Routine inspection·October 8, 2025

Licensing Program Analysts (LPAs) Angela Barutyan and Quoc Huynh arrived at the facility unannounced to conduct a required annual visit at 10AM. Upon arrival, LPAs met with Administrator Holly Gold and explained the reason for the visit. Entrance interview conducted. Beginning at 10:04AM, the LPAs, along with the Administrator, toured the physical plant areas inside and outside to ensure there are no health and safety hazards and facility is in compliance with Title 22 Regulations. The following was observed: KITCHEN: At 10:04AM, LPAs toured the kitchen. The kitchen is kept inaccessible to residents. Knives and sharps were stored inaccessible to residents. Kitchen appliances were observed to be in operable condition. The facility has a sufficient supply of perishable and non-perishable food. Emergency food and water supply is stored in a locked storage room. COMMON AREAS: The common areas include two (2) lounges, two (2) outdoor patios, dining room, activity room, beauty salon, and book nook. LPAs observed required postings throughout the common areas. Common areas were observed to be properly furnished with enough seating to accommodate residents and had a screened fireplace. Fire extinguishers throughout the facility were fully charged and last serviced 05/19/2025. Fire system devices are tested annually by Perfect Connections and were tested 06/10/2025. BEDROOMS: LPAs inspected five (5) randomly selected bedrooms. Resident bedrooms were observed to be furnished appropriately with clean linens, appropriate furnishings, and sufficient lighting. At 10:17AM, LPAs observed baseboards in room 38 in disrepair. Administrator stated that baseboards will be repaired or replaced. Report Continued on LIC 809. LPAs observed two (2) rooms with missing window shade panels. Administrator stated that panels will be repaired. BATHROOMS: Resident bathrooms are shared between rooms with door access from each. Some bedrooms have private bathrooms that are not shared. LPAs observed bathrooms in each resident bedroom to be clean and properly supplied with functional grab bars and fixtures. LPAs observed pull cords by the toilet. Hot water was measured in four (4) bathrooms and were between 108.9-118.8 degrees F, which is within the required range. There are eight (8) shower rooms, however, four (4) are in use. Shower rooms were observed to be clean, sanitary, in operating condition with slip-resistant surfaces, and sufficiently stocked with linens and personal hygiene supplies. MEDICATION REVIEW: LPAs began medication review at 10:35AM and reviewed medications for three (3) residents. Medications are centrally stored in the medication room by the business office. Medications are prepped up to 24 hours in advance in medication cups. All medications reviewed were stored and documented per regulation. RECORDS REVIEW: Beginning at 11:08AM, LPAs reviewed five (5) personnel and five (5) residents files for documents including but not limited to: resident Admission Agreement, resident physician’s report, TB test, health screening, staff training and fingerprint clearance. All five resident files reviewed were in compliance with regulation at the time of the visit. LPAs observed one (1) staff member without a criminal record clearance. Administrator stated that the staff member will obtain a criminal record clearance and will not provide care until cleared. INFECTION CONTROL/EMERGENCY DISASTER PLANNING: During today's visit, LPAs 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. Emergency disaster plan is updated annually as required. Emergency disaster drills are conducted quarterly as is required, with the last drill conducted on 07/17/2025. During today’s visit, LPAs obtained a copy of the facility’s liability insurance. Pursuant to Title 22, CA Code of Regulations, the following deficiency was cited (refer to LIC 809-D). Civil penalty was issued in the amount of $500 for criminal record clearance. Administrator was informed that failure to correct deficiency may result in additional civil penalties. Exit interview conducted, report issued, and appeal rights provided.