Facility Evaluation Report

On 3/24/2026 at 11:30 AM, Licensing Program Analyst (LPA) A Gomez arrived unannounced to conduct the Annual Continuation Inspection to complete the Annual Required Inspection that began on 3/6/2026. LPA met with Executive Director, Gilbert Castro and explained the purpose of the visit.

On 3/24/2026 LPA reviewed 6 resident records and 5 staff records. 5 of 5 associated to the facility. Emergency Disaster Plan was last reviewed on 3/13/2026. Emergency disaster drill was last conducted on 3/8/2026.

THE FOLLOWING DEFICIENCIES WERE OBSERVED DURING VISIT 3/6/26:

Downstairs common bathroom emergency call button not notifying caregivers pagers- disrepair ***

Dangerous Items identified: gardening sheers unlocked in activities room under sink, chemicals unlocked under sink/ butane, room 196 memory care (mc) hot tools, room 297 mc unlocked cleaning supplies/chemical hot tools.

Not enough staffing memory care; observed residents left unattended in activities room (2 caregivers on the floor for 30 residents. 1 upstairs 1 down), staff were also unaware that MC has emergency call buttons.

Room 293 Incontinence not properly disposed creating an Odor (thrown in open waste basket by bed)

Hot water measured at 129.2 degrees F room 269 ***

R3, R4, R5,and R6 appraisals of needs and services not up to date

***Civil Penalties assessed for repeat violations in 12 months $250 X 2***

Updated copies of the following documents were requested for facility file and are to be submitted to CCL by 3/31/2026:

LIC 308 Designation of Administrative Responsibility

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.