Non-compliance follow-up·March 13, 2026

Licensing Program Analyst (LPA) Simi Rai conducted an unannounced Case Management - Legal/Non-compliance inspection. LPA Rai met with Administrator (ADM) Nicholas Inneh and stated the purpose of today's visit. 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 Rai 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 proactively 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 Rai toured the facility to include the resident bedrooms, hallways, bathrooms, dining room, kitchen, and exterior. LPA Rai observed 2 staff members present were observed to be fingerprint cleared and associated to the facility. Continuation on LIC 809-C, Page 1 of 2. Page 2 of 2. LPA Rai entered into all the resident bedrooms. All rooms are currently occupied. There were no observation of bed bugs. ADM states the facility does not have any active cases of bed bugs. ADM states a third party vendor for pest control inspected the facility on 02/10/2026 and no rodent or insect activity was noted at the facility. ADM states a third party vendor for pest control inspects the facility at least twice a month. LPA Rai observed the facility has a weekly cleaning and maintenance log for 03/01/2026 - 03/12/2026. During visit, LPA Rai observed staff cleaning resident rooms and completing the weekly cleaning and maintenance log. LPA Rai at random reviewed 2 staff files (S1-S2). 2 Out of 2 staff were provided 20 hours of training which include the follow topics: 'Assisting resident with ADLs (Activity of Daily Living)', 'Dementia Care', 'Personal Rights', 'Basic Medication Training', 'Reporting Requirements', 'First Aid', 'Emergency Procedures', 'Food Services', 'Nutrition & Hydration', 'Infection Control', 'Observing and Documenting Resident Changes', and 'Communication & Working with Difficult Behaviors'. LPA Rai at random reviewed 3 new resident files (R1-R3) who moved into the facility from June 2025 - December 2025. 3 Out of 3 files contained LIC 602 Physician's Report including TB result and LIC 624 New Admission Appraisal. All 3 residents do not have a special diet per LIC 602 Physician's Report. LPA Rai reviewed Incident Report dated 02/01/2026 for resident R4 and noted no issues. 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 per California Code of Regulations, Title 22. This report was reviewed with Administrator (ADM) Nicholas Inneh and a copy of the report was provided.