Facility Evaluation Report

On 12/04/2025, Licensing Program Analyst (LPA) Jose Anguiano conducted an unannounced Case Management – Deficiency visit to document a deficiency observed during a complaint investigation at this facility. LPA met with Administrator Kyle Watanabe.

During the complaint investigation, LPA requested the admission agreement for Resident 1 (R1), who is the reporting party for the complaint. The licensee was unable to provide a copy of the admission agreement at the time of the visit.

Per Title 22, California Code of Regulations, Section 87506(a)(b)(15), the licensee shall ensure that a separate, complete, and current record is maintained for each resident, and that each resident’s record shall contain, at minimum, the admission agreement and pre-admission appraisal. The failure to maintain and make available this required documentation is a violation of resident recordkeeping requirements.

Deficiencies are being cited from Title 22 Regulations please see LIC809-D. An exit interview was conducted, and a plan of correction was developed. Appeal Rights and a hard copy of this report were provided to Administrator Kyle Watanabe.