Routine inspection·March 26, 2025

Licensing Program Analyst (LPA) Marcella Tarin arrived unannounced to conduct the facility's Required -1 Year inspection and met with General Manager (GM) J.P. Rollet and stated the purpose of the visit. GM states previous General Manager Griselda Galvan retired on 3/21/2025. GM states the facility has 84 residents and 26 staff. LPA toured the interior and exterior of the facility with GM to include but not limited to lobby, dining rooms, kitchen, laundry rooms, 10 resident rooms, 10 bathrooms, and facility activity rooms. All exits and passage ways are free and clear of obstruction. LPA interviewed 6 residents and 3 staff. LPA toured the kitchen area and observed a perishable food supply of at least two days and a non-perishable food supply of at least seven days. LPA observed refrigerator temperature at 31 degrees F and Freezer at 0 degrees F. LPA observed the medication storage area, knives storage area, and cleaning product storage area as locked and inaccessible to clients in care. Fire and smoke detectors were last inspected on 2/20/2025. The facility's emergency drill log was reviewed. The facility's last emergency drill was conducted on 1/26/2025. Facility fire extinguisher was last serviced on 10/14/2024. Page 1 of 2 LPA toured 10 resident rooms and 10 resident bathrooms. LPA measured water temperature with a range of 111.9 to 113.9 degrees F. LPA reviewed 7 resident records. Resident records included emergency contact information, physician’s report, needs and service plans, and personal rights. LPA reviewed 7 resident’s Centrally Stored Medication and Destruction Records (CSMDR’s). LPA reviewed 7 staff records. 7 out of 7 staff records were found to be complete. Staff records included fingerprint background clearance, medical assessment with TB result, personnel record, and staff training. LPA requested the following documentation during inspection for change of administrator: • LIC501 • LIC500 showing J.P. Rollet as ADM (Personnel Record) • LIC200 (application for Community Care Facility or Residential Care Facility for the Elderly License) • LIC308 • LIC 9182 with Admin box checked • Copy of Valid photo ID/DL No deficiencies were cited during today's visit per California Code of Regulations Title 22. An exit interview was conducted with General Manager (GM) J.P. Rollet and a signed copy of this report was provided.