LPA Tea reviewed six resident files and two staff files. All files contained the required documentation. AD Celis' administrator certificate expires on July 7, 2027, and AD Rebecca's administrator certificate expires on September 17, 2027. The facility's last emergency disaster drill was conducted on September 3, 2026.

LPA Tea, accompanied by both administrators, conducted a tour of the facility. The home consists of four resident bedrooms, one staff room, two bathrooms, a living room, a family room/staff office area, a dining area, a kitchen, and an attached garage.

LPA observed that smoke and carbon monoxide detectors in the common areas and bedrooms were operational. Resident bedrooms were equipped with the required furniture, bed linens, and adequate closet and drawer space. Resident bathrooms were inspected, and toilets and water faucets were operational. Grab bars were secure, and showers were free of mold and mildew. The water temperature measured approximately 111.0 degrees Fahrenheit. Bath towels, toiletries, and personal hygiene supplies were adequately stocked. Common areas were clean and free of hazards, and doorways were clear of obstructions. The first aid kit contained the required supplies, including dressings, bandages, tweezers, a

(Annual inspection continued on LIC809-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.

LPA Tea inspected the kitchen and observed an adequate supply of perishable and non-perishable food. Kitchen appliances were operational. Sharp objects were locked and secured in a cabinet beneath the kitchen sink. Toxic substances were secured in locked cabinets in the garage and inaccessible to residents. Emergency food, water, and supplies were observed in the kitchen and garage. LPA also inspected the outdoor grounds and observed adequate shaded seating areas. Two exit gates, located on both sides of the home, were operational and equipped with self-latching mechanisms.

The facility provides activities based on residents' individual preferences and health conditions, including walking, watching movies, puzzles, and games. During the visit, LPA observed residents playing cards, watching television, and resting.

LPA Tea reviewed medication storage and administration. Medications were secured in a locked cabinet and administered according to physicians' orders. LPA also interviewed residents regarding their quality of care and spoke with staff present regarding the care and services provided.

Based on observations, interviews, and records reviewed during today's inspection, no deficiencies were noted in the areas inspected under Title 22, Division 6, of the California Code of Regulations.

An exit interview was conducted with facility representatives. This report was reviewed, and copies of LIC809, LIC809-C, LIC858, and LIC859 were provided to the facility.