Facility Evaluation Report

On 10/03/2025 at 9:00 AM, Licensing Program Analysts (LPAs) K. Nguyen and P.Manalo and arrived unannounced to conduct case management legal/Non-compliance visit and met with Direct Care Staff, Teresita Collong and explained the purpose of the visit. The Administrator was unavailable to come.

While at the facility, LPA observed the following deficiencies:

During the visit, LPAs observed that Resident 1 (R1) who is bedridden per Physician's Report and is staying in an approved non-ambulatory room. The facility has an approved one bedridden fire clearance for Room #2 only. However, R1 is occupying Room #3. Interview with Direct Care Staff, Teresita, stated that the R1 was discharged from hospice on September 09, 2025. However, interview with Staff 1 (S1) revealed that R1 is unable to move side to side.

Administrator not present for a sufficient enough hours.

The auditory signal in the kitchen/living room sliding door was not working.

The Facility was cited from the California Code of Regulations, Title 22 and/or Health and Safety Code Failure to correct deficiencies by POC date may result in additional Civil Penalties.

Civil penalty of $750 for fire clearance violation is issued today.

Exit interview was conducted and Appeal Rights was provided to Collong.