Routine inspection·January 12, 2026

At 10:00 a.m. Licensing Program Analyst (LPA) Esther Cortez arrived at the facility unannounced to conduct a required annual visit. The LPA was greeted by Assistant Administrator Theresa Burdick and Administrator Nickie Perez and informed them of the reason for the visit. Record Review: A review of facility files was initiated. Facility records are stored in a locked office. The LPA observed documentation of Infection Control, Disaster prevention and last disaster drill (conducted on 11/12/2025). The LPA obtained Client Roster, Staff Roster, and Insurance Liability. The LPA reviewed five (5) of twenty-seven (27) resident files. Residents’ records were reviewed for, but not limited to care plans, medical records, admissions agreement, consent forms. All resident records were in order. The LPA reviewed five (5) of twenty-two (22) staff files. Personnel records and Administrator’s file were reviewed for, but not limited to personnel records, health assessments, criminal record clearances, first aid/CPR training, and the appropriate training. All staff records were complete and current. Medications: A medication review was conducted for three out of five residents and the following was observed. The medications were stored in a medication room and med carts which are locked and inaccessible to the residents. Medications are properly documented on the Centrally Stored Medication and Destruction Record (CSMDR). Interviews: The LPA conducted three (3) resident and three (3) staff interviews. No concerns were voiced. Report will continue on LIC809-C, 2nd page. The LPA conducted a tour of the physical plant with Administrator Nickie Perez to ensure there are no health and safety hazards and facility is in compliance with Title 22 Regulations. The following was noted: Facility is a residence that consists of two (2) buildings, with ten (10) resident rooms in each building. Building #2 is two stories and the second story is designated solely for staff. The LPA observed fire extinguishers throughout the facility, which were fully charged and last serviced 01/09/2026. All smoke alarms and carbon monoxide detectors were tested and functioned properly. The LPA observed all required postings throughout the facility. The facility serves residents with dementia, the auditory alarms on the exit doors were tested and functioned properly at the time of visit. Kitchen : During the facility tour, the kitchen appeared clean and the appliances and fixtures functional. The LPA observed a sufficient amount of perishable and non-perishable food at the facility. Food is prepared based on the menu. Snacks and beverages are available for residents. The LPA observed one of two kitchen refrigerators with the temperature of 49*F, upon observation the Administrator stated that the attached thermometer was not working properly and placed a second thermometer inside the fridge, however that thermometer was also showing temperature above 40*F. Bedrooms: During today’s visit, the LPA observed five (5) randomly selected resident units. The resident bedrooms were properly furnished with at least one chair, nightstand and sufficient lighting for each resident. The bedrooms had appropriate and adequate bedding and linens such as sheets, pillowcases, mattress pads, and blankets. Bathrooms: The LPA observed all bathrooms, properly supplied and had functional fixtures. The LPA observed grab bars and non-skid mats in all bathrooms. Water temperature measured in the restrooms in both buildings ranged between 110.7 degrees Fahrenheit and 117.5 degrees Fahrenheit. Common Areas: These included the dining areas and living areas. The common areas were checked for cleanliness and furniture was checked for functionality during time of visit. There were no obstructions and/or tripping hazards throughout the facility. Cleaning supplies and toxins were observed locked and inaccessible. Surrounding Grounds (Outdoors)/Garage : The LPA observed appropriate outdoor furniture, with a covered shaded area for residents. The garage is detached and locked at all times. No bodies of water were observed. Pursuant to Title 22 of the CA Code of Regulations, the following deficiencies were cited (refer to LIC 809-D): Exit interview conducted and copy of the report and appeal rights provided.