Routine inspection·August 28, 2025

Licensing Program Analyst (LPA) Tena Herrera arrived unannounced to conduct the required annual inspection, LPA and met with Administrator Brandie Mendibles and the purpose for today’s visit was explained. The facility is licensed to serve 252 Non-Ambulatory Residents ages 60 and over (of which 5 may be bedridden in rooms #136,#102,#103, #104 and #112). The facility has an approved Hospice Waiver on file for thirty (30) residents and currently have 15 residents using Hospice Services.. LPA utilized the Compliance and Regulatory Enforcement (CARE) tools for the visit today and observed the following: Infection Control: Facility maintains the required Infection Control Plan. Operational Requirements: The facility has an approved fire clearance, there is a plan of operation with required Infection Control Plan, Dementia Plan and additional information for Bedridden Residents. Facility maintains the required liability insurance and Surety Bond. Physical Plant & Environment Safety: LPA toured facility, a total of 10 residents’ bedrooms/units were checked and had the required closet/drawer space to accommodate each resident comfortably available. The resident rooms have signal systems located in each bathroom that were tested an operating properly. There are smoke detectors, carbon monoxide detectors and an emergency sprinkler system throughout the facility that are operable and in compliance. The fire extinguishers were observed throughout the facility and are fully charged. No bodies of water were observed at the facility. There are no security bars or weapons on the premises. Hygiene products are readily available. The hot water temperature was tested throughout the facility resident private bathrooms and measured within the required range of 105-120 degrees. There are two shaded patio/garden areas for residents one within the memory care wing and the other in the assisted living area. (continued on LIC809-C) Staffing : There appears to be sufficient staffing at all times in the facility. Personnel Records-Training : Staff have criminal record clearance, current First-Aid/CPR/AED training along with training in postural supports, Alzheimer’s and Dementia, medication assistance, and other ongoing training are documented in personnel files. Administrator Brandie Mendibles certificate expired on 7/12/25, however, there is a pending renewal on CCL website dated 7/23/25. Resident Records-Incident Reports: Resident files are kept in a secure location and have the following documents in their files - Pre-admission appraisal/Appraisal Needs & Services Plan, Admission Agreements, Identification & Emergency Information and current Physician's Report. During review LPA observed 4 residents that were missing their updated (yearly) Reapprisal, details will be documented on the LIC809-D. Residents Rights-Information: Residents are provided with telephone and internet at the facility. The facility has the following posters posted on each floor/section: Residents Rights, Complaint Poster, and Ombudsman. Planned Activities: Facility provides scheduled activities with a monthly calendar and the required full-time staff that conduct and evaluate planned activities. There is sufficient space both indoor and outdoor for activities. Food Service: The kitchen was observed for the ability to prepare and serve food. LPA observed an appropriate food supply of two (2) days of perishables and one week (7 days) of non-perishables. Incidental Medical & Dental: Medication is properly labeled and are centrally stored and are in their original containers. There are 2 medication rooms one for assisted living and the other for memory care, both medication rooms were toured. LPA found that there were missing medications for 3 out of 10 residents during medication review, details will be documented on the LIC809-D page. Disaster Preparedness: The facility has an Emergency Disaster Plan with contact numbers and at least 2 relocation sites. The last drill was conducted on 8/19/25. Residents with Special Health Needs: Facility admits residents with dementia and staff files reviewed today all have required training documented, the delay egress within the memory care wing was tested and was observed to be operable. Per California Code of Regulations, Title 22, and California Health and Safety Code, the deficiencies observed during todays visit will be documented on the LIC809-D page. Exit interview held and a copy of the report and appeal rights will be emailed to Administrator Brandie Mendibles.