Facility Evaluation Report

Licensing Program Analyst (LPA) Hanna Gough arrived at the facility to conduct a health and safety check in regards to the quality assurance noncompliance plan. LPA was greeted and granted entry by staff. LPA met with Assistant Administrator (AA) Alex Blancarte and discussed the purpose of the visit.

LPA toured the facility and checked on residents in care. LPA observed the water to be between 105.8 and 108.8 degrees Fahrenheit in the resident restrooms. LPA observed the facility to have a two day perishable and seven day non perishable food supply on hand. LPA observed residents playing games in the activity room and relaxing in the living room. Residents appeared clean and well taken care of.

LPA reviewed daily monitoring logs and weekly medication audits for the weeks of September 9, 2025, through November 29, 2025 with notations of missing medtech signatures. LPA observed an in service conducted on November 25, 2025, regarding missing signatures on the medication administration record. LPA reviewed resident medications and observed signatures missing for two of five residents in the MAR.

Based on today's observations a citation is being noted per Title 22 Division 6 of the California Code of Regulations. An exit interview was conducted with AA Alex Blancarte and a copy of this report, LIC809D and appeal rights were left at the facility.