Routine inspection·September 9, 2025

Licensing Program Analyst (LPA) Zabel Chochian arrived at the facility for the purpose of a required annual visit. Upon arrival LPA was greeted by facility staff who contacted the Administrator. The Administrator, Laila Kulunga arrived at approximately 11:30am. Reason for the visit was stated. At approximately 10:45am, the LPA along with the 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: KITCHEN: The LPA inspected the kitchen/food service area. Knives and sharps were observed in a locked drawer inaccessible to residents in care. Kitchen appliances observed in operable condition. At least 2-day supply of perishable and 7-day supply of non-perishable food items observed; properly stored. Refrigerator and food pantry were checked for proper storage; items observed labeled and dated. A fire extinguisher observed in the kitchen area with a purchase receipt dated 4/25/2024. COMMON AREAS: This includes the living room and dining room area. The common areas were furnished appropriately and appeared to be in good condition at the time of the visit. Fireplace made inaccessible. The facility maintained a comfortable temperature. LPA observed required postings throughout the common space. LPA observed a hallway closet with resident’s personal hygiene items locked at the time of the visit. Activities observed in the living room. Auditory alarms observed operable at the time of the visit. (Continue to LIC809c) BEDROOMS: There are four (4) bedrooms for resident use; two (2) bedrooms are designated as single occupancy; and two (2) bedrooms are designated as double occupancy. All resident rooms were observed to be furnished appropriately and had sufficient lighting. Additional clean linens, towels, and washcloths were observed in the hallway closet. RESTROOMS: The two (2) resident restrooms were clean and sanitary and in operating condition with grab bars and non-skid surfaces. The bathrooms were sufficiently stocked with supplies and paper towels. Hand washing signs were observed posted inside the bathrooms. The hot water temperature was measured at 118 degrees Fahrenheit in both bathrooms. GARAGE: The garage is maintained inaccessible to residents in care. LPA observed an additional refrigerator with food in good condition. There is a washer and dryer inside the garage. Cleaning supplies, detergents, and toxins were observed inaccessible to residents in care. Facility has an adequate amount of emergency food and water. LPA observed a sufficient supply of Personal Protection Equipment (PPE). Administrator was reminded to ensure a 30 day supply is maintained at all times. Administrator agreed to inventory current supply and ensure they maintain a 30 day supply. BACKYARD: The backyard has a covered patio area with adequate furniture for resident use. The exterior passageways were clear of any obstructions at the time of the visit. LPA observed two (2) self-latching side gates. There were no bodies of water noted at the time of the visit. RECORDS REVIEW: Emergency disaster drills conducted quarterly as per regulation; the last drill was conducted on 09/1/2025. LPA reviewed Resident Records at approximately 12:45pm and Personnel Records at 1:15pm. Three (3) resident files were reviewed for, but not limited to, the following: signed admission agreements, current medical assessments with TB results, LIC627(c) Consent for Treatment form, and current needs and services plan. Resident #2 and Resident #3 did not have the PRN Authorization letter on file. All files were complete. Four (4) personnel files including the Administrator’s file were reviewed for, but not limited to: personnel records, health assessments, criminal record clearances, first aid / CPR training, and the appropriate training. Staff training documentation observed incomplete. MEDICATIONS: Medications review began at approximately 2:30pm. The medications are locked in cabinet in the kitchen. Resident #1’s (R1’s) is provided assistance with several over the counter medication and vitamins; however, the facility did not have prescription orders on file. Staff obtained copy of doctor’s order / prescription during the inspection. There was no PRN authorization letter on file for resident #2 and resident #3. Administrator obtained the PRN authorization letter during the inspection visit. The following deficiencies were observed (See LIC 809-D.) and cited from the California Code of Regulations, Title 22 and California Health and Safety Code. Failure to correct the deficiencies may result in civil penalties. Exit interview conducted. A copy of the report and appeal rights were provided.