Routine inspection·January 23, 2026

Licensing Program Analyst (LPA) Valeria Conway arrived at the facility unannounced to conduct a required annual visit at 09:30 A.M. The LPA was greeted by caregivers Felicidad Portugal and Celso Espiritu. LPA informed the reason for the visit. At 9:40 A.M., Caregiver Portugal contacted the Administrator by phone, Margarita Colon. Administrator was unavailable during today's visit, but authorized Celso Espiritu to sign today's report. Entrance interview conducted. Beginning at 10:15 A.M., the LPA, along with caregiver Celso Espiritu toured the physical plant areas inside and outside to ensure there are no health and safety hazards and that facility is in compliance with Title 22 Regulations. The following was observed: A fire extinguisher is fully charged and purchased on 12/25/2025. Between 10:40 A.M. and 10:57 A.M. smoke detectors and two (2) Carbon Monoxide detectors were tested and functional at the time of the visit. KITCHEN : The LPA observed the kitchen to be clean. Kitchen appliances appeared to be in operable condition. The facility has a sufficient supply of seven (7) days non-perishable and two (2) days perishable food. Cleaning supplies and sharps are located in a locked cabinet under the kitchen sink. LPA conducted a review of expiration dates on product labels. At 10:53 A.M. hot water temperature was tested and measured at 112.5 degrees Fahrenheit. Continued on LIC 809-C Continued from LIC 809 COMMON AREAS : This includes the living room, family room, and dining room areas. LPA observed common area to be clean and properly furnished at the time of the visit. An adequately screened fireplace was noted in the living room. 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 71 degrees. LPA observed a working phone available for residents use whenever needed. Facility provides sufficient space to accommodate indoor activities. BATHROOMS : There are two (2) bathrooms which are designated for shared use. Restrooms were observed to be equipped with slip-resistant surfaces and contain slip-resistant mats. Grab bars were observed in the bathrooms. LPA observed all bathrooms were clean, properly supplied and had functional fixtures. Residents have sufficient amounts of supplies for personal hygiene. Hot water temperature was measured in both shared bathrooms and measured within the required range of 105-120 degrees Fahrenheit. BEDROOMS : There are five (5) total bedrooms in the facility; 1 (one) is designated as a shared room and 4 (four) are designated as private resident rooms. Occupied rooms were observed to be furnished appropriately with clean linens, appropriate furnishings and sufficient lighting. There is an additional bedroom for staff use. GARAGE : Garage was observed locked and inaccessible to the residents in care. Garage contained laundry area, extra food, PPE and incontinence supplies, 1 st aid kit and emergency food and water. LPA observed a low supply of emergency water. Technical assistance (TA) issued. OUTDOOR SPACE: The backyard has a covered patio area with patio furniture for residents’ use. All passageways were observed to be clear. There were no bodies of water on the premises at the time of the visit. Facility has a side gate which was observed to be self-closing and self-latching with clear passageways for emergency exit use. LPA observed cameras throughout the outside of the property only. Facility provides sufficient space to accommodate outdoor activities. LPA observed two (2) sheds containing holiday decorations, extra PPE and incontinence supplies, mobility devices and gardening tools. The property has two (2) homes with different house numbers/address. The homes are separated by a fence. Continued on LIC 809-C Continued on LIC 809-C RECORD REVIEW: Starting at 11:15 A.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. All 2 (two) resident files observed were missing the Personal Rights form (LIC 613). Technical Violation (TV) issued. All other forms were inside their files. During this visit, LPA requested two (2) staff files and the administrator’s file for review. The administrator’s file was reportedly maintained offsite and was not available at the time of the visit. Review of the two (2) caregiver files revealed missing documentation that had been available during the previous year’s visit. Missing documents included updated CPR and as personnel record or job application for Staff #1 and personnel record or job application and health screening for Staff #2. MEDICATION REVIEW: At 12:45 P.M. medications for 2 (two) residents were observed by the LPA. Medications are maintained locked in a hallway cabinet leading to the garage and they are inaccessible to residents. All medications observed were labeled and stored properly. However, discrepancies were identified on both residents during the medication count. The following was observed: Resident’s 1 Metroprolol Succ ER 100 MG , 1 tab twice a day, with a start date of November, 9, 2025 containing 180 pills, had 25 left . Eliquis 2.5 mg, 1 tab twice a day, with a start date of January 4, 2025 containing 60 pills, had 37 pills left. Resident’s 2 Atrovastatin 40 MG t ake, 1 tab a day, with start date of December 15, 2025 containing 100 pills had 59 pills left. LPA requested the following documents during today’s visit; Personnel Report (LIC 500), Resident Roster, Liability Insurance. Emergency disaster drills are conducted quarterly, with the last drill conducted on 12/28/2025. Additionally, LPA observed emergency disaster plan to be complete and updated annually, as required. INTERVIEWS: During today's visit, LPA interviewed 2 (two) staff members and 2 (two) residents. Pursuant to Title 22 CA Code of Regulations, the following deficiencies were cited (refer to LIC 809-D) and civil penalty issued. Exit interview conducted. Today's reports and appeal rights were discussed, and copy will be email to the Licensee.