Facility Evaluation Report

Licensing Program Analyst (LPA) A Gomez arrived unannounced to conduct an Annual Continuation on this date starting at 9:00AM. LPA met with Resident Care Director, Kimari Pinkney and explained the reason of the visit. The facility's fire clearance was approved for all may be non-ambulatory which 10 may be bedridden.

At 9:10am, LPA reviewed 6 residents records. At 11:00 am, LPA reviewed 5 staff records and 5 of 5 have current first aid training and associated to the facility.

THE FOLLOWING DEFICIENCIES WERE OBSERVED DURING VISIT ON 12/08/2025:

During inspection of the med-tech cart LPA observed medications not stored in their original container for R1 and R9

LPA observed soiled bedding with an odor in R6's room

LPA observed PRN medication in memory care in R8's room and prescription and PRN medications in R7's room

Observed dangerous items in R10's room (ie. 2 Knives, windex)

The following deficiencies were observed (see LIC 809D) and 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.

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