Facility Evaluation Report

On this day, July 2, 2026, at 1:50 pm, Licensing Program Analyst (LPA) Delmundo conducted case management inspection to ensure the health and safety of residents as a result of the Department receiving a Priority 2 complaint (Complaint Control Number: 15-AS-20260630155242). LPA met with Mirriam Paras, administrator (ADM), and informed the reason for visit.

LPA toured the facility with ADM. LPA inspected the living and dining rooms, kitchen, bathrooms and residents' bedrooms on the first and second floors. LPA reviewed resident records.

LPA observed and learned about the following:

R1 and R2 had an incident. LPA observed R1 with bruises and wounds/lacerations, and when verified, ADM stated she did not submit incident report.

R2's Physician's Report indicated R2 has advancing neuro cognitive disorder and non-ambulatory and R2 is in the bedroom not cleared/approved by the fire department for non-ambulatory.

Deficiencies are cited from Title 22 California Code of Regulations and listed on 809Ds. An immediate $1,000.00 civil penalty is assessed for repeat violation within 12 month of deficiency section 87202(a)(1) and will continue for $100.00/day until corrected.

Deficiencies, plan and proof of corrections and civil penalty assessment were discussed with ADM.

Exit interview conducted. Appeal Rights, LIC421IM Civil Penalty assessment and copy of this report provided.