Facility Evaluation Report

Licensing Program Analyst (LPA) Kimberly Lyman made an unannounced visit to the facility for the purpose of a Plan of Correction (POC) visit, based upon the deficiencies cited in LIC form 809D on 08/25/2025. LPA was greeted and granted entry into the facility and explained the reason for the visit.

*Deficiency cited under Title 22 Regulation 87307(e)(1)(A) pertaining to Heating Devices has been cleared. Licensee has removed cook top knobs. Licensee has complied with the terms of the POC.

*Deficiency cited under Title 22 Regulation 87465(h)(4) pertaining to Centrally Stored Medications has been cleared. Licensee submitted proof of correction. Licensee has complied with the terms of the POC.

*Deficiency cited under H & S Code 1569.319(a) pertaining to Internet Device has been cleared. Licensee obtained device. Licensee has complied with the terms of the POC.

*Deficiency cited under Title 22 Regulation 87608(a)(c) pertaining to Postural Supports has been cleared. Licensee has provided proof of correction. Licensee has complied with the terms of the POC.

*Deficiency cited under Title 22 Regulation 87628(a) pertaining to Diabetes has been cleared. Licensee has provided proof of correction. Licensee has complied with the terms of the POC.

*Deficiency cited under Title 22 Regulation 87303(e)(2) pertaining to Water Temperature has NOT been cleared. Water temperature measured between 131.1 and 132 degrees F. Licensee has NOT complied with the terms of the POC. CIVIL PENALTY ASSESSED.