Facility Evaluation Report

On 09/25/2025, Licensing Program Analysts (LPAs) J. Duarte and L. Salazar arrived at the facility unannounced to conduct a case management visit based on deficiencies found during a complaint investigation.

LPAs conducted a facility tour and and observed R1's room to have five unsecured Oxygen tanks. R1 was observed in a wheelchair. While R1 was moving around the room, the wheelchair wheels were observed to be rolling over the canula tube that measured approximately 20 ft in length, causing possible obstruction to oxygen flow. LPAs conducted interviews with R1 and R2 and observed both residents to not have a signal system to call for assistance.

A review of records reveal, Business Office Manager does not have a criminal background clearance.

Based on observations and records review, and per California Code of Regulations, Title 22, Division 6, Chapter 8, deficiencies are being cited on the attached 809-D. A Civil Penalty in the amount of $500 for Criminal Record Clearance is hereby assessed on LIC421BG. If not corrected, the violation will have a direct and immediate risk to the health, safety, or personal rights of persons in care.

An exit interview was conducted with AD and a plan of correction was developed by 09/26/25. A copy of this report and appeal rights were discussed and provided at the time of visit.