Routine inspection·March 20, 2026

Licensing Program Analyst (LPA) Valeria Conway arrived at the facility unannounced to conduct a required annual visit at 9:20 a.m. The LPA was greeted by Caregiver, Virginia Ching. Caregiver contacted the Administrator by phone, Bernadette Abiera. At 9:30 a.m. Administrators arrived at the facility. LPA informed the reason for the visit. Entrance Interview. At 9:35 a.m. LPA conducted a physical plant tour inside and outside to ensure there are no health and safety hazards and the facility is in compliance with Title 22 Regulations. Fire extinguishers are fully charged and last serviced 7/15/2025. At 9:41 a.m. the smoke detectors and carbon monoxide detectors were tested and functioned properly. The facility has a fire door in the hallway which also functioned properly. COMMON AREAS : This includes the living room and dining room areas. LPA observed common areas to be clean and properly furnished at the time of the visit. The facility serves residents with dementia, the auditory alarms on the exit doors were tested and functioned properly. The facility maintained a temperature of 73 degrees. Facility provides sufficient space to accommodate both indoor and outdoor activities. LPA observed a working phone available for residents use whenever needed. BEDROOMS : There are 6 (six) total bedrooms; 5 (five) are designated as resident rooms - 1 (one) shared and 4 (four) private and 1 (one) is designated as a staff room. All residents’ rooms were observed to be furnished appropriately with clean linens, appropriate furnishings and sufficient lighting. Continued on LIC 809-C Continued from LIC 809 BATHROOMS : The LPA observed three (3) bathrooms in the facility; one is a shared resident bathroom, one is a private bathroom, and one is a staff restroom. Bathrooms were observed to be equipped with non-slip resistant surfaces and grab bars. Hot water temperature was measured in both residents’ bathrooms and were within the required range of 105 and 120 degrees Fahrenheit. KITCHEN : The LPA observed the kitchen to be clean. Kitchen appliances appeared to be in operable condition. The facility has a sufficient supply of perishable and non-perishable food and water. LPA conducted a review of expiration dates on product labels. Cleaning supplies are located in a locked cabinet under the kitchen sink and separate from food supplies. All sharps were locked in a kitchen drawer next to the refrigerator and inaccessible to residents in care. At 9:45 a.m. hot water temperature measured 118.5 degrees Fahrenheit. OUTDOOR SPACE: The backyard has a covered patio area with patio furniture, and the front porch is covered and equipped with furniture as well. All passageways were observed to be clear. The LPA observed a non-operable water fountain in the backyard, with no water present inside the fountain during today’s visit. Facility has four gates; the two (2) side gates leading to the front yard were observed to be self-closing and self-latching gates with clear passageways for emergency exit use. Garage/Laundry room: The garage is attached to the house, and it remains locked and inaccessible to the residents in care. Inside, LPA observed emergency food and emergency water, mobility aids such as walkers, wheelchairs, adult briefs. Additionally, in the garage is where the washer and dryer are kept. INFECTION CONTROL/EMERGENCY DISASTER PLANNING: During today’s visit, the LPA reviewed the facility's infection control practices and emergency disaster plan. The facility’s policies and procedures as they pertain to infection control are adequate, however they were neither reviewed nor annually updated. Technical Violation (TV) issued. Emergency disaster drills are conducted quarterly, with the last drill documented on 01/02/2026. Continued on LIC 809-C Continued from LIC 809-C RECORD REVIEW: Between 12:15 p.m. and 1:30 p.m. LPA reviewed five (5) staff files and six (6) resident files. Files were reviewed for, but not limited to: Physician's Reports, Personal Rights, Admission Agreements, staff training records, health screenings, TB tests, and background clearance. All files reviewed were observed to be in compliance with regulation. MEDICATION REVIEW: Medications are securely stored in a locked closet located in the main hallway. At 11:40 a.m. LPA reviewed medications for six (6) residents. All medications observed were labeled, stored, and properly documented at the time of the visit. INTERVIEWS: One (1) staff was interviewed; no concerns noted, and staff answered questions appropriately. During today's visit, LPA gathered the following Personnel report (LIC 500), Resident Roster, a copy of the facility's liability insurance. No citations issued. Exit interview conducted and a copy of this report was provided.