Facility Evaluation Report

On 06/24/25, Licensing Program Manager (LPM) Ulysses Coronel and Licensing Program Analyst (LPA) Regina Cloyd conducted an unannounced case management – deficiency and met with Staff and explained the purpose of this visit. The purpose of this visit is to issue a deficiency observed on 06/19/25 and during today’s visit. On 06/19/25, Licensing Program Analyst (LPA) Regina Cloyd conducted a Case Management - Other visit in association with the noncompliance conference (NCC) with the Licensee on 11/24/2024. 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.

On 06/19/25, record review of medical assessments for R1 – R4, R6 revealed that the residents are non-ambulatory. R2 was the fifth non-ambulatory resident admitted to the facility on 06/01/25. On 06/19/25 and today, LPA observed five (5) non-ambulatory residents (R1 – R4, R6).

Deficiencies are being cited based on LPA observation and record review in accordance with the California Code of Regulations, Title 22, see LIC809D. An immediate civil penalty of $500 is issued.

An exit interview was conducted, plans of correction developed, and a copy of this report and appeal rights was discussed with Administrator Designee Charesa Reyes over the phone. A hard copy of this report was left with Staff Maria Nita.