Facility Evaluation Report

Licensing Program Analyst (LPA) Talwinder Bains arrived on 11/19/25 to conduct the annual inspection. LPA met with staff, Sevrena Miller (S1) and explained the purpose of today's visit.

During today's annual inspection, the Compliance and Regulatory Enforcement Tool was used.

LPA checked the medications for four (4) residents and no errors were identified. LPA reviewed four (4) residents files and two (2) staff files.

LPA and S1 toured the facility together 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. Fire Extinguisher was last serviced on 04/06/25 and was ready for emergency use. Inside temperature was 70 degree F during visit. Facility was conducting fire and disaster drills per requirement.

Several topics were discussed. LPA requested a copy of the LIC308, LIC 500, LIC610E and current liability insurance to be sent to the Department by 11/30/25.

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.