Shoreline Care Home

Type of visit: Required - 1 Year

On May 13, 2026, Licensing Program Analyst (LPA) Garlli Tat conducted an unannounced visit to the facility for the purpose of a required annual inspection. LPA explained the purpose for the visit and was greeted and granted entry by staff on duty. During the visit, staff on duty contacted the facility administrator (AD) Grace Marie Tomas about the visit. For this visit, there are two staff members on duty, both of which are background cleared and associated. AD later arrived to assist with the inspection. The PUB475 ‘See Something, Say Something’ poster was observed to be located near the front entrance. LPA observed that Grace Marie Tomas has a valid Administrator certificate which expires on September 14, 2026. The facility is a Residential Care facility for the Elderly (RCFE) licensed for six residents, six of which may be non-ambulatory, four of which may be bedridden, and a hospice waiver for six. LPA toured the interior and exterior portions of the facility with AD. For this visit, there are a total of four non-ambulatory residents in care, one of which is on hospice, and none are bedridden. The facility is a single story home. There are a total of six private resident bedrooms, four of which are for bedridden residents, and two are for non-ambulatory residents. LPA toured each bedroom with the AD and observed that bedrooms were provided with furniture in good repair, clean linens, adequate storage space, and free of any hazards. Smoke and carbon monoxide detectors as well as auditory exit alarms were tested and operational. There are a total of four bathrooms, two full bathrooms and two half baths. Continued on LIC 809-C. Bathrooms were observed to be in good repair, toilets and faucets were operational and showers were equipped with grab bars and non-skid floor mats. Water temperature in the bathrooms were measured to be between 118.7 and 119.1 degrees Fahrenheit. Facility met the minimum two-day perishable and seven-day non-perishable food supplies. Sharp items and knives were locked in a kitchen cabinet and inaccessible to residents in care. Fire extinguisher was charged, mounted and located in the kitchen. Fire extinguisher was purchased on April 7, 2026. LPA observed all the required postings in the hallway. LPA observed the facility conducted their last emergency disaster drill on March 30, 2026. Facility had back-up emergency food and water supply, located in the garage. LPA observed that the First Aid kit had all the required components. Medications were observed to be locked in a storage room in the hallway, inaccessible to residents in care. Chemicals were observed to be locked in the garage and underneath the kitchen sink. LPA observed the door leading to the attached two car garage is kept locked and inaccessible to residents in care. The garage is used for storage and laundry. For the exterior portion, LPA observed patio furniture under shading. There are two gates in the backyard that can be opened in case of an emergency. No bodies of water were observed. During this visit, four resident files and two staff files were reviewed. All staff are background cleared and associated with the facility. LPA reviewed residents’ medication and medication records and one resident interview was conducted. The facility has valid liability insurance that expires in November 11, 2026. Based on today's observations, there are deficiencies being cited per Title 22 of the California Code of Regulations. An exit interview was conducted with Administrator. This report was reviewed with the Administrator and a copy was provided at the end of the visit. Appeal Rights were reviewed.the state’s words, verbatim · CDSS document, May 13, 2026

Type of visit: Prelicensing

Licensing Program Analyst (LPA) Hanna Gough conducted an announced visit to the facility for the purpose of a pre-licensing inspection. LPA arrived at the facility and was greeted and granted entry. LPA met with applicant Alberto Chavez and Grace Nguyen. An initial application to operate a Residential Facility for the Elderly for six non-ambulatory of which four can be bedridden and a hospice waiver for six was submitted to CCL on October 21, 2024. The pending facility is a one story home with a kitchen, living room, attached two car garage, five resident bedrooms, four resident bathrooms and a backyard. LPA observed the garage is locked and made inaccessible. The kitchen is clean and free of debris and vermin. LPA observed a seven day food supply ready and on hand. LPA observed the emergency food and water supply located in the kitchen and in the garage. LPA observed the knives to be locked in a kitchen drawer located by the dishwasher. LPA observed chemicals and toxins to be locked and stored under the kitchen sink and in the locked garage. LPA observed resident bedrooms to have all the required components and furnishings. LPA observed extra storage space for resident use. LPA observed the bathrooms to have toilet paper, paper towels and non-slip mats. LPA tested the water to be 107.2 to 120.0 degrees Fahrenheit. LPA observed the facility had extra clean linens in the closet located by the front door. LPA observed the centrally stored medication will be in a locked closet located in the hallway. LPA observed the facility first aid kit had all the required components. LPA tested smoke and carbon monoxide detectors and they were found to be operational. LPA observed the backyard to have a shaded seating area for resident use and was free of obstructions. LPA observed two fire extinguishers located in the kitchen charged and with a purchase date of June 10, 2024. Continued on LIC 809-C LPA observed all appliances to be operational including a washer, dryer, stove, refrigerator, freezer, microwave and dishwasher. LPA observed that facility staff and resident files will be stored in a locked cabinet located by the back door. The fire clearance was approved on November 5, 2024. LPA conducted the Component Three Orientation with applicant. Applicant was notified that the final application approval will be issued by the Centralized Applications Bureau in Sacramento. An exit interview was conducted with Alberto Chavez and Grace Nguyen and a copy of this report was provided at the time of inspection.the state’s words, verbatim · CDSS document, May 9, 2025