Office review·January 13, 2026

An informal meeting was conducted today on 1/13/26 at the Sacramento Regional Office via Microsoft Teams. The purpose of this informal meeting was to discuss the recent trends that have been observed by the Department has made while investigating them. Present at this meeting were Licensing Program Manager (LPM), Czarrina Camilon-Lee, Licensing Program Analysts (LPAs), Cynthia Tamayo and Avelina Martinez, Designated Facility Licensee, Cleopatra Gardiner and Administrator, Isikeli Tuikenatabua. LPM Camilon-Lee explained the Informal Conference process which included the Administrative Process as well. The facilities have been licensed since November 2024 of which the facility has been cited for 7 Type A citations, and 19 Type B citations. The focus of concerns at this time were as follows: 1. Personal Rights: Food 2. Accountability/Oversight of Licensee and Administrator 3. Uncleared persons assisting residents 4. Reporting Requirements 5. General food requirement: Food Inventory supplies and ensuring that resident's dietary needs are met. 6. Maintenance and operation 7. Fire safety: not operation beyond the capacity of the license Technical Support Program (TSP) assistance was offered and the licensee stated they are interested in TSP and a referral will be made on their behalf. CONTINUED ON 809-C The facility has stated they will do the following to achieve continued and substantial compliance: 1. Administrator has agreed to ensure only cleared persons may assist the facility operations and assist residents 2. Administrator agrees to conduct reappraisals as needed or at least annually. 3. Administrator agrees to continue to Inventory quality food is at the premises and available to residents in care, food supplies will be replenished as necessary. 4. Administrator agrees to conduct self-assessments and conduct mock inspections to ensure continued facility compliance at least once monthly. 5. Provide LIC 500 identifying Administrator and licensee hours for Legacy Lane. The LIC 500 must list all individuals should to attend the facility and shall be updated whenever there is a change in staff roster/schedule. 6. Administrator agrees to not operate outside of approved fire clearance capacity. 7. Administrator agrees to ensure timely Reporting Requirements are followed. 8. Administrator agrees to ensure accurate medication administration 9. Licensee ensures Administrator is adhering to all applicable laws and regulations at all times while employed. All proof of training and documentation for the items listed above will be sent to the LPA Cynthia Tamayo by 02/02/26 at cynthia.tamayo@dss.ca.gov. These actions are not punitive, but collaborative as ways to improve on areas of concern are addressed. According to the California Code of Regulations, Title 22, no citations were delivered during this meeting and a copy of this report was provided. A copy of this report will be emailed to licensee/administrator for signature and sent back with signature to the Department by 1/14/2026. The licensee should be advised at the end of the Informal Meeting that failure to correct deficiencies by the given due dates, agreed upon during the meeting, could result in a Non-Compliance Conference. Exit interview conducted.