Post-licensing visit·March 2, 2026

Licensing Program Analyst (LPA) Martha Arroyo arrived at the facility unannounced to conduct a post-licensing visit today. Upon arrival, there were two (2) staff members and four (4) residents present. The LPA met with facility staff who contacted Administrator, Jennifer Pantig and at this time the reason for the visit was explained. The Administrator arrived at the facility during the inspection. Entrance interview. Beginning at 10:02 AM, the LPA along with staff 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: KITCHEN : The LPA observed the kitchen area to be clean. Kitchen appliances appeared to be in operable condition. The facility has a sufficient supply of two (2) days perishable and seven (7) days non-perishable food. The LPA observed knives and sharps in a locked drawer at the time of the visit. Cleaning supplies were observed under the kitchen sink locked and inaccessible. Refrigerator and pantry were checked for expirations dates. COMMON AREAS : This includes the two (2) living rooms and dining area. The LPA observed the living rooms to be clean and properly furnished at the time of the visit. The dining area was observed to be equipped with adequate seating for resident use. All furniture throughout the facility was observed to be clean and in good repair. Report Continued on LIC 809C... Report Continued from LIC 809... There is a fireplace adequately screened at the time of the visit. The LPA observed two (2) fire extinguishers with a purchase date of 08/07/2025. The LPA observed a working telephone on premises. No tripping hazards were observed inside or out. BEDROOMS : There are five (5) bedrooms in the facility for resident use; four (4) are designated for single occupancy, and one (1) is designated for shared / double occupancy. All resident rooms were observed to be furnished with appropriate furnishings and sufficient lighting. Additional clean linens and towel were observed in a storage closet by the hallway. The LPA observed personal hygiene items locked and inaccessible to residents in care at the time of the visit. BATHROOMS : There are two (2) bathrooms at the facility for resident use. One (1) is designated as a private resident bathroom, and one (1) is designated as a shared/common resident bathroom. All resident bathrooms were observed to be clean and were equipped with nonskid surfaces. Beginning at 10:10 AM, the water temperature was measured in resident bathrooms, and they measured within the required range of 105 – 120 degrees Fahrenheit. OUTDOOR SPACE: The LPA observed an adequate shaded seating area with appropriate outdoor furniture for resident use. The facility has one (1) self-latching gate for emergency use. All passageways were observed to be clear of any obstructions. No bodies of water noted at the time of the visit. GARAGE: The garage is attached to the house. Washer and dryer were observed inside. Laundry detergents and cleaning supplies were observed inaccessible to residents at the time of the visit. The LPA observed an adequate amount of emergency food and water at the time of the visit. RECORD REVIEW: Record review began at 10:25 AM. Four (4) resident files were reviewed for but not limited to; signed admissions agreement, medical assessment, negative tb test results, consent for treatment form, pre-appraisal, appraisal, needs & service plan, and personal rights. Report Continued on LIC 809C... Report Continued from LIC 809C... Six (6) staff files were reviewed for but not limited to; personnel record, health screening with negative tb test result, fingerprint clearance, first aid / cpr certification, and annual staff training. Files were in order. Administrator Certificate valid until 01/15/2027. MEDICATION REVIEW: Medication review began at approximately 12:50 PM. Medications are centrally stored and kept in a locked kitchen cabinet. Medications for two (2) residents were observed. Start dates noted and actual start dates did not match. LPA was unable to verify pill count. The Administrator will review centrally stored medications and records to match correct dates. EMERGENCY DISASTER PLANNING: During today’s visit, the LPA reviewed facility's emergency disaster plan. The facility’s emergency disaster plan is up to date and is adequate. Emergency disaster drills are conducted quarterly; the facility’s last emergency disaster drill was conducted on 02/13/2026. Pursuant to Title 22, California Code of Regulations (CCR), the following deficiencies are cited (refer to LIC809-D). Exit interview conducted. A copy of report and appeal rights were provided.