Routine inspection (multi-day)·August 5, 2025

Licensing Program Analysts (LPAs) Elena Mallet and Luis De Leon conducted a continuation annual required visit. LPA met with Director Dennis Robeniol and the purpose of the visit was discussed. The facility is licensed to serve elderly residents age 60 and above. It is approved for 136 non-ambulatory residents and 47 bedridden residents, approved for 10 hospice waivers. REVIEW OF FILES Resident record review consisted of Admission Agreements, Physicians Report, Needs and Service Plan, Personal Rights, and Centrally Store Medication. Staff record review consisted of Personnel Report, Health Screening, and Background Clearance. Deficiencies were noted for resident’s for missing updated Needs and Service Plan for R4, TB results missing for R1 and R2, and ambulatory status for R5. Staff records were missing health screening for S1-S5, annual training missing for S2-S4, and first aid certificate missing for S2-S4. Deficiencies were noted on 809D pages. Observations during facility tour: Bedrooms were furnished with a bedframe, dresser, lamps, and chairs. LPA observed that there was clean linen, bath towels, and personal hygiene with reasonable closet space available for residents. Wall and floors are in good repair. Hallways were clean and free of obstructions. Report continues on page 809C... Kitchen appliances were in working order and clean. There is sufficient two (2) days of perishables and seven (7) day supply of non-perishable food. Dining room has sufficient seating area. Weekly food menu is posted at facility. LPA observed list of residents with modified diets to be available to kitchen staff. LPA observed all food to be stored properly Toilets, showers, and water faucets are found in compliance with Title 22 regulations for temperature and function. Restrooms were stocked and clean. The water temperature was tested and measured. It was found in compliance with Title 22 regulations between 105º and 120º F degrees. POC was cleared for previously cited hot water deficiency. Also, disinfectants and cleaning supplies are locked and secured inaccessible to residents. Combo Smoke and carbon monoxide detectors were observed and tested on all rooms. Two (2) fire extinguishers were observed on each floor and were fully charged with the last inspection date on 9/23/2024 . There has not been a fire/earthquake/emergency drill conducted since 12/19/2023. A deficiency was noted on page 809D. Front outdoor grounds provide seating and shade and are free from debris and obstructions. The facility offers residents various activities throughout the week. Residents were observed actively engaged on various activities. The medications are centrally stored and locked in the MedTech room. The facility uses the Medication Administration Record (MAR) log to document medications given. LPA reviewed medications for all five ( 5 ) residents. LPA conducted interviews with five staff and five residents. LPA reviewed Disaster Emergency Plan and noted deficiency because it calls for the use of inoperable emergency backup generator. The licensee needs to update plan to include instruction for alternate power in the event of power outage. Deficiency noted on page 809D. Per California Code of Regulations, Title 22, and California Health and Safety Code, the deficiencies observed during the visit are documented on the LIC809D page. Reports LIC 809, LIC 809D and Appeal Rights were discussed and provided to Director Dennis Robeniol.