Routine inspection·October 27, 2025

On 10/27/2025 at 8:24am, Licensing Program Analysts (LPAs) Zina Brown and Lizeth Villegas conducted an unannounced visit to the above facility. The purpose of today’s visit was to conduct the one- year inspection. LPA met with Jared Mikos (Director of Operations) and the purpose of the visit was discussed. Facility is licensed to serve 73 non-ambulatory residents, 7 bedridden residents and an approved hospice waiver for 7 residents. The facility does handle residents cash resources. Currently the facility has 50 residents who reside at the facility. The facility has residents diagnosed with the following: 3 dementia residents 11 receiving home health residents 7 hospice care services residents. The facility is a 3 story building which consist of the following: 1st floor : Lobby, business offices, conference room, salon, laundry, designated smoking area outside, and parking lot 2nd floor: 20 resident rooms, outdoor shaded area, kitchen, and dining room and an emergency evacuation chair is located on the 2nd floor stairwell. 3rd floor : 20 resident rooms, activity room, library, medication and storage room. The facility has a current administrator Jared Mikos certificate # 7008348740 (valid 08/27/2024 - 08/26/2026) The facility annual fees are current. Liability Insurance Policy is with Continuing Care Risk Retention Group, Inc (NAIC #11798) (Policy # PL0002277) is current and valid from 01/01/2025 - 01/01/2026 and as followed occurrence at $1,000,000 and general aggregate at $3,000,000. The facility has a surety bond of $6,000,000 as of April 29, 2014 Between the hours of 9:45am - 11:00am LPA Brown reviewed (5) resident records, (1) Home Health Care Plan and (2) Personal & Incidental Records (P & I's) and (5) Client Medication Administration Records - review conducted by LPA Villegas, who did not observe any discrepancies at the time of visit. Between the hour 10:00am - 10:45am, LPA Villegas toured the facility with Jesus Chavez (Assistant Administrator) & Jared Mikos (Director of Operations and inspected resident bedrooms which had the required furniture, bed linens and closet/drawer space to accommodate each resident comfortably. Resident bathrooms were checked, emergency pull cords observed. Toilets and water faucets worked properly, grab bars were secure, shower was free of mold/mildew and a non-skid mat was in place. Common areas were clean and clear of hazards; doorways were free of obstructions. The water temperature tested at: 116.9°F in the breakroom and 105.8°F in the medication room. First Aid kit was checked and is fully stocked which is located in the medication room and kitchen. Upon document review by LPA, the inspection and drills were conduct: Fire Marshall Inspection on 07/01/2025 Fire Drill & Disaster Drill on 08/05/2025 at 10:00am Fire extinguisher are fully charged are located on each floor of the facility. Carbon monoxide and smoke detector are operational. According to the California Code of Regulations (Title 22, Division 6, Chapter 8), LPA did not observe deficiencies therefore no citations were issued at this time. An exit interview was conducted, and a copy of the report was provided to Jared Mikos (Director of Operations.