Facility Evaluation Report

Licensing Program Analyst (LPA) Rose Ruppert arrived unannounced for a Case Management Deficiencies Visit. LPA was greeted and granted entry at 8:15am by Administrator (AD) and LPA explained the purpose of the visit.

The facility has four residents in care. One resident recently moved in on July 28, 2026 and one resident receives hospice services. LPA toured the facility and the temperature was 73 degrees Fahrenheit. LPA tested hot water temperatures in three of four bathrooms and the hot water temperature ranged from 107.0 to 109.5 degrees Fahrenheit. The facility was clean and there were no odors detected. Utilities have remained on. LPA observed the facility had two days of perishable food supplies and seven days of non-perishable food on-hand.

During the tour, LPA observed two of four residents had bed rails but did not have bedrail orders on file. A deficiency will be cited and bed rails will be removed by staff. LPA interviewed two of four residents and two of two live-in staff. At this time, staff have not been paid for the pay period of 7/1-7/15/2026 and were to be paid on July 22, 2026. Staff continued to be owed back pay. A penalty will be assessed for the dates of 7/10-7/30/2026 for the lack of a financial plan to ensure that staff receive their pay that is due, and for pay periods moving forward. The amount assessed on this date is $100 per day X 21 days = $2100. LPA spoke with Administrator regarding $1,237 of licensing fees that are due and provided documentation for facility.

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

An exit interview was conducted with Shaleemar Balingnasay, Administrator and a copy of this report was given to the facility along with a copy of the LIC 809-D, LIC421FC and Appeal Rights.