Routine inspection·February 10, 2026

On 02/10/2025, Licensing Program Analyst (LPA) Arielle Pascua arrived unannounced to this facility to conduct an annual visit. LPA met with Facility Designated Administrator (FDA), Estrellita Banci and explained the purpose of the visit. The purpose of this visit was to conduct an annual visit. Current census was 4. A brief interview was conducted with FDA Banci. This facility is licensed to serve and retain 6 non-ambulatory elderly residents. 1 of 6 residents may be bedridden and could only reside in bedroom #1. This facility also holds a dementia plan on file and has a hospice waiver for 2 residents. There are currently 2 residents on hospice services, 1 resident with assistance on oxygen and 0 are on home health services at this time. A review of the facility records were conducted. LPA Pascua conducted a review of 4 resident files and 3 staff files. 3 out 3 staff files were complete and up to date. Based on LPA Pascua's record review of 4 resident files. 4 out 4 resident files did not have a current Needs and Services plan on file. All other components were complete and up to date. LPA Pascua provided Technical Assistance to FDA Banci regarding some best practices for resident files. FDA Banci holds an active and current administrator certificate #6029266740 and expires on 06/24/2026. A tour was conducted with FDA Banci. Fire extinguisher located by the living area appeared to have been purchased on 02/10/2026 with a receipt attached and is in compliance. Smoke detectors and carbon monoxide was present and in good repair. The kitchen area was toured. LPA Pascua observed a sufficient seven days of non-perishable as well as two days worth of perishable food supplies in the main kitchen. Knives and additional cleaning supplies were locked and made inaccessible to the residents at this time. LPA Pascua observed a locked centralized stored medication cabinet located in the hallways. Along with Administrator, the LPA observed, reviewed, and compared resident medication with the medication dispensing logs. First Aid Kit was present and contained all of the required components. A linen closet was located in the hallway and presented a sufficient amount of linens to adequately supply and meet the needs of the residents at this time. Common areas were toured. Living room, dining area and all other areas intended for resident use were in compliance and good repair. A washer and dryer were identified in the hallway. Laundry detergent was made inaccessible to residents in care. A tour of the garage was conducted. Additional storage for supplies were stored in cabinets. A tour of the bathrooms was conducted. Hot water temperature was measured and observed to be within the required range of 105-120 degrees. Grab bars were present and in good repair. A tour of the resident bedrooms was conducted. Resident furniture was observed to be sufficient to meet the resident needs at this time. The exterior of the physical plant was in good repair with no hazards present. Perimeter fence was observed to be stable and gates were in good repair. The facility has a pool in the backyard with a locked perimeter surround the pool. The following forms and documents were requested to be updated and submitted into CCL. -LIC 308 -LIC 400 -LIC 500 -LIC 610e Per California Code of Regulations (CCR) – Title 22 – Division 6, Chapter 6, deficiencies were observed during today’s visit. Citations can be found on the LIC 809 – D. Failure to correct deficiencies may result in civil penalties. Appeal Rights were provided to facility administrator. An exit interview was held, and a copy of the report was provided in-person.