Routine inspection·February 12, 2026

Licensing Program Analyst (LPA) Valeria Conway arrived at the facility unannounced to conduct the required annual visit at 9:15 A.M. The LPA initially met with caregiver Calixto “Alex” Calixtro and staff Eufrecina Tabuena. Licensee, Maricar Lee was contacted via telephone. At 10:10 A.M. facility designee, Michelle Viernes, arrived at the facility. Licensee arrived at 11:20 A.M. Entrance interview was conducted. Beginning at 10:20 A.M., the LPA along with facility designee toured the physical plant areas inside and outside to ensure there are no health and safety hazards and the facility is in compliance with Title 22 regulation. The following was observed: COMMON SPACES: In the common areas, walls and flooring were checked for cleanliness and good condition. At the time of the visit, common seating area and dining room furniture were observed to be in good condition. The LPA observed the required postings in the common areas. The facility serves residents with dementia, the auditory alarms on the exit doors were tested and functioned properly at the time of visit. The facility maintained a temperature of 72 degrees. LPA observed a working phone available for residents use whenever needed. Fire extinguisher was observed to be fully charged and last serviced 07/18/2025. LPA observed that fire extinguisher was mounted on the far wall of the common/TV area. Recliners, wheelchairs and other items were positioned in front of and around the extinguisher, obstructing direct access. LPA requested to relocate the fire extinguisher to a readily accessible location. Hardwired combination of carbon monoxide and smoke detectors and a fire door were tested at 10:46 A.M. and all were functional at the time of the visit. This facility doesn’t have a staff room; facility will provide 24/7 care. Continued on LIC 809-C Continued from LIC 809-C BEDROOMS : The LPA observed the resident bedrooms, which were furnished appropriately with clean linens, appropriate furnishings and sufficient lighting. There are 5 total bedrooms – one (1) bedroom is designated for shared resident use and four (4) are private. BATHROOMS : Three (3) bathrooms were observed to be clean and sanitary and in operating condition. Showers were also observed to have grab bars and slip resistant mats and surfaces. The LPA observed sufficient amounts of soap and paper products in each restroom. Water temperature was measured in both shared resident bathrooms and private bathroom and measured within the required range. KITCHEN: Kitchen appliances appeared in operable condition. The facility has a sufficient supply of perishable and non-perishable food. LPA conducted a review of expiration dates on product labels. Knives and sharps were locked inside a toolbox on top of the kitchen counter. Hot water temperature was measured at 10:55 A.M. and measured 111.5 degrees Fahrenheit. OUTDOOR SPACE: The backyard has a covered outdoor area equipped with furniture for residents’ use. There was a three-tier water fountain and a bird bath fountain noted. A small amount of standing water was present in both fountains due to rainfall from the previous day. During today’s visit, LPA requested that staff immediately dry out and empty both fountains. Facility has two (2) total side gates; both were observed to be self-closing and self-latching gates, however, during today’s visit the side gate located adjacent to the garage was observed to be secured with a metal wire, obstructing the gate from opening. LPA observed a clear passageways for emergency exit use. Facility provides sufficient space to accommodate both indoor and outdoor activities. GARAGE: The Garage remains locked and inaccessible to the residents in care. There’s an area for the washer and dryer machine. Cleaning and laundry supplies were locked and properly storage inside a locked cabinet. A separate pantry with emergency supply was observed. Additionally, LPA observed a sufficient amount of emergency water. Continued on LIC 809-C Continued on LIC 809-C RECORD REVIEW: Between 11:30 A.M. and 1:05 P.M., staff and resident records were reviewed for documents including, but not limited to: health screening, TB test, staff training records, fingerprint clearance, resident physician's report, needs and service appraisal, and personal rights. Five (5) resident records were reviewed. LPA observed that Resident #1 (R1) and Resident #2 (R2) have no capacity for self-care and they are not receiving hospice services. The LPA informed the licensee and designee that the facility needs to have an approved exception with the department for each resident that requires full care and is not on hospice. Additionally, LPA observed that four (4) out of five (5) residents did not have a signed needs and service plan form. Six (6) staff files reviewed were complete and contained all required documents. MEDICATION REVIEW: Began at 1:15 P.M. Medications for five (5) residents were observed. All medications are centrally stored in a locked closet at the end of the hallway between room #1 and room #5. Prescribed medications including PRN were labeled, stored, and inaccessible to residents in care. During today’s visit LPA informed the licensee and designee that removing medication from their original packaging in advance of administration (pre-popping) is not permitted. LPA did not observe any discrepancies during today’s visit. LPA obtained the following documents during today’s visit; Personnel Record (LIC500), Resident Roster (LIC9020A), current Liability Insurance, and infection control policy as well as the emergency disaster plan. Infection control and disaster plan forms were updated yearly as required by regulation. Last emergency disaster drill was conducted on 1/25/2026. Pursuant to Title 22, California Code of Regulations and/or CA Health and Safety Code, the following deficiencies were cited (refer to LIC 809-D.) Administrator was informed that failure to correct the deficiencies may result in civil penalties. An immediate civil penalty of $500 was issued. Exit interview conducted, appeal rights discussed, and a copy of this report and appeal rights were provided.