Routine inspection·September 17, 2025

Licensing Program Analyst (LPA) Alviso, conduct a Required- 1 Year inspection, on 9/17/25 at about 1:50pm, and met with Administrator Ryanne Tapnio. LPA observed a caregiver,Mielo, on shift upon LPA's arrival. Five residents are in care, and one resident is currently hospitalized. Facility has a required infection control plan. Facility has a required emergency disaster plan. Facility has an approved hospice waiver for two (2) residents. There is an approved plan of dementia care. Fire clearance is approved for six (6) non-ambulatory, of which one may be bedridden. LPA is requesting the following documents be updated and submitted by 10/17/25 LIC308 - Designation of Administrator Responsibility LIC500 - Personnel Report LIC610E 9-pages-Emergency Disaster Plan (review and update as needed/required) Submit if any changes. Infection Control Plan- (review and update as needed/required) Submit if any changes. Copy of LIC400 Handling of Client Cash Resources -complete & submit (required form) Copy of Surety Bond- if handling cash Copy of Current Liability Insurance Resident Roster Copy of Administrator Certificate LPA and Administrator toured the facility. The LPA observed the following: All exits were free and clear of obstruction. Hot water was measured at 109.4 degrees Fahrenheit, which is within regulation. Continued on LIC809C... Sufficient supply of linens, cleaners/disinfectants, PPE supplies, and sufficient supply of paper products. Sufficient supply of food for residents in care. Sufficient furnishings for residents use. Sufficient lighting in facility common areas, bathrooms, and resident rooms. Cleaners/disinfectants were locked up and inaccessible to residents in care. Fire extinguishers, two (2) were serviced and tagged as required. Backyard has a large covered deck and the pathway from the ramp to the fire gate is free and clear of any obstructions. The fire gate opened freely. LPA will continue the annual inspection at a later date. LPA will review files of residents and staff, facility records, and staff training. LPA observed the following deficiencies. LPA obtained photos. LPA observed the medication cabinet had the lock on it, and it had the key inserted and hanging in the lock. Resident medications were stored in this cabinet, and all medications were not secure and inaccessible to residents in care. Deficiency cited, 87465(h)(2) Incidental Medical and Dental Care , see LIC809D. LPA observed that in a drawer in the kitchen were pre-poured medications, pm medications, for residents in care. Regulation does not allow for pre-poured medications, facility is not in compliance. Deficiency cited, 87465(h)(5) Incidental Medical and Dental Care, see LIC809D. LPA observed food not stored appropriately during the inspection; Food leftovers, cold soup in a small pot on the stove, two plates of food sitting in a cold counter-top oven, and leftover cold rice sitting in a rice cooker on the counter. Three small fruit plates uncovered on a shelf in the refrigerator, and a small uncovered bowl of sliced apple that had turned brown in the refrigerator. LPA observed that food is not being stored appropriately in order to prevent them from potential contamination. Deficiency cited, General Food Service Requirements 87555(b)(9)-see LIC809D. LPA observed the freezer in the garage to be dirty inside, with food stains, food crumbs, and in need of a deep cleaning. Deficiency will be cited, General Food Service Requirements 87555(b)(21), see LIC809D. Deficiencies cited from the California Code of Regulations, Title 22, Division 6 of California Regulation. Failure to correct the deficiency and/or repeat deficiencies within a 12 month period may result in civil penalties. Exit interview conducted with Administrator Ryanne Tapnio. Appeal rights provided to the Administrator.