Facility Evaluation Report

On 11/04/25 Licensing Program Analyst (LPA ) Javina George conducted an unannounced case management deficiencies visit. LPA met with administrator Jose Ricardo Ramirez. During today's visit LPA observed the following:

LPA observed for Resident #1 (R1) to be receiving hospice services since 03/12/25, the facility does not have an approved hospice waiver, or approved exception for R1.

LPA observed for there to be two (2) smoke detectors beeping from two separate resident bedrooms. Administrator changed the batteries during LPAs visit.

LPA observed for there to be several spider webs throughout the facility on the ceiling in resident bedrooms, more specifically in the den/common area.

Additionally LPA observed for there to be a bed, mattress, boxes with various items to be stored inside the den/common area that allegedly belong to caregivers.

Deficiencies are being cited in accordance with the California Code of Regulations (Title 22, Division 6, Chapter 8) on the attached 809D.

An exit interview was conducted where a copy of this report, 809D, appeal rights and LIC9098-proof of corrections form was reviewed and provided to Jose Ricardo Ramirez, administrator.