Non-compliance follow-up·December 9, 2025

Licensing Program Analyst (LPA) Maria (Mita) Partoza, conducted an unannounced visit for a case management – legal/non-compliance requirement. LPA met with Administrator (ADM), Nicholas Inneh. At the time of arrival LPA was greeted by 2 staff, administrator arrived at approximately 10:00 a.m. The purpose of the visit is to ensure the facility is adhering to the compliance plan submitted to Community Care Licensing (CCL) after a non-compliance meeting held on 10/23/2024. LPA discussed the non-compliance plan with the ADM to include ensuring that all staff are trained to provide resident care meeting physical, emotional, and social needs; plan for regular observation from the resident and documentation of resident functioning changes; ensuring the facility is kept clean, safe, sanitary and in good repair, addressing bed bugs pro-actively and promptly; ensuring all incident and death reports are documented and reported to CCL per Title 22; ensuring all staff obtain a criminal record clearance and association to the facility; ensure all residents medical assessments include a TB result prior to admission; ensure all resident’s reappraisals are updated annually; ensure all meals meet dietary and physician ordered nutritional requirements, and ensuring the Administrator provides proper oversight and administration of the facility operations in alignment with Title 22 regulations. During visit, LPA toured the facility to include the resident bedrooms, hallways, bathrooms, dining room, kitchen, and exterior. LPA observed some wear and tear on the building grounds. ADM stated that there are plans to renovate/remodel the facility, fix the bathrooms, floors, and parking. Page 1 of 2 L PA toured the facility with ADM and most rooms were occupied and residents were there. There are 15 room, 2 of the 15 are single occupancy and 13 are shared. The facility currently has 27 residents. There were no observation of bed bugs. ADM states the facility does not have any active cases of bed bugs. ADM provided a copy of the Clark Pest Control service report dated 12/02/25. Report stated the pest control person, did a visual check and did not notice any rodent and insect(ants, cockroaches, spiders, and bedbugs) activity. There was 1 mice caught in the food closet, replaced the glue boards and the device. They checked the exterior rodent monitoring station and did not notice rodent activity. ADM states the pest control company comes at least 2 times a month. LPA observed the facility has a cleaning and maintenance log. During visit, LPA observed staff actively mopping the floors of the facility. LPA reviewed 5 out 25 resident files and observed the files were updated and complete, including but not limited to Physician's report (LIC 602), Appraisal Needs and Services Plan (LIC 625), Admission Agreement, Personal Rights (LIC 613) and the client's personal valuable (LIC 621). LPA reviewed 2 staff file (S1 and S2). 2 out of 2 staff have current training on record from online (Relias and Community Senior Living). On 4/7/2025, ADM conducted a staff training for the following: Dementia Care - 2 hours, Personal Rights 1.5 hours, Basic Medication Training - 2 hours, Reporting Requirements and Mandated Reporting - 2 hours, Basic First Aid and Emergency Procedures 1.5 hours, Food Service, Nutrition and Hydration - 2 hours, Universal Precautions & Infection Control - 1.5 hours, Observing and Documenting Resident Changes - 1 hour, Resident's Right and Cultural Sensitivity - 1.5 hours, Activities and Social Services - 1 hours, Assisting with Activities of Daily Living (ADLs) - 2 hours, Communication & Working with Difficult Behaviors - 2 Hours. ADM has a valid administrator certificate for ARF and RCFE that would expire on 11/20/2026 (ARF) and 7/20/2026 (RCFE). The Administrator was advised regarding the importance of adhering to the facility's corrective action plan that was developed on 10/23/2024 to ensure the facility's stays within compliance of Title 22 regulations. No deficiencies were cited during today's visit based on California Code of Regulations Title 22. An exit interview was conducted with Administrator Nicholas Inneh and a copy of the report was provided. page 2 of 2 - end of report