Most inspections found no deficiencies, including the most recent report on September 12, 2025, which was clean with all areas such as infection control and medication management satisfactory. Earlier reports showed some issues, notably in September 2023 when multiple immediate health risks were identified, including expired food, unsecured medications, and excessively hot water, all of which were promptly addressed by the administrator. The September 2024 inspection cited two deficiencies related to medication administration inconsistencies and missing annual medical assessments for a resident with dementia, but these were less severe and isolated. There were no fines, enforcement actions, or license issues noted in any report. Several complaint investigations were not applicable as no complaints were filed during this period.
The inspection was an unannounced required annual visit to evaluate the facility's compliance with Title 22 regulations.
Findings
The facility was found to be in compliance with all applicable regulations, with no citations issued. The physical plant, resident and personnel records, infection control, emergency planning, and medication management were all satisfactory.
Report Facts
Number of resident files reviewed: 6Number of personnel files reviewed: 5Number of resident rooms: 7Number of resident rooms with exterior exits: 2Number of restrooms: 4Number of refrigerators checked: 2Number of residents whose medications were reviewed: 3Hot water temperature range in resident restrooms: 105.6-116.1Kitchen faucet hot water temperature: 118.6Number of self-latching gates in backyard: 2
Employees Mentioned
Name
Title
Context
Elmira Sabyrova
Administrator
Facility Administrator present during inspection and involved in entrance interview
Erica Mosley
Licensing Program Analyst
Conducted the inspection visit
Ernis Sabyrov
Facility Designee
Greeted Licensing Program Analyst and assisted during inspection
The inspection was an unannounced required annual visit to evaluate the facility's compliance with Title 22 regulations and ensure health and safety standards are met.
Findings
The facility was generally found to be in compliance with health and safety regulations, including fire safety, kitchen and common area conditions, and infection control plans. However, two deficiencies were cited related to medication administration inconsistencies and lack of a current annual medical assessment and reappraisal for a resident with dementia.
Severity Breakdown
Type B: 2
Deficiencies (2)
Description
Severity
One medication for each of two residents had changes in orders, but the amount of medications distributed did not match the days elapsed since the changes, posing a potential health risk.
Type B
One resident with dementia did not have an annual medical assessment nor a current reappraisal, posing a potential health and safety risk.
The Licensing Program Analyst arrived unannounced to conduct a required annual visit to ensure the facility's compliance with Title 22 Regulations and health and safety standards.
Findings
The inspection found multiple deficiencies including expired food items in the refrigerator, unlocked refrigerated medications, accessible cleaning supplies and medications, and hot water temperatures exceeding regulatory limits. The administrator took immediate corrective actions during the visit and agreed to plans of correction for all deficiencies.
Severity Breakdown
Type A: 4
Deficiencies (4)
Description
Severity
Multiple expired food items were identified in the refrigerator posing an immediate health and safety risk.
Type A
Unlocked refrigerated medications were observed which need to be kept in a lock box.
Type A
Cleaning supplies, over the counter medications, vitamins, and refrigerated medications were accessible to residents with dementia, posing an immediate health and safety risk.
Type A
Faucets delivering hot water in bathrooms were delivering water about 120 degrees Fahrenheit, exceeding the maximum allowed temperature and posing an immediate health and safety risk.
Type A
Report Facts
Facility capacity: 6Census: 5Plan of Correction due date: Sep 14, 2023Hot water temperature: 122.5Hot water temperature: 128.6
Employees Mentioned
Name
Title
Context
Elmira Sabyrova
Administrator
Facility administrator present during inspection and named in findings related to medication and food safety
The inspection was an unannounced Required 1-Year Annual Inspection with a focus on Infection Control, conducted as the first annual inspection following the pre-licensing visit on 2021-09-16.
Findings
The facility was found to be in compliance with Title 22 regulations, with no health or safety hazards observed. Infection control practices were adequate, including proper signage, PPE supply, symptom screening, and vaccination of all staff. No citations were issued.
Report Facts
Days of perishable food supply: 7Days of non-perishable food supply: 2Hot water temperature: 118.4Hot water temperature: 110.7Facility capacity: 6Resident census: 5
Employees Mentioned
Name
Title
Context
Elmira Sabyrova
Licensee / Administrator
Met during inspection and discussed infection control practices
Martha Arroyo
Licensing Program Analyst
Conducted the inspection visit
Desaree Perera
Licensing Program Manager
Named in report header and signature section
Inspection Report Original LicensingCapacity: 6Deficiencies: 0Sep 16, 2021
Visit Reason
An announced pre-licensing visit was conducted to evaluate the facility for licensure and compliance with regulations.
Findings
The facility was found compliant with regulations, with no corrections needed at the time of the visit. The facility has appropriate fire clearance, safety equipment, furnishings, and emergency preparedness measures in place.
Report Facts
Facility capacity: 6Census: 0Number of bedrooms: 6Number of bathrooms: 3.5Hot water temperature: 114.8Hot water temperature: 116.6Hot water temperature: 118.4Hot water temperature: 113Non-perishable food supply: 7Perishable food supply: 2Number of exit doors: 6Number of resident bedrooms furnished: 5Number of bathrooms for resident use: 3Number of ramps: 2Number of fence gates: 2
Employees Mentioned
Name
Title
Context
Elmira Sabyrova
Administrator
Facility representative met during inspection
Martha Guzman Chavez
Licensing Program Analyst
Conducted the pre-licensing visit
Desaree Perera
Licensing Program Manager
Named in report header
Inspection Report Original LicensingCapacity: 6Deficiencies: 0Sep 7, 2021
Visit Reason
Initial licensing evaluation conducted via telephone call with the administrator to confirm understanding of licensing requirements and program policies.
Findings
The applicant and administrator successfully completed the Component II evaluation, demonstrating understanding of facility operation, staff qualifications, program policies, and other licensing requirements. No deficiencies or violations were noted.
Report Facts
Capacity: 6Census: 0
Employees Mentioned
Name
Title
Context
Elmira Sabyrova
Administrator/Licensee
Participated in COMP II telephone call and confirmed understanding of licensing requirements
Jude De La Concepcion
Licensing Program Manager
Named as Licensing Program Manager on report
Marisa Holabird
Licensing Program Analyst
Named as Licensing Program Analyst on report
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