Routine inspection·October 6, 2025

At approximately 11:30AM, Licensing Program Analyst (LPA) Chris Arnhold arrived at this facility unannounced to conduct a Required-1 Year inspection. LPA met with Caregiver Estela Camba and explained the purpose of the visit. Administrator certificate is current. Facility has a Hospice waiver for 3 residents. At approximately 11:45AM, LPA toured the facility to ensure the health and safety of residents in care. The facility was observed to be at a comfortable temperature. Areas toured include but are not limited to resident rooms, common areas, bathrooms, kitchen, storage areas and back yard. In the areas toured no immediate health, safety, or personal rights violations were observed. Fire extinguishers were fully charged. Smoke detectors are all operational. Carbon Monoxide Detector was present. The common areas, bathrooms and kitchen were clean and in good repair. All bedrooms had required furniture, bedding, and lighting. The kitchen equipment was clean and in good repair. Dishware appeared to be stored in a sanitary manner. Food appears to be stored and prepared properly. Refrigerators and freezers were maintained at the proper temperature. Facility has required seven-day non-perishable and two-day perishable supply of food. Emergency food stores and water was present to ensure facility can be self-sufficient for 72 hours. Facility has a generator to supply power in an emergency. Emergency lighting devices were present. First aid kit was present. No pools/bodies of water are on the premises. LPA was not able to find documentation that facility has been conducting Emergency drills every 3 months. At approximately 12:15PM, LPA reviewed 6 staff files. Staff files reviewed did not contain evidence of completed annual training. Three of six files contained current First Aid training. Staff on Duty did not have current CPR certification. All employees requiring background checks are cleared. Continued on LIC809-C… At approximately 1:15PM, LPA reviewed 6 of 9 resident files. All resident files contained the required documentation. Reappraisals were conducted within the last 12 months. Documentation of a physician visit within the last 12 months was present. Hospice care plans were not able to be located. LPA discussed with staff some concerns about diet orders that are not being followed, but there is confusion as to if they are still current. Medication records were organized and contained orders for each medication. There were two PRN authorization letters noting the resident is not able to communicate their need for a PRN and to contact the physician before each dose. There were no records of contacting the Physician. LPA requested Licensee conduct a medication audit to verify PRN orders for each resident. Medications were secured and not accessible. Updated copies of the following documents were requested for facility file and are to be submitted to CCL within 30 days of this visit: LIC500- Personnel Report LIC610E- Disaster Plan Evidence of Liability Insurance Deficiencies are cited from the California Code of Regulations (CCRs), and/or the Health and Safety Code. Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment. This report was reviewed with Estela Camba and Appeal rights were given.