B & B Residential Facilities, Inc.

On 07/07/2024, Licensing Program Analyst (LPA) Jaime Vado conducted an unannounced annual inspection visit. LPA met with administrator Noralee Reyes and explained the purpose of today's visit. There are 2 staff present and 6 residents in care at time of visit. This facility is licensed for ages 60 years and over. All may be non-ambulatory. Hospice wavier on file. There is currently 1 resident on hospice at time of this inspection. LPA was allowed entry into the facility. This is a multilevel facility but the residents only reside on the main floor where the front door is located on the ground floor. The upper floor are rented out to private renters. Renters do not have access to the residents in the facility. Annual fees are current. The physical plant was toured inside and outside to ensure the safety of the residents. LPA observed the facility kitchen which is clean and observed appliances are in good repair. Knives are stored and locked in the kitchen in a drawer adjacent to the stove top. Medications are also locked in a cabinet in the main living room area. Perishable and non-perishable food items are observed as in place. LPA advised that more canned goods to be in place. There are additional refrigerator/freezer in the garage areas which also carry additional food supplies. Laundry area is located in the garage and is in working condition during time of inspection. First aid kit is observed as complete with required items. LPA observed fire extinguisher in place and charged within operable range, smoke detector/carbon monoxide detectors are observed in place through out the facility, and central heating/cooling system. PPE and additional food supplies are observed as in place. Continued on next page. 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 Page 2 Emergency exit routes are observed inside and outside to be free and clear of obstructions. Last emergency/disaster drill was conducted on 06/15/2025. Water temperature was measured at 110F. All resident rooms contain a half bath. Shower floor have non-skid mats when shower is in use in the common bathroom located in the main hallway. LPA observed rooms at random and all appeared clean, free of odors, and contained all the required furniture per regulatory recommendations. Resident linen supplies are observed as in place stored in a closet that is locked with cleaning supplies. LPA reviewed 4 resident files and also reviewed 3 staff files on this day. Per resident files reviewed they are current. Per staff files reviewed all files were current with training and CPR/First Aid. Client medications are inspected and are current including facility medication administration records. Administrator certificate is observed as current expiring on 09/24/2025. The following updated forms are requested to be submitted to CCLD by 07/14/2025 : • Copy of updated Administrator Certificates • LIC308 Designation of responsible staff person • LIC610E Emergency Disaster Plan • LIC500 Staff Schedule No citations issued on this day. Report is reviewed with Noralee and a copy is provided.

On 07/03/2024, Licensing Program Analyst (LPA) Jaime Vado conducted an unannounced annual inspection. LPA met with administrator Noralee Reyes and explained the purpose of today's visit. There is 2 staff and 5 residents present. LPA was allowed entry into the facility. This is a multilevel facility but the residents only reside on the main floor where the front door is located. The upper and ground floors are rented out to private renters. Renters do not have access to the residents in the facility. Annual fees are current. The physical plant was toured inside and outside to ensure the safety of the residents. LPA observed the facility kitchen which is clean and observed appliances are in good repair. Knives are stored and locked in the kitchen in a drawer adjacent to the stove top. Medications are observed to be locked in a cabinet located in the living room. Perishable and non-perishable food items are observed as in place. There is an additional refrigerator and freezer in the garage area which also carry additional food supplies. First aid kit is observed as complete with required items. LPA observed that there are multiple fire extinguishers in place inspected 06/28/2023, smoke detector/carbon monoxide detectors are observed in place through out the facility, and central heating/cooling system. PPE and additional food supplies are observed as in place. Laundry area is also observed as fully operational located beneath the facility. Emergency exit routes are observed inside and outside to be free and clear of obstructions. Last emergency/disaster drill was conducted on 04/05/2024. Water temperature was measured at 107F. Shower floor uses non-skid mat when shower is in use. LPA observed rooms at random and all appeared clean, free of odors, and contained all the required furniture per regulatory recommendations. Resident linen supplies are observed as in place in a hallway closet. Continued on next page... 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 Page 2 LPA reviewed 2 client files and also reviewed 2 staff files on this day. Per resident files reviewed they are current. Per staff files reviewed all files were current with training and CPR/First Aid. P&I is not handled by the facility. Client medications are inspected and are current including facility medication administration records. Administrator certificate is observed as current expiring on 09/24/2025. The following updated forms are requested to be submitted to CCLD by 07/10/2024 : • Copy of updated Administrator Certificates • Copy of facility's liability insurance • LIC308 Designation of responsible staff person • LIC400 Affidavit Regarding Client/Resident Cash Resources • LIC610E Emergency Disaster Plan • LIC500 Staff Schedule • Copy of control of property No citations issued on this day. Report is reviewed with Noralee and a copy is provided.

LPA Audrey Jeung toured facility and grounds, consisting of 6 private client bedrooms, each with a half bathroom, and a staff bedroom, plus 1 common full bathroom, kitchen/dining area, living room.. The upper level has a separate entrance and is not used as part of the RCFE. It is a rental unit and currently occupied by someone that is fingerprint cleared. There is a 1 car garage that is used for storage, and a laundry room. No accessible bodies of water are present. Infection control practices are reviewed: entry procedures, staff training and policies, resident monitoring, containment strategies, environmental preparation and cleaning. PPE supply is adequate. Medications, toxins and sharps are stored appropriately and inaccessible to clients, a comfortable temperature is maintained, and lighting is sufficient for comfort and safety. Toilet and bathing facilities are equipped with grab bars and nonskid flooring material. First-aid kit is inspected and complete. A Disaster and Mass Casualty Plan is posted. There are 6 residents present, and 2 staff. Criminal record clearances or exemptions for facility staff or other individuals who have client contact have been reviewed, in addition to health screenings, TB test results, and valid first-aid training. Ante Buljan and Noralee Reyes are certified RCFE administrators (x 1/23 and 9/23) that oversee facility operations. The following updated forms/information are requested to be submitted to CCLD BY 8/15/22: • LIC 309 Administrative Organization • LIC 308 Designation of Administrative Responsiblilty • LIC 500 Personnel REport • Current liability insurance Updated Emergency Disaster Plan (LIC 610E) is provided to LPA today. No deficiencies of the RCFE California Code of Regulations, Title 22, Division 6, Chapter 8 are observed. See 4 Advisory Notes given to Ms. Reyes for additional information.