 1:45 pm, LPA conducted review of five (5) staff records/training. Upon a review of staff records, LPA found all staff were background cleared by DOJ and associated to facility, as well, have required initial training & annual training as well have current 1st Aid & CPR certification on file. Administrator certificate for Crisante Cardenas # 7007975740 expires 3/24/2027. Facility conducts quarterly disaster drills, in different shifts, with the last conducted 6/11/2025. Facility has emergency lighting system in hallways connected to built in generator should power go out. Facility has weekly guitar and piano players entertain residents along with every other day activity director conducts exercises/stretch & flex’s & dancing. No deficiencies observed during today’s inspection; no citations given. Updated copies of the following documents were requested and submitted to LPA or CCL by 8/22/2025: LIC500- Personnel Report LIC308- Designation of Responsibility LIC309- Administrative Organization Liability Insurance Administrator Certification (emergency/disaster plan and infection control plain - if any changes have been made) Exit interview conducted with Administrator and a copy of this report was provided .