Office review·September 25, 2025

A Non-Compliance Conference office meeting was held on 09/25/2025, at Sacramento Regional Office with the licensee Adi Lina Tuiloma and facility representative Una Phyllis to discuss the deficiencies found at the facility and the actions needed to bring the facility into compliance with Title 22 regulations. Present in the meeting were Community Care Licensing (CCL) staff, including Regional Manager Alycia Rayner, Licensing Program Manager Troy Ordonez, Licensing Program Manager, Laura Munoz, Licesning Program Manager, Stephen Richardson, Licensing Program Analyst Cassie Yang, Licensing Program Analyst Cheyenne Ratajczak and Licesning Program Analyst, Christina Valerio. During the meeting, CCL reviewed the facility’s history of citations, including several Type A and Type B violations since December 2024. The citations involved issues such as fire safety, resident rights, medication administration, staffing levels, administrator oversight, reporting requirements, and unsecured access to hazardous areas. CCL stressed the importance of taking immediate corrective action to ensure resident safety and meet licensing requirements. CCL expressed concern about limited administrator oversight, including the administrator’s low on-site hours, unresponsiveness to calls, and insufficient supervision of staff. Staffing levels were also noted as a concern, with coverage gaps that could put residents at risk. Delayed submission of Plans of Correction and incomplete documentation were identified as issues that need to be corrected right away. Please continue to LIC809C... The licensee agreed to take specific steps to fix these issues. These actions include making sure resident rooms meet licensed capacity, providing adequate staffing at all times, increasing administrator on-site hours or designating a qualified substitute, submitting personnel reports and supervision outlines, ensuring medications are available and administered on time, and conducting safety checks to secure chemicals and equipment. Licensee was provided a copy of Hospice Guide, Medication Guide, and Self-Assessment Guide. Additionally, CCL will submit a referral for technical support program. Exit interview was conducted and a copy of this report was provided. Signature on these forms acknowledges receipt of these documents.