Facility Evaluation Report

On 06/15/2026, at 9:00 AM, Licensing Program Analyst (LPA) James Sampair arrived unannounced to conduct this Plan of Correction (POC) visit concerning the citation issued on 05/26/2026 for complaint 15-AS-20260518143132 that was due on 06/09/2026. Upon entrance, the LPA informed Staff S1 of the purpose of the visit. S1 did not have a criminal record clearance, so the LPA asked him to leave and to get a staff member to take his place at the facility.

At approximately 9:40 AM, the LPA and the Administrator (ADM) Dr. Falemei "Mei" Paongo, PhD spoke over the phone. She was out of the facility during the whole of the visit. During the call, the ADM informed the LPA that she had not completed an online course in medication training nor had she trained all of the staff in properly assisting residents in the self-administration of medications. She also informed the LPA that she had not set up a medication binder with the Centrally Stored Medication and Destruction Record and the MAR forms. The LPA informed her that not completing the POC resulted in civil penalties today that would continue to accumulate until the POC was cleared and she had informed the LPA of them being cleared.

At approximately 11:00 AM, Caregiver Ulisese Togotogo arrived at the facility.

A civil penalty for $600 was issued during the visit.

Deficiencies are cited per Title 22 California Code of Regulations and listed on LIC 9099-D and LIC 421FC. Failure to submit Proof of Corrections (POCs) by plan of correction due date and/or any repeat deficiencies within a 12-month period may result in civil penalties.

Exit interview conducted and a copy of this report was provided.