Facility Evaluation Report

Licensing Program Analyst (LPA) Sabrina Calzada arrived unannounced to conduct a required annual inspection and met with Karen Padilla, Director of Nursing (DON), and Kayla Peria, Director of Care and Admissions. LPA stated the reason for the inspection. The facility is licensed for (78) non-ambulatory or bedridden residents and has a hospice waiver for (20) residents. Currently, there are (15) residents under hospice care. There is a separate Assisted Living Unit (ALU) and Memory Care Unit (MCU) on site.

During today's inspection, LPA and staff toured the interior and exterior of the ALU and MCU, including the dining rooms, activity areas and enclosed patios. (6) rooms were inspected in ALU and (4) rooms in MCU. Hot water temperature was taken in (2) resident rooms on each side and measured 111-112*F. The main kitchen was toured. There is sufficient 2+ day perishable and 7+ day non-perishable supply of food and a weekly menu is posted. There is a large monthly activities calendar posted in ALU and MCU. In all areas toured, there were no health and safety concerns, and the facility was observed to be clean, in good repair and odor free. The fire extinguishers were last serviced 8/25/25. All required postings are visible in the common areas. Inside temperature measured 72*F. Vehicle service records reflect regular maintenance is scheduled/completed and daily checks are done. Monthly Resident Council meeting notes were reviewed.

LPA reviewed (7) resident files and (7) staff files. Files were organized, current and complete. Medications were reviewed for (2) residents and are being administered per orders. A pharmacy audit is completed every quarter to ensure compliance. All staff is cleared/associated and is completing the required initial/ongoing training, including First Aid/CPR. Recent Dementia Care updates to be added to the Plan of Operation to reflect regulation changes made in January 2025.

There were no deficiencies observed. Exit interview. Copy of report provided.