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Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) K. Brown arrived unannounced to conduct the Annual Inspection. LPA met with and explained the reason for the visit with Administrator (AD) Amor Alegre. During this visit, LPA Brown toured the facility inside and out with AD. Resident rooms and common areas were clean, in good repair containing required furnishings and lighting. LPA observed required items in bathrooms which were clean with hot water measuring as required in restrooms. LPA observed hygiene items, paper products, towels, extra bedding, and linens which were available for use. The kitchen was clean, containing necessary cooking items and appliances. LPA observed required food supply, including emergency food. Medications are centrally stored and securely locked in a kitchen cabinet. Doors and passageways are unobstructed throughout the facility including outdoors. LPA walked outside to find the grounds well-kept with patios, walkways and seating areas. There is a small shed in the back yard used to store furniture, facility supplies and yard tools which was observed by LPA. Fire extinguishers were serviced 7/14/26. During this visit, LPA conducted resident and staff file reviews including medication and P&I audits. LPAs observed the following deficiencies during today’s inspection: -AD, Does not have Infection Control Lead Certification -Storage space and Access to hygiene items Deficiencies are being cited in accordance with California Code of Regulations on the attached LIC 809-D An exit interview was conducted, a Plan of Correction was developed with HSD and a copy of this report was provided. LPA requested the following updated forms faxed to CCLD by 8/24/2026- Designation of Facility Responsibility (Lic308), Administrative Organization (Lic309), Client Roster (LIC 9020) and Proof of current Liability Coverage.the state’s words, verbatim · CDSS document, Aug 10, 2026

Type of visit: Required - 1 Year

On 10/27/2025, Licensing Program Analyst (LPA) M. Vega arrived unannounced at the above facility to conduct an Annual Inspection. LPA introduced self, stated the purpose of the visit, and was granted entry to the facility-by-facility Staff 1 (S1). Administrator (AD) - Amor A Alegre was notified of Licensing visit over the phone and was able to attend the visit. LPA toured facility with AD - Amor A Alegre. Facility has one entrance/exit point. LPA toured facility with Administrator inside and out. The facility was observed to be at a comfortable temperature, of 78 degrees F. Facility is free of debris, in good repair, and no passageway obstructions or fire hazards were observed. Common areas were properly furnished and well-lit throughout. LPA observed residents were at day program and arrived at facility a short time later. Department phone number and infection prevention information signs were posted thought the facility. Inspecting kitchen LPA observed the required 7-day supply of non-perishable food and 2-day supply of fresh perishables to be properly stored. An emergency disaster supply was observed. Fire extinguisher was observed with a service date of 7/08/2025. All 4 residents’ bedrooms were observed to be with comfortable temperature. Medications observed to be locked in a cabinet in the kitchen. LPA reviewed medication records and there were no deficiencies at the time of inspection. Cleaning supplies were observed to be in a locked cabinet under the kitchen sink and in the laundry room. An outdoor seating area was observed for residents in care. Back yard was free from obstructions to fire exit. Continuation on LIC 809C LPA reviewed Staff and Resident files. Resident files observed to have updated information. No deficiencies were cited during inspection. Exit Interview conducted. LPAs requested documents to be submitted to the department by 11/11/25: current Administrator certificate, LIC 308, LIC 400, LIC 402, LIC 500, LIC 610D, LIC 9020, and updated facility sketch. A copy of this report was provided to administrator, whose signature on this form confirms receipt of these report.the state’s words, verbatim · CDSS document, Oct 27, 2025

Type of visit: Required - 1 Year

On 7/24/24, Licensing Program Analyst (LPA) D. Williams arrived at the facility unannounced to conduct a required Annual Inspection visit. LPA introduced himself, stated purpose of visit, and was allowed entrance by Licensee . LPA toured the inside of the facility including entry, kitchen, dining, living room, bedrooms, & bathrooms. Facility thermostat reflected 72 degrees Fahrenheit. All fire exit routes were free and clear of obstruction. LPA observed medications are stored in a locked cabinet. Knives and sharp objects are secured. Facility has 4 bedrooms and 4 bathrooms. All rooms and had required linens, required furniture, and were clean and in good repair. The bathrooms all had grab bars and non-slip mats available for resident use. Licensee has fire extinguisher and is in good standing. Smoke detectors were present and operational Carbon monoxide detector was tested and in working condition. LPA reviewed 3 resident files and 2 employee files. All employee files had documents requested by the LPA. 1 of 3 resident files did not have a recorded Tuberculosis test. Licensee stated she will get a copy of the TB test and provide to the Department. A deficiency is being issued per the California Code of Regulations Title 22 on the attached LIC809D page. Plan of correction was discussed and reviewed. An exit interview was conducted and a copy of this report LIC809, LIC809D, and appeal rights were provided to Administrator.the state’s words, verbatim · CDSS document, Jul 24, 2024

The state marks this report as 3 pages; the online copy we transcribed has 2. You can request the full file from the county licensing office.