Facility Evaluation Report
On 04/08/2025 Licensing Program Analyst (LPA) Cheyenne Ratajczak arrived at the facility unannounced to conduct a required 1 year annual inspection. LPA met with Administrator Ruby Liu and explained the purpose of the visit.
LPA and Administrator conducted a tour of the interior and exterior of the facility. Areas toured include but not limited to six (6) private resident bedrooms, two (2) bathrooms, kitchen, dining room, common areas, and storage area. LPA observed required furniture, and lighting throughout the residents' bedrooms and facility. LPA observed food supplies of non-perishables for a minimum of seven (7) days and perishable foods for a minimum of two (2) days. Toxins, knives and medications are locked and inaccessible to residents in care. LPA observed required Licensing posters posted throughout the facility.
LPA conducted a file review of six (6) residents records. Resident records contained required documents. LPA conducted a file review of staff records. LPA observed S1 working at the facility without a fingerprint clearance.
CARE inspection tool completed and deficiencies was observed. Please see LIC 809D. Today's visit, civil penalties assessed.
LPA requested a copy of facility's liability insurance, LIC 500 and LIC 308 by Friday April 11, 2025
Exit interview conducted and copy of the report, LIC809G and appeal rights was left at the facility
Source: California Department of Social Services, Community Care Licensing. Methodology · Report a correction