Facility Evaluation Report

Licensing Program Analyst (LPA) Talwinder Bains arrived on 01/28/26 to conduct the annual inspection.

LPA met with Staff, Benjamin Suiugan who assisted LPA during today's inspection.

During today's annual inspection, the Compliance and Regulatory Enforcement Tool was used. LPA reviewed three (3) residents and three (3) staff files. All residents files contained the required paperwork. All required postings were observed.

LPA and staff toured the facility together to ensure the health and safety of residents in care. The areas toured included residents rooms, bathrooms, kitchen, common areas and outside area. The food supply is within compliance, 2 days of perishable and 7 days worth of non-perishable food items. All exits were unobstructed. The administrator's certificate is current. LPA checked the kitchen area for the ability to prepare and store food. Knives and Sharp objects found to be locked . LPA observed cleaning products and other toxins to be locked away. LPA observed the area used for medication to be locked and inaccessible to residents. LPA observed smoke detectors and carbon monoxide detector at the care home are operational. Fire extinguisher was serviced on 10/24/25 and was ready for emergency use .Water temperature is within compliance (115 degree F) .Inside temperature was observed to be 73 degree F.

LPA requested a copy of the LIC500, LIC610E and current liability insurance to be sent to the Department by 02/10/26.

Deficiencies were observed and cited per Title 22, CCR Regulations as listed on LIC 809-D. Civil penalties shall be assessed if facility does not comply with POC requirements which were issued today.

Exit interview conducted. Copy of this report and appeal rights were provided.