Routine inspection·October 30, 2025

Licensing Program Analyst (LPA) Quoc Huynh arrived at the facility unannounced to conduct a required annual visit at 2:53PM. The LPA met with the Administrator Jovy Sarreal who arrived shortly thereafter. Entrance interview conducted. Beginning at 3:07PM, the LPA, Administrator, and Staff toured the physical plant areas inside and outside to ensure there are no health and safety hazards and facility is in compliance with Title 22 Regulations. The following was observed: COMMON AREAS: At the time of the visit, living room and dining room furniture was observed to be in good condition. There was a fireplace in the living room, which was observed to be screened and inaccessible. Attached to the living room was a sun room with an office area in the corner. Also attached to the living room was the garage entrance which was secured and contained emergency food and water, extra facility food, general storage, and laundry machines that were in good condition. The facility maintained a comfortable temperature throughout the visit. The LPA observed required postings on entryway walls. KITCHEN: Knives were stored inaccessible in a drawer in addition to secured cleaning supplies under the kitchen sink. Kitchen appliances were in good and operable condition. The facility had a sufficient supply of perishable and non-perishable food. Resident medications were locked in a cabinet with files. Report Continued on LIC 809-C BEDROOMS/RESTROOMS: There were five (5) total bedrooms: four (4) resident bedrooms and one (1) secured staff room. All resident bedrooms had a direct exit to the outside and was cleared for a total of six (6) Bedridden residents. Bedrooms were furnished appropriately with clean linens, appropriate furnishings and sufficient lighting. Extra linens were observed in the hallway. The LPA observed Bedroom #2 did not have a bed and the Administrator ordered a hospital bed to be delivered the next day. There were two (2) total restrooms: one (1) private resident restroom and one (1) shared restroom located in the hallway. Restrooms were clean and sanitary and in operating condition with grab bars and non-slip surfaces. All restrooms were sufficiently stocked with soap and paper towels. The shared restroom contained locked cabinets that had extra hygiene supplies and cleaning supplies. Hot water was tested and measured between 103.8 degrees F and 109.4 degrees F, which was in the required range. OUTDOOR AREA: The backyard had a covered patio area equipped with furniture for residents’ use. There were two (2) side gates for emergency exit use and were self-latching. All exits and passageways were free of obstruction. RECORDS: Record review began at 3:37PM. Resident records were reviewed for, but not limited to care plans, physician's report, admissions agreement, and consent forms. All records were in order. Personnel records were reviewed for, but not limited to health assessments, criminal record clearances, first aid/CPR training, and the appropriate training. All files were in order. INFECTION CONTROL/EMERGENCY DISASTER PLAN: During today's visit, the LPA reviewed the facility's infection control plan and emergency disaster plan. Both documents were observed to be complete and updated annually as required. Emergency disaster drills are conducted quarterly, with the last documented drill on 10/09/2025. Smoke and carbon monoxide detectors were tested at 4:14PM and were operational at the time of the visit. The fire extinguisher was fully charged and serviced on 6/17/2025. Report Continued on LIC 809-C MEDICATIONS: Medication review began at 4:17PM. Medications were centrally stored and kept inaccessible. Medications were observed for two (2) residents. Medications were labeled and checked for expiration dates. Medications were properly documented on the centrally stored medications and destruction record. No errors observed during the medication review. No deficiency cited. Exit interview conducted. A copy of today's report was reviewed and provided.