Facility Evaluation Report

On this day, Licensing Program Analyst (LPA) Andrea Mendivil conducted an unannounced Plan of Correction (POC) visit to follow up on deficiencies cited on 09/23/2025. LPA was greeted and granted entry into the facility and explained the reason for the visit.

LPA Mendivil observed the following: Deficiency cited under Title 22 Regulation Health & Safety Code 1569.605 pertaining to the facility retaining liability insurance. Licensee emailed LPA a copy on 10/3/2025 at 8:25am.

Deficiency cited under Title 22 87458 (c ) (1) (A) pertaining to medical assessment including an examination of TB. Licensee has complied with POC as Licensee emailed document to LPA at 9:20am on 10/3/2025.

Deficiency cited under Title 22 87463 (a) pertaining to appraisals. Licensee has NOT complied with POC as Licensee emailed 2 out of 5 appraisals to LPA on 10/3/2025. . CIVIL PENALTY ASSESSED.

Deficiency cited under Title 22 87463 (h) (1) pertaining to documentation of an annual routine visit. Licensee has complied with POC as physician reports were emailed to LPA at 8:30am on 10/3/2025.

Deficiency cited under Title 22 87412 (a) (11) pertaining to health screenings for staff. Licensee has complied with the POC. Licensee emailed copies of health assessments for staff at 8:33am on 10/3/2025.

Deficiency cited under Title 22 87468 (c ) (2) (A) pertaining to PUB 475. Licensee has NOT complied with POC. CIVIL PENALTY ASSESSED.

Deficiency cited under Title 22 87057 ( c) pertaining to admission agreements are signed by facility and resident/ resident representatives. Licensee has NOT complied with the POC. CIVIL PENALTY ASSESSED.