complaint·November 6, 2025

Allegation: Illegal eviction The information obtained during investigation indicated that facility Administrator did issue a written 30-day notice to the R1/R1's Responsible Person. During the review of eviction notice, LPA observed that the eviction notice indicated the issue date of 10/22/2025 and pro-rated charges until 11/22/2025. However, the written notice did not include the reason for the eviction, a list of referral agencies, the right of the resident or resident’s legal representative to contact the department and the contact information for the local Long-Term Care Ombudsman nor did it include specific language in reference to the filing of an unlawful detainer as per SB 781 and 1569.683 H&S . In addition, Community Care Licensing Office was never notified or received a copy of the eviction notice since it was issued. Based on the information obtained during the investigation the allegation is Substantiated. Deficiency cited on LIC9099-D Exit interview conducted, appeal rights explained and copy of this report signed and delivered. Allegation: Staff do not ensure that facility is maintained in a sanitary manner It was alleged that R1 woke up in the middle of the night and there was urine on the bathroom floor. So, R1 set the box on top of it to prevent anyone from slipping and then waited in the kitchen for the staff to clean it up. To investigate this allegation LPA conducted an interview with the Administrator and was informed that on 09/20/25 R1 was prescribed a new medication and one of the side effects was “sleep disturbance”. The Administrator informed LPA that no urine was ever found on the floor and that the staff always make sure that the facility is clean. LPA conducted interviews with three (3) staff members, who corroborated the statement provided by the Administrator. Five (5) residents interviewed expressed no concern regarding this allegation. Additionally, R1 informed LPA that the staff is always keeping the facility clean and denied the above allegation. During today’s physical plant tour, LPA observed the kitchen, resident rooms, bathrooms and all common areas are clean and free from odor. Based on interviews and LPA observation, this allegation is deemed Unsubstantiated, at this time. Allegation: Licensee retaliated against resident The investigation included interviewing staff and residents. The Administrator and staff deny retaliating against any residents. LPA was informed that all residents are being treated with dignity and respect. Four (4) out of five (5) residents interviewed expressed no concern regarding this allegation. Therefore, based on interviews and information gathered during today’s visit, this allegation is deemed Unsubstantiated, at this time. No deficiency issued. Exit interview conducted and copy of this report signed and delivered.