Routine inspection·July 9, 2025

Licensing Program Analyst (LPA) Christi Coppo arrived unannounced to conduct a required Annual inspection and was greeted by Administrator Angelica Martinez. At approximately 9:35am LPA toured the building and grounds. The facility was found to be clean and at a comfortable temperature. LPA observed at least a 2 day supply of perishable and 7 day supply of non-perishable food. Food was found to be stored in a safe manner with open items covered. LPA observed frozen milk. LPA discussed with Admin reason for freezing milk. LPA advised best practices not to freeze milk as it can cause the fat and protein to separate and affect the flavor and texture as well. Kitchen drawer with sharp knives locked. All bedrooms were equipped with lighting, night stand, and chest of drawers. Room #2 was found to have a soiled brief in an uncovered waste basket as well as urine present in an uncovered bedside commode ( deficiencies cited, see 809D ). Resident bathroom had required bath mat and grab bar. Water temperature in sink accessible to residents measured at 117.5 and 115.7 degrees F which is within the allowable range of 105 to 120 degrees F. Fire extinguishers were last inspected 9/23/24. Smoke/Carbon Monoxide detectors located throughout the facility were tested and operational. Facility’s last quarterly disaster drills were conducted November 2024. LPA advised to be sure to conduct disaster drills quarterly. Continued on 809C... Continued from 809... At approximately 10:30am LPA conducted a review of 6 resident records. Hospital beds, half rails, and postural support poles all observed in resident rooms, but doctor orders for these items missing for some residents. LPA observed written communications from Admin to various doctors requesting the orders, but executed orders not on file for some residents. At approximately 11:30am LPA conducted review of 5 staff records. Staff S1 and S2 had recently expired CPR, expired 6/26/25, however all other staff current. Staff S2, S3, S4 did not have required number of training hours completed ( deficiency cited, see 809D ). At approximately 12:00pm LPA and Admin conducted a spot check of medication and medication records. Medication is centrally stored in a locked room. LPA advised to be sure to keep all discontinuation papers on file for each resident. LPA observed pre-poured medications present in medication room for most residents ( deficiency cited, see 809D ). Angelica Martinez Administrator Certificate 7000290740 expires 4/10/27. Updated copies of the following documents were requested for facility file and are to be submitted to CCL within 30 days of this visit: LIC500- Personnel Report LIC308- Designation of Responsibility Liability Insurance Deficiencies cited from the California Code of Regulations, Title 22, Division 6 of California Regulation and the Health and Safety Code. Appeal rights given and discussed with Administrator. Failure to correct the deficiency and/or repeat deficiencies within a 12 month period may result in civil penalties. Exit interview conducted with Administrator and a copy of this report was given .