Facility Evaluation Report

Licensing Program Analyst (LPA), Mayra Cota, conducted a Plan of Correction Visit (POC) to follow up on a deficiency cited during the annual visit conducted on 6/19/25. Upon arriving at the facility, LPA met with Jacqueline Mikin, Administrator and explained the purpose of this visit.

The purpose of this visit is to follow up on the POC that was due on 7/10/25 and to correct a deficiency issued in error on the LIC 9099-D (section 84068.4(g)) issued on 6/19/25 which will be dismissed. On today's visit, LPA is issuing a citation under section 85068.4(g).

For CCR 85068.4(g): On 6/19/25, licensee did not have an age exception in place for Client 1 who was the last client to be admitted to the facility over the age of (60), whereas the facility is already retaining one client above the age of (60), which exceeds the (50) percent of the census.

During today's POC visit, the facility was able to provide LPA with all documents relevant for the age exception request for C1 and therefore, the POC was cleared at the time of visit.

Per California Code of Regulations, Title 22, and California Health and Safety Code, there were no deficiencies observed during the visit and the POC was cleared. Exit interview was held with Jacqueline Mikin, Administrator and a copy of this report, POC letter and corrected LIC 809 and LIC 809-D for visit held on 6/19/25 were provided.