Routine inspection·March 24, 2025

Licensing Program Analysts (LPA) Alviso conducted a Required- 1 Year visit, on 324/25, at approximately 2:00pm, and met with James Homer, Administrator. Facility has an approved dementia plan of operation. There is an approved hospice waiver for eighteen (18) residents. Facility has an infection control plan as required. The facility has a required emergency & disaster plan. Fire clearance is approved for one hundred fourteen (114) non-ambulatory, of which six (6) may be bedridden. LPA reviewed staff files. LPA toured the facility with the Administrator James Homer. Hot water was measured at 115.5 degrees Fahrenheit. All exits were free and clear of obstruction. All stairwells had the required evacuation chair, and user instructions posted. All required postings were up and visible to all residents, visitors, and staff. Facility has required emergency "72 hour shelter in place" supplies. Medications were centrally stored and locked in the assisted living area and in the memory care area. LPA observed that each medication room has a refrigerator for storing refrigerated medications. Food supply was observed to be sufficient. LPA is requesting the following documents be updated and submitted by 4/24/25: LIC308 - Designation of Administrator Responsibility LIC500 - Personnel Report LIC610E-Emergency Disaster Plan (ensure to review and update as needed/required) Infection Control Plan (ensure to review and update as needed/required) Copy of LIC400 Handling of Client Cash Resources (include copy of surety bond if handling cash) Copy of Current Liability Insurance Continued on LIC809C During today's inspection the LPA observed the following deficiency: LPA observed open commercial size boxes/bags of chocolate chips, pancake mix, walnuts, horchata drink mix, and jello pudding mix, open in the kitchen/pantry with no means to close the packages securely in order to prevent them from potential contamination. The Administrator and the Kitchen Chef discarded the items during the kitchen inspection. LPA obtained pictures for the file. This deficiency will be cited, 87555(b)(9)- General Food Service Requirements- The following food service requirements shall apply: Procedures which protect the safety, acceptability and nutritive values of food shall be observed in food storage, preparation and service, see LIC809D. California Code of Regulations, (Title 22, Division 6, Chapter 8), is being cited. Failure to correct deficiency (s) by due date (s), may result in additional deficiency citations and/or civil penalties being assessed. Exit interview conducted with the Administrator James Homer Appeal Rights Provided. LPA will continue the annual inspection at a later date .