Routine inspection·June 17, 2025

At 9:47 AM, Licensing Program Analysts (LPAs) Huma Rahimi and Leslie Ngo-Castaneda conducted an unannounced annual inspection to the above facility. LPAs were greeted at the front desk and met with the Administrator Susan Park. LPAs explained the reason for the visit. LPAs and the Administrator toured the facility inside and out and observed the following: The Administrator had to leave and the General Manager Brenda Chacon was designated to sign today's report. The facility is a single story building with private and shared bedrooms, private bathrooms, kitchen, dining room, recreation room, common area, patios, and outdoor areas. The facility is licensed for 98 residents ages 60 and over. The fire clearance is approved for 98 non- ambulatory residents of which 15 can be . There is a hospice waiver approved for 10 residents. Bedrooms: LPAs and Administrator toured vacant and occupied bedrooms. Rooms # 46, 50, 80, 47 28, 38, and 22 were inspected. LPAs observed lamps, nightstands, beds, linens, and private bathrooms with liquid soap, hand towels, and trash cans. Bathrooms: The facility currently has two common restrooms. Additionally, staff has their own private bathrooms. The bathroom was sanitary with liquid soap, paper towels, handwashing instruction sign, and a trash can with a tight-fitting lid. At 9:55 AM, LPAs measured the hot water temperature of a private resident bathroom in room #46 to be 106.3F. Common Areas: All floors, walls, and ceilings were clean. Furniture in the dining room, lounges, living room, and activity room were clean and in good repair. At 10:00 AM LPAs measured the room temperature to be 72 F. Continue on LIC 809C Outdoor Space: LPAs and Administrator toured the outside space. LPAs observed two shaded areas with enough outdoor furniture which was observed in a good condition. LPAs tested the facility's emergency exit doors and observed that the emergency exit requires an access code to exit out to the back of the facility. Both exit doors were functional and operational. LPAs also observed two main exits in the back of the facility to be free of any obstruction and hazard. Laundry: LPAs observed a laundry room to be locked and inaccessible to residents in care. All detergents were locked inside the laundry room. LPAs observed the washer and dryer actively working and in a good working condition. Medication Room: LPAs observed a locked Medication Room where all the residents medication were kept and supervised by a Med Tech. LPAs reviewed random residents medication and did not observe any discrepancies. Storage: LPAs observed a storage room in the basement which has an access through the facility kitchen. LPAs observed that the storage room to be locked and inaccessible to residents in care. Additional emergency supplies and kitchen supplies closets were observed in the hallway by room #50. They were also observed locked and inaccessible to residents in care. Kitchen: LPAs observed menus outside of the kitchen in the dining room. Menus applied to typical and diabetic diets. The kitchen floors and surfaces were clean, and all food was sealed and labeled. The dining room contained tables with designated seating for the residents. Fire Safety: LPAs observed that the facility has fire extinguishers in every wing of the facility and were last serviced on 08/15/2024. All fire extinguishers were fully charged. At 2:05 PM, LPAs reviewed the most recent fire safety report from Atlantic Electric Company conducted on 03/17/2025. All systems were functional and passed inspection. At 11:10 AM LPAs tested the call system in Room #55 to be functional. Staff responded to the call within eight and half minutes. Between 11:30 AM to 2:00 PM, LPAs reviewed records of eight (8) residents and four (4) staff. Resident and staff records appeared to be complete and updated. No deficiency cited during today’s visit. Exit interview conducted and copy of this report signed and delivered.