Routine inspection·February 25, 2025

On February 25, 2025, Licensing Program Analyst (LPA) Cassie Yang arrived unannounced at the facility to conduct a required 1-year annual inspection utilizing the inspection tool. LPA met with caregiver who then contacted Administrator who arrived to the facility shortly afterwards. LPA observed posted license to be outdated. LPA printed a new facility license to post. LPA observed the posted Administrator Certificate to be expired but file review reveals Administrator Certificate is active on CCLD website. LPA will reach out to Admin Cert unit for a copy to provide to Administrator. LPA observed the resident roster to be present. LPA observed six residents to be residing in the "South" part of the facility. In the "North" part of the facility, LPA observed three tenants name listed. LPA and Administrator conducted a tour of the North and South of the facility. Areas toured included but not limited to: North bedrooms, bathroom, and common areas. South bedrooms, laundry room, bathroom, kitchen and the common areas. Administrator and LPA discussed facility's current hospice waiver of two. Administrator stated she was informed her license was approved for four. LPA will provide Administrator a copy of CCR 87632 Hospice Care Waiver. Additionally, LPA and Administrator discussed the pending fingerprint clearance for T1. LPA informed Administrator, LPA will return a later date to complete this annual inspection. At this time, LPA obtained a copy of staff schedule and facility liability insurance. Exit interview and a copy of report was provided.