Routine inspection·October 2, 2025

On 10/02/2025, Licensing Program Analyst (LPA) Renee Campbelll arrived unannounced to conduct an annual inspection with Stephenie Doub, Regional Manager. Krystal Calderon, Administrative Assistant assisted with the visit. LPA Campbell observed residents eating breakfast. The contact information for the Long-Term Care Ombudsman was displayed in the entrance for residents and visitors. There was also a See Something Say Something poster available to call in complaints. Throughout the day, LPA Campbell overheard residents using the signal system to call for a caregiver. Later during the visit, LPA Campbell observed two residents working on a puzzle together and a religious service was done in the common area with a priest and residents as parishioners. Upstairs, residents were observed eating lunch in the dining room. Staff were observed serving the meals and assisting where needed. The community is licensed to serve residents age 60 and over who are non-ambulatory of which 16 of them may be bedridden. Only the first floor is approved for bedridden residents and the community has a waiver granted for 16 hospice residents. A tour was conducted with Dawn Pero, Care Coordinator in the Med room, resident rooms, kitchen and common areas. LPA Campbell conducted a medication audit using randomly selected residents and found that the residents medication matched their name, rx, number, name of medication and the dosage prescribed. The first aid kit was inspected and included tweezers, scissors, thermometer and first aid manual along with bandages. LPA Campbell observed three resident rooms and found that the appropriate furnishings were present. However one room (#101) did not have a lamp available for residents outside of the overhead lights. LPA Campbell reminded the Care Coordinator that each resident is to have a lamp on the night stand for their personal use. Lamps were found in the other two rooms that were inspected. The water temperature in the three residents rooms inspected were all found to be over 120 degrees Fahrenheit. However all bathrooms were found to have signage warning of hot water and all residents were able to discern if the water was too hot. The thermostat was set at 75 degrees F During a tour of the community kitchen, LPA Campbell observed stoves with a fire supression system that was last inspected on 06/19/2025. There was a class K fire extinguisher for cooking oil and fat fires and a Class A fire extinguisher. Both fire extinguishers were last inspected on 12/18/2024 and were fully charged. When LPA Campbell observed the freezer and refrigerator, the temperature displayed was within regulations. The refrigerator was 35 degrees Fahrenheit (F) and the freezer was -5 degrees Fahrenheit. There were enough perishable foods to last the community 2 days and enough non-perishable items in the pantry to last 7 days. A temperature log was observed to be kept on the front of freezer and refrigerator. No insects, spiders or spider webs were observed in the community. LPA Campbell also observed the emergency food supply stored in an outside shed. LPA Campbell reviewed the fire drill log for the community. Staff conducted quarterly drills once per quarter and recorded the date, time, number of residents and staff who participated and the scenario practiced. The administrator reviewed and signed off on each drill. After a review of the emergency and disaster plan, RM Stephen Doub consulted with staff regarding feasability. The community will update and expand the Emergency and Disaster Plan and provide the new plan to LPA Campbell by 10/10/2025. LPA Campbell compared the staff roster to the online Guardian report. One staff was not found in the Guardian but was added during the visit. LPA Campbell conducted 10 file reviews for residents and 5 file reviews for staff. All files were found to be complete. The following documents will be email to LPA Campbell ( Renee.Campbell@dss.ca.gov ) by 10/09/2025 by 5:00 PM by end of day: (1) LIC 308 Designation of Administrative Responsibility (2) LIC 500 Personnel Report (4) LIC 610 Emergency Disaster Plan Updated Insurance Certificate Per California Code of Regulations, Title 22, no deficiencies were observed during today’s visit. A copy of this report was provided to the facility