Facility Evaluation Report

At approximately 9:15AM, Licensing Program Analyst arrived unannounced to conduct a Case Management - Deficiencies visit and met with Staff Members, Elena Mendoza and Ana Renderos. Licensee, Ana Bautista, and Administrator, Bella Nachor, arrived during visit at approximately 9:55AM. Licensee left facility at approximately 11:40AM.

At approximately 9:45AM, LPA observed that PM and Bedtime medications were pre-poured for four residents. Per conversation with Staff Member, the medications were poured the night before on 11/18/2025 and placed in the medication cups this morning, on 11/19/2025.

LPA discussed regulation with Licensee, Administrator, and Staff Member. All parties stated their understanding that medications must be poured during the appropriate time frame.

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 (Deficiency Page), Plan of Corrections, and Appeal Rights discussed and provided to Administrator. Signature on form confirms receipt of documents.