Routine inspection·April 25, 2025

On 4/25/25 Licensing Program Analyst (LPA) M. Garza arrived unannounced for an annual visit. LPA met with Licensee, Jerome Esteban. LPA explained reason for visit and was permitted entry into the facility. Currently there are no residents that are residing in the facility. Facility was toured inside and out. Pathways and doors were clear and free from obstruction. Facility was clean and without odor. Common areas were clean, adequately furnished, and adequately lit. Smoke detectors and carbon monoxide detectors were present and operational at time of visit. Fire extinguisher last serviced 08/13/2024. Last fire drill on 3/11/25. Resident rooms observed to have the required furnishings and with adequate lighting. Linen supplies are kept in linen closets. Sharps, chemicals and medications were locked. LPA observed sufficient seating under covered patio areas. Sample staff files reviewed. The following issues were observed during todays visit: Pre-admission appraisals and reappraisals were not completed in R1's file reviewed. TV's provided per Title 22. Annual training for staff was not completed for 2 of 2 staff. Deficiency cited per Title 22 on 809D. LPA requested the following documents to be submitted to CCL by 5/2/25: current copy of Administrator’s Certificate, Administrator Organization (LIC 309), Designation of Administrative Responsibility (LIC 308), Emergency Disaster Plan (LIC 610-E), Personnel Report (LIC 500), Register of Facility Clients/Residents (LIC 9020) in order to update the facility file. Exit interview completed with Licensee, Jerome. Due to IT issues a copy of this report, deficiency, TV's and appeal rights will be provided via email. A delivered and read receipt serves as confirmation.