Routine inspection·October 21, 2025

Licensing Program Analyst (LPA) Hansen arrived unannounced to conduct a Required - 1 Year visit, on 10/21/25 at approximately 8:15am, and was greeted by staff, Tracy Nava, Health & Wellness Director (HWD) who contacted Administrator Stacy Ford that arrived during inspection. Facility has a hospice care waiver approved for six (6) residents. Fire clearance approval is for one hundred and twelve (112) non-ambulatory residents. The facility consists of two floors and provides assisted living services to residents as needed. During today’s visit there were 95 residents with one (1) under hospice care. LPA and HWD toured the facility finding; all exits were free and clear of any obstructions. All five (5) stairwells had the required evacuation chairs. Fire Extinguishers were found to be last charged on 6/19/2025 at the time of the visit. Facility smoke detectors are hard wired and sound directly to the fire station. Smoke detectors and fire sprinklers are inspected, and inspection records are current. Every resident apartment has an individual smoke detector in addition to hard wired, which smoke and carbon monoxide detectors were found to be operational on today’s visit. Hot water temperature measured between 114 degrees F and 120 degrees F within Title 22 acceptable regulation of 105 to 120 degrees F in 6 resident’s bathroom faucets while touring facility on 10/21/2025 at 9:00 AM. Bathrooms were equipped with necessary grab bars, and slip-resistant mats, strips, or flooring in all bathtub and shower floors as required by Title 22 regulations. All bedrooms have lighting & appropriate furnishings per Title 22 regulations. There was a sufficient supply of both perishable and nonperishable foods as required by Title 22 Regulations. Food stored in the kitchen refrigerators/freezers/storage rooms, was properly stored as per regulations on this day at the time of the visit. The facility had sufficient supplies of cleaners/disinfectants, paper products, emergency 72-hour shelter in place supplies, emergency water supplies, and sufficient supply of personal protective equipment (PPE). Continue on LIC809C Continued from LIC809 Facility had sufficient lighting in all inspected hallways, bathrooms, and common areas. Facility was at a comfortable temperature during the inspection. All medications were locked /centrally stored and inaccessible to residents in care. Audit of medications showed all in compliance during today’s visit. All cleaners/disinfectants/toxins were locked and inaccessible to residents in care. At approximately 10:30am LPA reviewed six (6) resident records. All records were complete including Care Plans/Assessments/Re-assessments. Based on file review there are residents with dementia diagnosis. LPA will follow up regarding the plan of operations (POO) with Administrator. At approximately 11:45 LPA reviewed six (6) staff records. All staff records reviewed along with additional staff have criminal record clearance as required by regulation. LPA reviewed staff training records. All staff had required training. Staff have First Aid and CPR certification as required. Facility holds required emergency disaster drills on a bi- monthly basis, with all shifts ensuring all staff participate in the evacuation drills. Last drills were held 9/24/2025. Administrator Certificate for Stacy Ford 7024907740 expires 4/4/2027. No deficiencies cited during today's inspection. Exit interview conducted with Administrator Stacy Ford Documents required from annual inspection provided by Administrator at visit.