Facility Evaluation Report

On 06/19/25, Licensing Program Analyst (LPA) Regina Cloyd conducted a Case Management - Other visit at this facility. LPA met with Staff who allowed for entry in this facility. LPA informed Staff the purpose of the visit is to conduct a case management - other visit in association with the noncompliance conference (NCC) with the Licensee on 11/24/2024. Administrator Designee Charesa Reyes joined later. The facility is licensed to serve four (4) non-ambulatory residents and two (2) ambulatory residents age 60 and over. Rooms #1 and #4 are for ambulatory residents and rooms #2 and #3 are for non-ambulatory residents.

During today's visit, LPA Cloyd toured rooms one and four and reviewed facility records, three staff records, and six resident records. Deficiencies are being cited based on observations, record reviews, and interviews in accordance with the California Code of Regulations, Title 22, see LIC809D. Civil Penalties will also be issued today.

Register of Facility Residents indicated the Resident #1 (R1) is non-ambulatory and lives in room #1 (for ambulatory residents only). R1's medical assessment (03/13/25) reveals resident to be bedridden. LPA observed R1 in hospital bed. Continue to LIC809-C.