Facility Evaluation Report

Licensing Program Analyst (LPA) Rose Ruppert made an unannounced Case Management and Health and Safety visit. LPA was greeted and granted entry by Staff #1 (S1) and explained the purpose of the visit.

At time of visit two residents were seated and listening to music, while waiting for lunch. Both residents were groomed and dressed for the day. A third resident was eating lunch in their bedroom and stated to LPA they were doing fine. LPA toured the facility with Licensee Maricel Nepomuceno. Licensee Allen Medina was touring a prospective resident family.

LPA toured the facility and discovered the storage room was used as a staff bedroom. A deficiency will be cited. Licensees and Administrator will remove bedding and staff items from storage room and staff member will reside at another location.

LPA interviewed two of two staff members. Two of two staff members received partial payment for the pay period 2/4-2/18/2026. A Civil Penalty will be assessed for 87213 Finances from 3/04 - 3/11/2026 for $100/day X 8 days = $800. The facility does not have current liability insurance. A Civil penatly will be assessed for Liability Insurance HSC 1569.605 at $100/day X 8 days from 3/04 - 3/11/2026 for $100/day X 8 days = $800. Total assessed is $1600.

The following deficiencies are being cited per Title 22 Division 6 of the California Code of Regulations.

An exit interview was conducted with Licensees Maricel Nepomuceno and Allen Medina and a copy of this report was given to the facility along with a copy of the LIC 809-D, LIC 421-FCs and Appeal Rights.