Facility Evaluation Report

On 12/12/24 at 8:50AM, Licensing Program Analyst (LPA) K. Nguyen arrived unannounced to conduct an continuation of an annual required inspection upon arrival LPA met with Administrator Josephine Santos (Administrator certificate #6063810740 exp 6/23/26), and explained the purpose of the visit.

LPA reviewed 5 resident files and 3 staff files. LPA interviewed 2 residents and 2 staff.

The following deficiencies were observed:

· medicine unlocked inside the small cabinet on the table- Cleared but Repeated Violation from 1/27/24.

· Cleaning supplies/ detergent left unlocked under shared resident bathroom and common bathroom- Cleared.

· Knives left unlocked in on the kitchen counter- Cleared.

The deficiencies were observed (see LIC809D) and cited from the California Code of Regulation, Failure to submit proof of corrections (POC) by plan of correction due date and/or any repeat deficiencies within a 12-month period may result in civil penalties.

*An immediate $250.00 civil penalty will be assessed on today's date for reported violation within 12month. *

Exit interview conducted. A copy of the LIC421FC, this report and appeal rights provided.