Facility Evaluation Report

Licensing Program Analyst (LPA) Sarah Hurt conducted an unannounced visit today for the facility’s annual inspection. LPA met with Executive Director, Larry VanHorn, Continual Administrator's Certification expires 12/01/2026. There are currently 77 residents who reside at this home and there is 9 residents on hospice at this time. LPA inspected the interior and the exterior of the facility including the common living spaces, resident bedrooms and bathrooms, activity rooms, medication storage, kitchen, and outdoor areas. Bedrooms were clean and in good repair.

Fire extinguisher is within the safety regulation period. Smoke alarms are tested and are operational. The home has a carbon monoxide detector. Water temperature was tested between 115 degrees and 119 degrees in multiple different resident bedrooms throughout the facility. First Aid kit is on site and complete.

Staff 1 does not have required annual dementia training/ or 20 hours required annual training. The facility is not conducting quarterly disaster drills as required. The staff listed as Infection Control lead is no longer employed by the facility. The facility is not following Plan of Operation (annual staff dementia training.) LPA observed antacid medication in Room 122 of memory care resident. LPA observed cleaning spray in room 147. Non- perishable food supply was low.

The following deficiencies observed or cited during today's inspection per California Code of Regulations, Title 22.

LPA requested the following documents: LIC 500 Personnel Report, LIC 308 Designation of Administrative Responsibility, LIC 610-E the Emergency Disaster Plan and copy of current Administrator’s Certificate to update the facility file. Listed documents shall be sent to Licensing.

Exit interview conducted with Executive Director, Larry VanHorn, and copy of report left at facility