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Maintain fire clearance before retaining specified persons

a) All facilities shall maintain a fire clearance approved by the city, county, or city and county fire department, or district providing fire protection services, or the State Fire Marshal. This is not met as evidenced by: Based on observation, the Licensee did not ensure that the facility garage was cleared for staff use. LPA Pascua observed an air mattress along with personal items in the garage. This poses a potential health, safety, and personal rights risks to persons in care.

Maintain facilities for fire and panic safety

All facilities shall be maintained in conformity with the regulations adopted by the State Fire Marshal for the protection of life and property against fire and panic. This it not met as evidenced by: Based on observation the facility did not ensure that exit gate and bedroom door were not locked. This poses an immediate health, safety, and personal rights risks to persons in care.

Facility personnel sufficiency and competence

Maintain facility in clean, safe, sanitary condition

(a) The facility shall be clean, safe, sanitary and in good repair at all times. Maintenance shall include provision of maintenance services and procedures for the safety and well-being of residents, employees and visitors. This is not met as evidenced by: Based on observation, the liensee did not ensure that the toilets used for resident used were unclogged. This poses a potential health,safety, and personal rights risks to persons in care.

Onsite food stock levels for nonperishables and perishables

(26) Supplies of nonperishable foods for a minimum of one week and perishable foods for a minimum of two days shall be maintained on the premises.This is not met as evidenced by: The licensee did not ensure there was a sufficient 2 day perishable food supply at the facility at the time of this LPAs visit. This poses an immediate, health,safety, and personal rights risks to persons in care.

Assist residents with self-administered medication

Created this page by mistake.See 9099-D dated 1/9/2026.This page was not provided to facility.

Freedom to leave and not be locked in

Residents in all residential care facilities for the elderly shall have all of the following personal rights: To leave or depart the facility at any time and to not be locked into any room, building, or on facility premises by day or night. This does not prohibit a licensee from establishing house rules, such as locking doors at night to protect residents, or barring windows against intruders, with permission from the Department.This requirement is not met as evidenced by: Based on observation and interview, the licensee did not comply with the section cited above. Staff are still placing a door knob cover equipped with combination lock on the knob of the front door to prevent residents from leaving without supervision.This poses an immediate health, safety or personal rights risk to persons in care.

Assist residents with self-administered medication

A plan for incidental medical and dental care shall be developed by each facility…The licensee shall assist residents with self-administered medications as needed.This requirement is not met as evidenced by: Based on observations, record reviews and interviews, the licensee did not comply with the regulation cited above. Facility staff did not ensure that R4 received their medication refills on time, including their seizure medication, which resulted in R4 sustaining a seizure and fall during today’s visit. This poses an immediate health, safety or personal rights risk to persons in care.

Care and supervision as defined by statute and rules

Basic Services: (f) Basic services shall at a minimum include: (1) Care and supervision as defined in Section 87101(c)(3) and Health and Safety Code section 1569.2(c). Based on interviews, by admission of the facility manager, there were 2 instances where resident was not adequately supervised: one was when was reported by neighbor urinating on the street; and another instance where resident eloped, and staff did not follow. Record reviews showed is not able to leave the facility unassisted. This poses immediate health, safety and personal rights risks to persons in care.

Safe, healthful, comfortable accommodations

Personal Rights of Residents in All Facilities: (a) Residents in all residential care facilities for the elderly shall have all of the following personal rights: (2) To be accorded safe, healthful and comfortable accommodations, furnishings and equipment.This is not met as evidenced by: Based on interviews, by admission of facility manager, staff yelled at residents and deemed it inappropriate. This poses a potential health, safety and personal rights risks to persons in care.

Report specified resident events within seven days

Reporting Requirements: A written report shall be submitted to the licensing agency and to the person responsible for the resident within seven days of the occurrence of any of the events specified in (A) through (D)…\This requirement is not met as evidenced by: Based on record review and interviews, the licensee did not comply with the regulation cited above. LPA discovered that a resident (R3) had a hospitalization on 12/1/25 due to psychiatric issue and same resident eloped on 12/15/25. The Department did not receive incident reports for these incidents. This poses an immediate health, safety or personal rights risk to persons in care.

Safe, healthful, comfortable accommodations

87468.1(a)(2) Personal Rights of Residents in All Facilities: (a) Residents in all residential care facilities for the elderly shall have all of the following personal rights: (2) To be accorded safe, healthful and comfortable accommodations, furnishings and equipment.This is not met as evidenced by: Based on interviews, by admission of facility manager, staff yelled at residents and deemed it inappropriate. This poses a potential health, safety and personal rights risks to persons in care.

Care and supervision as defined by statute and rules

87464 Basic Services: (f) Basic services shall at a minimum include: (1) Care and supervision as defined in Section 87101(c)(3) and Health and Safety Code section 1569.2(c).This requirement is not met as evidenced by: Based on interviews, by admission of the facility manager, there were 2 instances where resident (R2) was not adequately supervised: one was when R2 was reported by neighbor urinating on the street; and another instance where R2 eloped, and staff did not follow R2. Record reviews showed R2 is not able to leave the facility unassisted. This poses immediate health, safety and personal rights risks to persons in care.

Freedom to leave and not be locked in

Based on observation and interview, the licensee did not comply with the section cited above. LPA observed staff on duty placing a door knob cover equipped with combination lock on the knob of the front door. Through interview, staff stated that he place the door cover because one resident has an elopement behavior. Staff stated that this is not their daily practice. This poses an immediate health, safety or personal rights risk to persons in care.

Ensure hazardous items are locked and not unattended

Based on observation, the licensee did not comply with the section cited above. During physical observation, LPA observed a cleaning chemical on a shelf inside the hallway closet. This poses/posed an immediate health, safety or personal rights risk to persons in care.

Store centrally held medications in locked secure place

Based on observation, the licensee did not comply with the section cited above. During the inspection of the garage area, LPAs observed a medication inside a cupboard. Note that this garage was not locked and accessible to residents in care at the time of the inspection. This poses/posed an immediate health, safety or personal rights risk to persons in care.

Based on [(interview) (record review)], the licensee did not comply with the section cited above. Licensee did not provide a written report of resident's death in a timely manner as required, which poses/posed a potential health, safety or personal rights risk to persons in care.

Request a transfer of criminal record clearance

Based on [(observation) (interview) (record review)], the licensee did not comply with the section cited above. Staff on duty (S1) was initially present during the visit and was observed to provide care and supervision to residents in care. It was discovered through record reviews and interviews that S1 was not associated to this facility which poses an immediate health, safety or personal rights risk to persons in care.

Ensure hazardous items are locked and not unattended

Based on [(observation) (record review)], the licensee did not comply with the section cited above. Scissors and knives were observed to be accessible to residents in care inside one of the ktichen drawers; grooming and hygiene products were accessible to residents who are at risks if given direct access to these items; two wooden items with nails sticking out were found inside a resident drawer. These pose an immediate health, safety or personal rights risk to persons in care.