Facility Evaluation Report

On 4/4/2025 at 10:10AM, Licensing Program Analyst (LPA) G. Luk arrived unannounced to conduct a Required - 1 Year inspection. LPA met with Caregiver, Wilma Nacis and explained the purpose of the visit. Administrator, Mercedes Morales arrived two hours later.

LPA toured the facility including but not limited to bedrooms, bathrooms, dining area, kitchen, garage, and outdoor area. Smoke and carbon monoxide detectors were observed. Fire extinguisher was observed to be full and purchased on 8/28/2024. One week of nonperishable and 2-day of perishable food supplies were available. Hot water temperature was measured at 105.6 degrees F in the hallway bathroom. LPA observed grab bars and non-skid mat in the bathrooms. There were adequate lights in each room. First Aid kit is complete. Last disaster drill was conducted on 3/19/2025.

LPA reviewed 4 residents and 4 staff files starting at 10:35AM. LPA reviewed a sample of residents' medications during inspection.

At 11:45AM, LPA observed R1 and R3 did not have current appraisal needs and service plan on file during record review.

At 1:00PM, LPA observed S2 and S3 did not have current annual training on file.

The deficiencies were observed (see LIC 809D) and cited from the California Code of Regulations, Title 22 and Health & Safety Code. Failure to correct deficiencies may result in civil penalties. Exit interview conducted with Mercedes Morales. A copy of this report and appeal rights was provided.