Routine inspection·August 8, 2025

On 08/8/2025, Licensing Program Analyst (LPA) J. Leffall arrived unannounced to conduct an annual inspection. LPA introduced self, stated the purpose of the visit and requested to meet with the Licensee. LPA was granted entry to the facility. Facility staff contacted Licensee (L1) John Nobleza, via telephone. L1 arrived shortly after LPA’s arrival. LPA conducted a tour inside and outside of facility. Facility observed to be clean, odor free and at a comfortable temperature. Common areas were furnished well with adequate seating and lighting available. Resident rooms appeared clean and had required furnishings. LPA observed an adequate supply of linen. Resident bathrooms were properly equipped with securely fastened grab bars in toilet and tub/shower areas, non-skid mats were observed. Hot water measured at a range of 108.1 to 111.3 degrees F in 3 bathrooms. Kitchen toured, appeared clean, observed a 7-day supply of non-perishable and 2-day supply of perishable food. Exterior tour conducted, all exits open and free of obstructions. Side gate was observed to be self-latching. Fire extinguisher serviced on 07/18/2025. Smoke detectors and carbon monoxide detectors observed operational during today’s inspection. Fire drill completed on 6/30/25. All cleaning supplies are locked in secured under kitchen sink. Samples of staff files and all Resident Files reviewed to have all of the required documents. Medications reviewed and observed to have original labels and be administered as prescribed. LPA observed 3 medications administered but staff did not initial medications upon administering for multiple days. Deficiency is being cited in accordance to California Code of Regulations, Title 22, Division 6 on the attached 809D. Exit interview conducted and a plan of correction was reviewed and developed. A copy of this report and appeal rights were discussed and provided to Licensee, whose signature on this form confirms receipt of this document. LPA is requesting the following documents be submitted to the Fresno CCL office by 08/22/2025 : Current copy of Administrator Certificate, Designation of Facility Responsibility (LIC308), Administrator Organization (LIC 309), Affidavit regarding Client/Resident Cash Resources (LIC 400), Liability Insurance, Emergency and Disaster Plan (LIC 610E) Personnel Report (LIC500), Register of Facility Clients/Residents for (LIC9020A), Surety Bond.