Routine inspection·May 14, 2026

Licensing Program Analyst (LPA) Christi Coppo arrived unannounced to conduct a required Annual inspection and was greeted by concierge. Interim Department of Health Services (DHS) Faveola York worked with LPA until Administrator (Admin) arrived. Administrator Grant Haywood arrived later. Grant Haywood Administrator Certificate 7039094740 expires 8/6/26. All fees are current as of this time. Fee notification given to Admin along with PIN for online payment. Facility currently has 42 residents in care nine (9) of which are currently on hospice. At approximately 9:30am LPA and DHS 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 and labeled with opened dates present. LPA observed kitchen cleaning products located on a shelf very back of kitchen, away from food preparation. LPA and Director of Dining Services (DDS) discussed adding a cabinet in which to store the disinfectants and cleaning products utilized in the kitchen. DDS will request from Admin immediately. All other cleaning supplies and laundry soaps are located in the laundry room or in cleaning carts, inaccessible to residents in care. LPA and DHS toured room # 3, #10, and #17. All bedrooms were equipped with lighting, night stand, and chest of drawers. All bedrooms were clean and in good repair. Extra hygiene products and linens were available. Resident bathrooms had required bath mats and grab bars. Water temperature in sinks measured at 116.4 degrees F in room #3, 115.2 degrees F in room #10, and 114.4 degrees F in room #17, all of which are within the allowable range of 105 to 120 degrees F. Facility has common bathrooms used by residents, staff, and guests. Faucets in these bathrooms are turned on by hand sensor. Hot water is an Continued on 809C... Continued from 809 ... option by turning lever all the way back. LPA discussed with Sean Elser Maintenance Director (MD), functionality of faucets and that lever should be set such that the hot water temperature remains within compliance which is a range of 105 to 120 degrees F. Fire extinguishers were last inspected 11/18/25. Smoke/Carbon Monoxide detectors located throughout the facility are hardwired and serviced by vendor. Vendor annual inspection was last conducted 11/6/25 all systems pass. Facility’s last quarterly disaster drill was conducted on 4.29.26. Facility has a backup generator for use during a power outage. LPA and MD toured outside of facility and emergency shut off sites for water, gas, and electric were all observed. LPA and DHS toured courtyard area. LPA observed two (2) table umbrellas providing shade. Facility has a gazebo in courtyard, but it does not provide shade. LPA and DHS discussed adding a top to the gazebo to provide shade, considering they have a capacity of 80. A shaded gazebo would act to provide much more shaded area. LPA observed video surveillance in resident rooms, signed notices all on file. LPA observed oxygen in use, sign present on door. At approximately 12:30pm LPA conducted a review of six (6) staff files. Staff do not have the required hours of training completed ( deficiency cited, see 809D ). Of the files reviewed, two (2) staff started within 12 months, but neither of them had the required numbers of hours and subjects matters completed within the 1st 4 weeks of employment. Additionally, of the six (6) files reviewed, LPA reviewed four (4) Medication Technician (MedTech) files. S2 and S3 MedTechs did not have the required medication training completed on file ( deficiency cited, see 809D ). At approximately 2:00pm LPA conducted review of eight (8) resident files . Residents R1, R3, R4, and R5 all had physician reports that were not current ( deficiency cited, see 809D ) At approximately 3:00pm LPA and MedTech conducted a spot check of medication and medication records. Medication is centrally stored in a locked room. Facility is required to have a medication management program review completed with a pharmacy every six months, date of last review for facility was 9/19/25 ( deficiency cited, see 809D ). Continued on 809C(2)... Continued from 809C... LPA reviewed medications and Centrally Stored Medication log for R7. Two (2) errors were found. Prescription for Zinc Oxide ointment not listed on CMSL ( deficiency cited, see 809D ). Bubble pack for Escitalopram 20mg had a start date of 4/21/26 and a beginning quantity of 30, but only four (4) pills remain, so bubble pack is missing 2 tabs ( deficiency cited, see 809D ). Facility does not have tracking system for medications that accidentally fall on floor or such accidents. Additionally, LPA observed pre-pouring of medication ( deficiency cited, see 809D ). LPA and Admin discussed Emergency Disaster Plan. Admin confirmed no updates needed. 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. 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.