Health check·July 2, 2025

On July 02, 2025, Licensing Program Analyst (LPA) Kiran Jain arrived unannounced at the facility to conduct a unannounced Case Management – Health Check inspection visit. LPA met with the Administrator (ADM) Zach Pilkerton and disclosed the purpose of the inspection. There were 33 residents in care and 11 staff members present at the time of the inspection. LPA initiated a walk-through of the facility, accompanied by the Administrator. LPA inspected random resident rooms. LPA inspected attached bathrooms in these random rooms. The hot water temperature at the sink faucets measured between 112.3°F and 112.6°F. LPA inspected common areas and observed eight (8) residents sitting in the front room, seven (7) residents watching TV in the TV room, and one (1) resident in the dining room. LPA inspected the kitchen next to the front lobby area. The refrigerator and freezer were checked, and there was a sufficient supply of fresh perishable food for two (2) days and nonperishable staples for seven (7) days. LPA inspected the pantry storage and laundry area in the basement, one level below the main floor. LPA toured the outside areas and found passageways free of obstructions, and without any blocking or tripping hazards. No accessible bodies of water were observed. LPA observed locked centrally stored medication cart in the medication room. Medications were organized separately for each resident. At 09:10 AM, Centrally Stored Medication Records were reviewed, and a medication count check was performed. LPA observed that the medication count for one (1) bedtime + dinner narcotic medication for one resident (R1) was found to be inaccurate and one less day of medication was administered to R1 for this medicine. Continued on LIC809-C The start date of this medication was 06/22/2025 and today’s date is 07/02/2025. Ten (10) days of medication should have been administered to R1 but only 9 days of medication were administered to R1. The MAR for this medication was reviewed and the entry for 06/29/2025 was not initialized. The deficiencies are being cited based on LPA observations, records reviewed, and interviews conducted in accordance with the California Code of Regulations, Title 22, see LIC809D. An exit interview was conducted, and Plans of Correction were reviewed and developed with the Administrator. A copy of this report and appeal rights were discussed and provided to the Administrator, Zach Pilkerton, whose signature on this form confirms receipt of these documents.