Facility Evaluation Report

This unannounced POC inspection is being conducted by Licensing Program Analyst (LPA) Sean Haddad for the purpose of verifying correction of deficiencies issued during the Required – 1 Year Inspection conducted on October 9, 2025. LPA met with Staff #1 (S1) Flordeliza Villena and discussed the purpose of the inspection. Administrator (AD) Charesa Reyes appeared via telephone.

During the inspection, LPA and S1 toured the facility and observed the following:

Type B Violation cited under California Code of Regulations (CCR) Title 22, Section 87463(a) pertaining to multiple residents not being reappraised yearly has been cleared. The proof of correction due date was November 6, 2025. LPA followed up with AD multiple times since the proof of correction due date and did not receive proof of correction of this violation. During today’s inspection, LPA reviewed the appraisals for all four current residents and confirmed they are all current.

During the inspection, LPA and S1 observed the licensee has a full bedrail on the bed of Resident #1 (R1) who S1 and AD confirmed is not on hospice.

Based on the observations made during today’s inspection, deficiencies are being cited per Title 22 Division 6 of the California Code of Regulations. See LIC809D. Civil penalties for repeat violations are being assessed. See LIC421FC. An exit interview was conducted and a copy of this report and appeal rights was discussed with and provided to facility representative.