Correction check·October 17, 2025

Licensing Program Analysts (LPAs) Mita Partoza and Marcella Tarin conducted a POC case management visit to clear deficiencies cited on October 2, 2025 and October 9, 2025, during a case management / Complaint investigation visit. LPAs met with Administrator (ADM) Xi-Hua (Julia) Luo and stated the purpose of the visit. Clearing pending Plan of Corrections: The facility was cited the following deficiencies on October 2, 2025 with the following POC dates and is being cleared today: • 87468.1 Personal Rights of Residents in All Facilities (a) Type A- POC due date October 3, 2025. Plan of Correction received on October 9, 2025. • 87202 Fire Clearance (a) -Type A, Issued CP of $800.00 beginning October 9, 2025, and will continue to accrue until corrected. • 87755 Inspection Authority of the Licensing Agency (a) - Type A, Issued initial CP of $800.00 beginning October 9, 2025 and will continue to accrue until corrected. The facility was cited the following deficiencies on October 9, 2025, with the following POC date and is being cleared today: • 87625 Managed incontinence (b)(2), Type A – POC due date October 10, 2025. Plan of Correction received on October 9, 2025. Page 1 of 2 •87507 Admission Agreements (g)(3)(B)(2), Type B- POC due date, October 16, 2025. Plan of Correction received on October 9, 2025. • 87405 Administrator Qualifications (d)(2), Type A – POC due date, October 10, 2025. Plan of Correction received on October 9, 2025 A Letter of Deficiency Citations Cleared was provided to ADM for the above deficiencies. LPAs Tarin and Partoza inspected the backyard shed and observed the shed being used as a storage area. On 9/25/2025 LPA Manuel Monter and Marcella Tarin conducted the facility's annual inspection. During the exit interview with Licensee, Licensee verbally threatened to take LPAs state owned phones and break them. Licensee stated LPAs did not have the authority to inspect and take pictures of the facility backyard shed. Based on review of the Department's approved facility's sketch dated 10/15/2007, the backyard shed is part of the facility sketch. A deficiency is being issued to the Licensee. A deficiency is being cited during today's visit per California Code of Regulations, Title 22. This report was reviewed with ADM Xi-Hua (Julia) Luo and a copy of the signed report and appeal rights were provided. Page 2 of 2 END OF REPORT