Facility Evaluation Report

Licensing Program Analyst (LPA) Talwinder Bains arrived on 10/21/25 to conduct the post licensing inspection. LPA met with Staff, Abraham Tewelderhan and explained the purpose of today's visit.

During today's annual inspection, the Compliance and Regulatory Enforcement Tool was used. LPA reviewed three (3) residents files. LPA requested staff files for audit but they were not available. 2 staff were working at the facility without fingerprint clearance .Deficiencies were observed and cited as listed on 809-D.

LPA toured the facility to ensure the health and safety of residents in care. The areas toured included resident rooms, bathrooms, kitchen, and common areas and outside area. The food supply is within compliance, 2 days of perishable and 7 days worth of non-perishable food items. Grab bars were present at the toilet and in the shower. All exits were unobstructed. LPA checked the kitchen area for the ability to prepare and store food. 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.

Following issues were observed during today's visit: 2 staff working without fingerprint clearance , no staff's files were available for department audit, incomplete residents files, therefore citations were issued as listed on LIC809-D.

LPA requested a copy of the LIC308, LIC 500, LIC610E and current liability insurance to be sent to the Department by 10/31/25.

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.