Routine inspection·March 23, 2026

Licensing Program Analyst (LPA) Martha Arroyo arrived at the facility unannounced to conduct the required annual visit today at 09:30 a.m. Upon arrival, the LPA was greeted by staff who then contacted the Licensee Representative telephonically and informed them of today’s visit. The Licensee Representative, Maricar Lee arrived at approximately 10:20 a.m. Entrance interview conducted. Beginning at 10:25 a.m., the LPA along with the Licensee Representative 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 at approximately 10:35 a.m. Knives and sharps were observed in a kitchen drawer locked and inaccessible at the time of the visit. Kitchen appliances were in operable condition. The facility has a sufficient supply of perishable and non-perishable food. Refrigerator and food pantry were checked for proper labels and expiration dates. Common Areas: At the time of the visit, furniture in the common areas was observed to be in good condition. The facility maintained a comfortable temperature. The LPA observed two (2) fire extinguishers to be fully charged with a charge date of 07/28/2025. Fireplace was observed adequately covered at the time of the visit. Required postings were observed throughout the common space. There is a working telephone on premises. Activities were observed in the common areas. At 10:43 a.m., the smoke detector and carbon monoxide were tested and operational at the time of the visit. hazards/obstructions observed inside or out. Report Continued on LIC 809C... Report Continued from LIC 809... Restrooms: There are two (2) restrooms for residents’ use. One (1) bathroom is located inside bedroom #1 and second bathroom was observed by the main hallway. Bathrooms were clean and sanitary and in operating condition with non-skid surfaces. The bathrooms were sufficiently stocked with supplies and paper towels. Starting at 10:28 a.m., the hot water temperature was measured in both bathrooms, and they measured within the required range of 105 – 120 degrees Fahrenheit. Bedrooms: There are three (3) bedrooms for resident use and are designated as shared / double occupancy bedrooms. Bedrooms were observed to be furnished appropriately and had sufficient lighting. Additional clean linens and towels were observed in a closet by the hallway. Staff bedroom was observed locked and inaccessible at the time of the visit. Garage/Laundry Room: The garage is accessible directly from the main house. Garage was locked at the time of the inspection. Washer and dryer were observed inside the garage. Cleaning supplies and detergents were observed locked and inaccessible at the time of the visit. The LPA observed an adequate amount of emergency food and water. Outdoors: The backyard has a covered patio area with adequate furniture for resident use. Emergency passageway was observed to be clear of any obstructions. There is one (1) side gate with latching mechanisms. No bodies of water noted at the time of the visit. Records: Record review began at approximately 10:55 a.m. Five (5) resident files were reviewed for, but not limited to, the following: signed admission agreements, current medical assessments with TB results, consent for treatment form, and current needs and services plan. Files were in order. Report Continued on LIC 809C... Report Continued from LIC 809C... Three (3) personnel files were reviewed for, but not limited to: personnel records, health assessments with negative TB test results, criminal record clearances, first aid/CPR training, and the appropriate yearly training. Personnel files were complete. Infection Control / Emergency Disaster Planning: The LPA reviewed the facility's infection control plan and emergency disaster plan. The facility’s policies and procedures as they pertain to infection control are adequate. The LPA observed the emergency disaster plan to be complete and recently reviewed/updated. Emergency disaster drills conducted quarterly as per regulation; last drill conducted on 03/02/2026. Medications: Medications review began at approximately 01:45 p.m. Medications are centrally stored and kept in a locked cabinet adjacent to the kitchen. Medications are properly documented on the centrally stored medication and destruction record. Medications appear to be administered as prescribed at the time of the visit. No citations issued at this time. Exit interview conducted. Report was reviewed and copy provided.