Routine inspection·April 8, 2026

Licensing Program Analyst (LPA) Valeria Conway arrived at the facility unannounced to conduct a required annual visit at 9:40 A.M. LPA met with Administrator Designee, Janette Villapando and explained the reason for the visit. At 9:52 A.M. LPA conducted a physical plant tour inside and outside to ensure there are no health and safety hazards and the facility is in compliance with Title 22 Regulations. Fire extinguishers are fully charged and last serviced 06/26/2025. At 10:26 A.M. the smoke detectors and carbon monoxide detectors are combined units; they were tested and functioned properly. The facility has two (2) fire doors to enhance safety and prevent the spread of fire. One in the hallway and one in room #1. This facility doesn’t have a staff room; facility will provide 24/7 care. BEDROOMS : There are four (4) private bedrooms and one (1) shared bedroom. All residents’ rooms were observed to be furnished appropriately with clean linens, appropriate furnishings and sufficient lighting. BATHROOMS : There are two (2) bathrooms for residents’ use. One is located in a shared bedroom, and one is a shared bathroom located in the main hallway. Bathrooms were observed to be equipped with slip resistant surfaces and grab bars. Hot water temperature measured between 105 - 120 degrees Fahrenheit F which was within the required range. Continued on LIC 809-C Continued from LIC 809 COMMON AREAS : This includes the living room and dining room areas. LPA observed common areas to be clean and properly furnished at the time of the visit. 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 of 70 degrees. Facility provides sufficient space to accommodate both indoor and outdoor activities. LPA observed a working phone available for residents use whenever needed. The LPA observed the required postings in the common area and fireplace was observed adequately screened. KITCHEN : The LPA observed the kitchen to be clean. Kitchen appliances appeared to be 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. At 10:07 A.M. hot water measured 116.4 degrees Fahrenheit. Cleaning supplies are located in separate locked cabinets with additional supplies in the locked garage. Garage/Laundry room: Inside the locked garage, LPA observed the washer and dryer, emergency water and emergency food, cleaning supplies and disinfectants. The garage remains locked and inaccessible to the residents in care. OUTDOOR SPACE: The backyard has a covered patio area with patio furniture, and the front porch is covered and equipped with furniture as well. Facility has one side gate; LPA observed the side gate to be self-closing and self-latching gate with clear passageways for emergency exit use. During the inspection the LAP observed a locked shed located in the backyard. There were no bodies of water on the premises. RECORD REVIEW: Between 10:53 A.M. and 12:45 P.M., staff and resident records were reviewed. Six (6) resident and five (5) personnel 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, health assessments, criminal record clearances, first aid/CPR training, and the appropriate training. All records were observed to be complete. Continued on LIC 809-C Continued from LIC 809-C MEDICATION REVIEW: Between 1:07 P.M. and 2:00 P.M. Medications for six (6) residents were observed. All medications observed were labeled, stored, and properly documented at the time of the visit. The LPA obtained the following documents at the time of visit: Personnel Report (LIC500), Resident Roster (LIC9020), last emergency disaster drill, and a copy of the facility’s liability insurance. Additionally, the LPA reviewed the facility's infection control practices and the facility's emergency disaster plan. Emergency disaster drills are conducted quarterly, with the last drill conducted on 04/02/2026. Exit interview conducted. No citations issued. A copy of the report was provided.