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 08/21/2025. LPA was greeted and granted entry into the facility and explained the reason for the visit.

*Deficiency cited under Title 22 Regulation 87555(b)(8) pertaining to Food Services has been cleared. Licensee provided proof of correction. Licensee has complied with the terms of the POC.

*Deficiency cited under Title 22 Regulation 87411(f) pertaining to Health Screen/ TB has been cleared. Licensee submitted proof of correction. Licensee has complied with the terms of the POC.

*Deficiency cited under H & S Code 1569.625(b)(2) pertaining to Staff Training has been cleared. Licensee provided proof of training. Licensee has complied with the terms of the POC.

*Deficiency cited under Title 22 Regulation 87705(f)(2) pertaining to Care of Persons with Dementia has been cleared. Licensee has provided proof of correction. Licensee has complied with the terms of the POC.

Licensee has been advised to maintain all items previously cited in compliance.

Exit interview conducted and a copy of this report was left at the facility.