Office review·September 25, 2025

A Non-Compliance Conference office meeting was held on September 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, Licensing Program Manager Stephen Richardson, Licensing Program Analyst Cassie Yang, Licensing Program Analyst Cheyenne Ratajczak and Licensing Program Analyst Christina Valerio. During the meeting, CCL reviewed the facility’s history of citations, including Type A and Type B violations since April 2025. The citations involved issues such as fire safety, reporting requirements, resident records, administrator oversight, and reporting requirements. 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. 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. Please continue on LIC 809-C. LIC 809-C 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.