Routine inspection (multi-day)·October 16, 2025

At approximately 12:50 PM, Licensing Program Analyst (LPA) Frank arrived unannounced to continue a Required 1 Year visit and met with Facility Administrator Razon. LPA was informed that there are currently four (4) residents in care. During the 7/11/2025 initial visit, LPA reviewed four (4) resident files. Four (4) of four (4) resident files were observed to be well organized and thorough with all required documentation. LPA observed that a resident (R1) was diagnosed with a prohibited health condition. The facility did not request an exemption to keep R1 at the facility from Community Care Licensing (CCL). This deficiency will be cited. LPA reviewed three (3) staff files. All staff files were observed to be well organized with all required documentation including First Aid and CPR certification and proper training documentation. LPA spot checked Medication for two (2) residents. LPA observed all medications to be centrally stored, secure and with proper documentation. The facility does not handle resident’s monies for personal and incidental items. Chin Razon’s Administrator Certification 496804244 is current with an expiration date of 2/26/2027. LPA requested the following documents be submitted to Community Care Licensing by 11/16/2025: LIC 500 Personnel Report LIC 308 Designation of Responsibility LIC 610E Emergency Disaster Plan Proof of Liability Insurance Continued on 809-C... ...Continued from 809 Deficiencies are cited from the California Code of Regulations (CCRs), and/or the Health and Safety Code. Failure to correct the cited deficiency, on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment. Exit interview conducted. Copy of report, LIC-809D, Plan of Corrections, 811 Confidential Names and Appeal Rights discussed and provided to Administrator Razon. Signature on form confirms receipt of documents.