Facility Evaluation Report

On 07/09/26 at 3PM, Licensing Program Analyst (LPA) D Panlilio arrived unannounced to conduct a Required - 1 Year inspection. LPA met with staff (LC, S1) and explained the purpose of the visit. LPA observed ADM has a current administrator certificate # 7016461740 which expires on 07/09/2028,

At 3:15PM, LPA toured the facility including but not limited to the front entrance, screening station, kitchen, bathrooms, bedrooms and common areas. There is one central entry point for universal screening for staff, residents and visitors. A sign-in policy, visitor’s logs, no touch thermometer, additional face masks and hand sanitizers were observed at the screening station. Emergency Disaster Plan, Complaint poster, Personal rights, Cough/sneeze etiquette, proper hand-washing signs were observed posted in common areas. Facility has a sufficient 2-day perishable and 7-day non-perishable food supply. Facility has a 30-day supply of PPEs, paper, medications locked in cabinets. Comfortable temperature is maintained at 74 deg F. Facility has a mitigation plan in place and the infection control leader is the administrator. Inside and outside pathways were free of obstruction and fire hazards. Fire extinguishers were observed fully charged and last inspected on 08/20/25. Smoke and Carbon monoxide detectors were operational. LPA reviewed 3 staff and 4 resident files.

At around 3:15PM, LPA observed the following deficiencies:

Hot water temperature measured at 126.2.deg F with no warning signs posted

Deficiencies were observed (see LIC 809D) and cited from the California Code of Regulations, Title 22. Failure to correct the deficiencies may result in civil penalties.

Exit interview conducted, Appeal rights and a copy of this report provided.