Routine inspection·September 30, 2025

Licensing Program Analyst (LPA) Brian Balisi arrived at the facility unannounced to conduct a required annual visit. Upon arrival, the LPA met with Administrator Maria Mendez and explained the reason for the visit. LPA toured the physical plant areas inside and outside to ensure there are no health and safety hazards and the facility is in compliance with Title 22 Regulations. LPA inspected the kitchen/food service area at approx. 10:15 a.m. Knives and sharp objects are stored underneath the sink in a locked box. Cabinet was locked and inaccessible to residents in care.  Kitchen appliances were observed  to be in operable condition. At approx 10:17 a.m. LPA observed staff preparing food. The facility has a sufficient supply of perishable and non-perishable food properly stored at this time. Office area located near entry way to the backyard.  LPA observed facility files securely stored in this area. At the time of the visit, the common area furniture's were observed to be in good condition. A variety of activities were observed stored in the living room.  A sufficient supply of clean linen and towels were observed stored in two (2) hallway closets.  The facility maintained a comfortable temperature of 71 degrees Fahrenheit. Smoke detector(s) and carbon monoxide detector were operational at the time of the visit. The LPA observed six (6) resident bedrooms, which were furnished appropriately with clean linens, appropriate furnishings and sufficient lighting. The resident restrooms were clean and sanitary and in operating condition with grab bars and non-skid surfaces. The bathrooms were sufficiently stocked with supplies and paper towels.  The hot water temperature was measured in each restroom between 105 - 120 degrees Fahrenheit. At approx. 10:27am, LPA observed staff interacting with residents. The staff room located next to the living room was observed to be inaccessible to residents in care and empty during the time of the visit. All exits have functioning auditory devices and were operational at the time of the visit. The LPA observed required postings throughout the common areas. There is an attached garage observed inaccessible to residents in care.  LPA observed garage to have an additional fridge to store extra perishable food. LPA also observed a laundry area, laundry supplies securely stored, extra incontinent supplies, linen, PPE , as well as additional furniture and medical equipment for facility use. The backyard has a covered outdoor area equipped with furniture including a table and chairs for resident use. The LPA observed two (2) self-latching gate with clear passageways clear of obstruction. There were no bodies of water noted at the time of the visit. Records review, six (6) resident records were reviewed for, but not limited to: appraisals, medical records, admissions agreement, consent forms. Six  (6) Personnel records were reviewed for, but not limited to: personnel records, health assessments, criminal record clearances, first aid/CPR training, and the appropriate training. All records were observed to be in order at this time. Medications review: medications are centrally stored and locked inside a cabinet in the office area.  All medications including PRNs were labeled, stored and locked inaccessible to individuals. PRNs have physicians order on file. Medications are labeled and checked for expiration dates. Medications are properly documented on the centrally stored medications and destruction record. No errors observed during medications review. During today's visit, LPA reviewed the facility's infection control policy as well as the emergency disaster plan. The facility’s policies and procedures as it pertains to infection control are adequate. Fire extinguisher was observed fully charged and last serviced 08/14/2025. Carbon monoxide detectors are wired and operational at the time of the visit. Emergency disaster drills conducted quarterly as per regulation; the last one conducted was an earthquake drill on 07/08/2025. LPA obtained the following documents at the time of visit: LIC500 Personnel Report, LIC9020 Client Roster, and facility’s liability insurance Interviews were conducted during the visit. Exit interview conducted and copy of report provided.