Facility Evaluation Report

Licensing Program Analyst (LPA) Michael Hood arrived at the facility unannounced on 3/26/25 to conduct a Required-1 Year Inspection utilizing the inspection tool.

LPA conducted an inspection of the care home to ensure compliance with Title 22 regulations. LPA observed five (5) apartments in Assisted Living, four (4) apartments in Memory Care, and three (3) common area bathrooms. LPA conducted interviews with four (4) residents and three (3) staff during inspection. LPA observed apartments to be properly furnished, with appropriate bedding and lighting. The bathrooms were in sanitary condition, properly maintained, and the hot water temperature was observed to be 116.6 degrees F.

LPA checked the kitchen area for the ability to prepare and store food. Care home has required (2) two-day perishable and (7) seven-day non-perishable food supply on hand. LPA observed the perimeter of the care home to be free of clutter and debris. LPA ensured that delayed egress in Memory Care was operational. Smoke detectors and carbon monoxide detectors are hard wired in the care home. Fire extinguishers are maintained and ready for emergency use. First aid kit is maintained and ready for emergency use. LPA checked medication storage and found medication to be locked away and inaccessible to the residents. LPA reviewed two (2) residents' medications, five (5) resident files and three (3) staff files. Facility has a current copy of certificate of liability insurance and LPA requested a copy.

As a result of today's visit, a deficiency is being cited per California Code of Regulations, Title 22, Division 6, Chapter 8. Deficiency is listed on the attached 809-D page. Exit interview was conducted with ED. A copy of this report and appeal rights were provided. Signature on these forms acknowledges receipt of these documents.