Routine inspection·August 22, 2025

Licensing Program Analyst’s (LPAs) Hanna Gough and Rose Ruppert arrived at the facility to conduct the required annual inspection. LPAs were greeted and granted entry by staff. LPAs met with Administrator (AD) Jenny Truong and explained the purpose of the visit. The facility currently has twenty two residents in care. The facility is a one story building with fourteen resident bedrooms, bathrooms, shower rooms, kitchen, living room, dining room, office, medication room, activity room, laundry room, and courtyard. Facility appears clean, safe, and sanitary. LPAs observed the required departmental postings in the lobby of the facility. LPAs observed all resident bedrooms had the required components and furnishings. LPAs observed R1 has bed rails with no orders on file. LPA observed room 11 to be a shared room with three residents. A civil penalty was assessed due to a violation to the fire clearance. LPAs observed the restrooms to have toilet paper, paper towels, and textured shower flooring. LPAs tested the water to be between 114.6-125.6 degrees Fahrenheit. LPAs observed the kitchen to be clean. LPAs observed a two day perishable and seven day nonperishable food supply on hand. LPAs observed the knives to be stored in the kitchen. LPAs observed a supply of toxins in the kitchen under the sink. The kitchen doors are locked making it inaccessible to residents in care. LPAs observed fire extinguishers throughout the facility charged and with a service date of November 4, 2024. LPAs observed the centrally stored medication to be in a locked closet located across from the caregiver counter. LPAs observed the laundry room to store a clean supply of fresh linens for resident use. LPAs observed the emergency food and water supply in the locked storage unit in the parking lot of the facility. LPAs observed the outdoor courtyard to be free of debris and cleared of obstructions with a shaded seating area for resident use. Continue on 809-C LPAs reviewed staff files and 1 of 3 staff does not have a health screening. LPAs reviewed files and 1 of 3 staff does not have initial training. LPAs observed resident files and 1 of 5 residents do not have a tb test on file. LPAs observed 3 of 5 residents do not have a needs and services plan. LPAs reviewed resident medication with staff and no discrepancies were observed. LPAs did a quarterly file review to check on the quality assurance noncompliance plan. Based on today’s inspection citations are being noted along with a technical violation per Title 22 Division 6 of the California Code of Regulations. An exit interview was conducted with AD Jenny Truong and a copy of this report along with LIC809-D, 858, 859, technical violation, an immediate $500 civil penalty on LIC421IM, 811 and appeal rights were given at the time of inspection.