Facility Evaluation Report

On 12/15/2025 at 9:45AM, Licensing Program Analyst (LPA) G. Luk arrived unannounced to conduct a Required - 1 Year inspection. LPA met with Assistant Administrator, Silvia Salazar and explained the purpose of the visit.

LPA toured the facility including but not limited to bedrooms, bathrooms, dining area, kitchen, garage, and outdoor area. Smoke and carbon monoxide detectors were observed. Fire extinguisher was observed to be full and last serviced on 9/5/2025. One week of nonperishable and 2-day of perishable food supplies were available. Hot water temperature was measured at 120 degrees F in the hallway bathroom. LPA observed grab bars in the bathrooms. There were adequate lights in each room. Resident rooms were observed to be cleaned and fully furnished. First Aid kit is complete. Last fire drill was conducted on 11/29/2025. LPA reviewed 5 residents and 3 staff files starting at 10:10AM. LPA reviewed a sample of resident's medications during inspection.

At 10:30AM, LPA observed all five residents does not have current Appraisal Needs & Service plans on file during record review.

At 11:30AM, LPA observed S2 does not have health screening on file.

The 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 with Silvia Salazar. A copy of this report and appeal rights provided.