Facility Evaluation Report

On 06/23/26, Licensing Program Analyst (LPA) M. Yang arrived at the facility unannounced to conduct the Annual Inspection. LPA met and toured facility with Administrator Douglas Rice.

Facility has sufficient furnishings inside and outside for resident use. The facility was observed to be at a comfortable temperature, clean, and no passageway obstructions or fire hazards. Residents were observed seating in common areas. Facility is equipped with pull stations and fire sprinklers throughout the facility. Fire extinguisher was observed throughout the facility with a service date of: 09/09/2025.

LPA toured kitchen. An adequate supply of perishable and non-perishable food was observed to be properly stored in freezer, refrigerator, and pantry. Rotten fruits were observed. Expired food was observed. Temperature observed for the refrigerator maintained at 32 degrees F and freezer with 0 degrees F. Medications are kept lock in medication cart in medication room. Chemicals stored and locked in house keeping’s room. A sample of resident bedrooms was toured. LPA observed a chemical bottle in R1’s bedroom. Medications were observed unlocked in R2’s bathroom. Bathrooms hot water temperature was tested at 109.7 degrees F in room 105, 110.2 degrees F in room 107. 110.8 degrees F in room 402 and 111.4 degrees F in room 507. LPA observed securely fastened grab bars in bathrooms. Nonskid strips in residents’ showers. A sample of residents' files was reviewed. Courtyard was toured and observed with available seating for residents with shade. Carbon monoxide was observed operational during visit.

Technical Support Program (TSP) assistance was offered. Administrator will make a decision and reach out the department regarding acceptance.

A deficiency is being cited on the attached Lic 809D in accordance to California Code of Regulations, Title 22, Division 6 see attached 809D. Exit interview was conducted. The requested documents are to be submitted to the department by 06/26/6: Lic 308, Lic 500, Lic 610E and current liability insurance. A copy of this report and appeal rights were provided to the Administrator.