Facility Evaluation Report

03/24/2026, Licensing Program Analyst (LPA) Loera arrived unannounced to conduct a Case Management - Incident visit and met with Executive Director, Corrine Tanchoco and Resident Service Supervisor, Omar Peraza Molina. The purpose of the visit was to follow up on self-reported incident that were submitted to Community Care Licensing (CCL).

CCL received an incident report on 03/11/2026 stating on 03/10/2026, around 5pm, resident (R1) reported accidentally consuming peanut sauce during dinner in the dining room. R1 stated he has a peanut allergy and reported a scratchy throat. 911 was contacted and paramedics arrived to assess R1.

Per conversation with Executive Director, R1 ordered the stir fry and the sauce in the stir fry contained peanuts to which R1 is allergic to per R1s physicians report (LIC602). Facility has a dietary board posted in the kitchens for cooking staff to review. Dietary board states R1 is allergic to peanuts.

Deficiencies are cited from the California Code of Regulations (CCRs), and/or the Health and Safety Code. Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.

Exit interview conducted. Copy of report, LIC809D, LIC811, and Appeal Rights provided to Executive Director.