LPA Tea reviewed five resident files and three staff files. Resident and staff files contained the required documentation. The Administrator's Certificate expires on May 1, 2027.

LPA Tea, accompanied by facility staff, toured the physical plant and inspected resident bedrooms and bathrooms, common areas, food service, medication storage, emergency supplies, and the first aid kit. The facility is a single-story home consisting of three resident bedrooms, one caregiver room, one and one-half bathrooms, a living room, dining room, kitchen, sunroom, and attached garage.

LPA observed smoke and carbon monoxide detectors in the common areas and resident bedrooms to be operational. Resident bedrooms contained the required furniture, bed linens, and closet/drawer space to accommodate each resident comfortably. LPA observed bed rails being used on resident beds. Record review revealed that only one out of five residents had documentation supporting the use of bed rails. LPA reminded the facility that appropriate documentation/orders are required for the use of bed rails.

(Annual Inspection continued on LIC 809-C)

• Type A deficiencies are violations of licensing requirements that, if not corrected, have a direct and immediate risk to the health, safety, or personal rights of persons in care.

• Type B deficiencies are violations of licensing requirements that, without correction, could become a risk to the health, safety, or personal rights of persons in care, a recordkeeping violation that could impact the care of said persons and/or protection of their resources, or a violation that could impact those services required to meet the needs of persons in care.

The first aid kit contained the required supplies, including bandages, dressings, tweezers, a thermometer, and scissors. The kitchen was inspected. The required supply of perishable and nonperishable food was adequately stocked at the time of the visit. LPA observed sharps secured in a locked kitchen drawer. Toxic substances were secured underneath the kitchen sink and inaccessible to residents. The fire extinguisher located in the kitchen was fully charged, and kitchen appliances were operational.

LPA toured the exterior grounds and observed adequate outdoor seating and shaded areas. Two exit gates, located on each side of the facility, were self-latching and operational. LPA observed emergency food and water supplies stored in the kitchen pantry and garage. The facility's most recent disaster drill was conducted on July 10, 2026. The facility provides activities based on residents' interests and physical abilities. Activities include watching television, dancing, completing puzzles, coloring, and reading books. During the visit, LPA observed residents participating in coloring and singing activities.

LPA reviewed medication storage and administration. Medications were secured in a locked cabinet in the office area and were being administered as prescribed by physicians.

Based on observations and record review conducted during today's inspection, a deficiency is being cited pursuant to Title 22, Division 6, of the California Code of Regulations.

An exit interview was conducted with Administrator Jessica Villanueva. A copy of this report, LIC 809-D, LIC 858, LIC 859, LIC 9102, and Appeal Rights were provided to the facility.