Routine inspection·July 1, 2025

Licensing Program Analyst (LPA) Trevor Byrne arrived at the facility unannounced to conduct a required annual visit at 02:16 PM. LPA met with facility staff who contacted the facility Administrator Edwin Paul Oyasan. The Administrator arrived to the facility at 02:23 PM. Entrance interview conducted and the reason for the visit was explained. Beginning at 02:25 PM the LPA, along with facility Administrator 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. LPA observed a secured under-sink cabinet to contain knives and other sharp objects. Additionally, this locked cabinet was observed to contain cleaning supplies. LPA informed the Administrator that toxins may not be stored in the same storage as kitchen equipment or utensils. Administrator agreed to remove the chemicals and store the items in an alternate locked storage. LPA observed a fire extinguisher mounted on the wall to be serviced on 06/03/2025. The kitchen contained a locked cabinet that contained resident medications. Continued on LIC 809C. COMMON AREAS : This includes the living room, hallway, and dining area. LPA observed the living room to be clean and properly furnished at the time of the visit. The living room contains a television and activities for resident use. The dining area was observed to be equipped with adequate seating for resident use. The hallway contained storage closets which contained extra linens for resident use and additional care supplies. All furniture throughout the facility was observed to be clean and in good repair. The facility’s combination fire and carbon monoxide alarms were tested at 02:52 PM and were functional at the time of the visit. During the fire alarm test LPA observed the facility’s hallway fire door to fail to close. LPA informed the Administrator that this is a zero tolerance violation of the facility’s fire clearance. LPA informed the Administrator that an immediate civil penalty in the amount of $500 is being assessed on today’s date (07/01/2025). The Administrator agreed to call a repairman to make appropriate repairs to the fire door. All exits in the facility were observed to contain functioning auditory alarms. BEDROOMS : There are four (4) bedrooms in the facility; one (1) is a dual occupancy resident room and three (3) are single occupancy resident rooms. LPA and the facility Administrator toured all four (4) bedrooms. All resident rooms were observed to be furnished appropriately with clean linens, appropriate furnishings, and sufficient lighting. Bedrooms #3 & 4 contained a direct exit to the outdoors of the facility. BATHROOMS : There are two (2) bathrooms at the facility. One (1) is designated as a shared/common resident bathroom and one (1) is a private resident bathroom. All resident bathrooms were observed to be clean and were equipped with nonskid surfaces. Both bathrooms contained locked under sink storage cabinets that contained resident grooming supplies. Grab bars were observed in all resident showers and near all resident toilets all were properly secured. The water temperature was measured to be between 108.0 and 110.7 degrees Fahrenheit, which is within the range required by regulation. OUTDOOR SPACE: The facility has two (2) emergency exit gates located on either side of the facility; LPA observed clear passageways for emergency exit use. The facility has adequate shaded seating outdoors for resident use. LPA observed a secured storage shed that contained miscellaneous care supplies. Continued on LIC 809C. GARAGE: LPA observed the garage to be inaccessible to clients in care. LPA observed the garage to contain the facility’s emergency food supplies, the facility’s washer and dryer, and locked storage for laundry chemicals. Additionally, the garage was observed to be utilized as the Administrator’s office. INTERVIEWS: LPA interviewed two (2) residents. Both residents interviewed stated that the staff treat them well and are attentive to their needs. No residents interviewed had concerns with the facility. Due to time constraints an LPA will return at a later date to conduct staff interviews, conduct a record/medication review, review the facility’s emergency disaster plan/infection control plan, and to obtain copies of the facility’s LIC 500, resident roster, and current liability insurance. Pursuant to Title 22 of the CA Code of Regulations, the following deficiencies and civil penalty were cited (refer to LIC 809-D): Exit interview conducted and copy of the report was issued and appeal rights provided.