Routine inspection·August 27, 2025

On 08/27/2025, Licensing Program Analyst (LPA) V Gorban arrived unannounced to conduct Required Annual Inspection. LPA met with staff Maria Flores. Administrator (AD) Jasmin Burns was notified and was able to attend the visit. LPA conducted facility tour inside and out of facility with staff. Residents observed at the facility before lunch time. The facility was observed to be at a comfortable temperature of 75 degrees, clean, in good repair, and no passageway obstructions or fire hazards observed. Fire extinguisher was observed with a service date of 05/01/2025. Recent fire drill recorded on July 2025 Dining area and Kitchen were toured. An adequate supply of perishable and non-perishable food was observed to be properly stored in freezer, refrigerator, and pantry. Food is delivered once a week. The facility is comprised of single level home. The census during the visit was four residents. Hot water temperature tested at 104 degrees F. LPA observed securely fastened grab bar and non-skid mat in shower area. The facility courtyard was toured and observed to be free from debris. There was outdoor seating available for the residents. Facility phone number observed operational 209-349-8457 Medications were stored in a locked medication closet in a common area. The first Aid Kit was observed with all required items. LPA reviewed facility Plan of Operation, Infection Control Plan, Emergency Disaster Plan and number of staff and residents’ files requested and reviewed during the inspection visit. Deficiency cited on attached LIC9099-D Exit interview conducted, report signed and provided with appeal rights