Facility Evaluation Report

Licensing Program Analyst (LPA), Robert Campbell conducted a case management visit to the facility for the purpose of issuing deficiencies related to Annual Inspection on 4/20/2026. LPA Robert met with Emelinda Tuazon - Caregiver and explained the purpose of the visit and assisted LPA. LPA spoke with William Lee - Administrator over the phone to explain the purpose of the visit. William Lee/Administrator came to the facility later during the visit.

LPA toured the facility, observed, took pictures of the following physical environment Type A deficiencies, Resident#4 six (6) medications (photos taken of each medication) was unlocked in kitchen cabinet by oven the same place as the Annual on 4/20/2026, Resident#2 in Room #2 had three (3) medications unlocked sitting on the dresser (photos taken by LPA), three (3) toxins were unlocked in the kitchen under the sink cabinet (lock was broken), bathroom#1 two (2) toxins unlocked again (same as Annual on 4/20/2026) under the sink cabinet, bathroom#2 two (2) toxins (photos taken) unlocked in cabinet below sink. LPA observed three structures (LPA took photos) with staff personal belongings stored and beds not on the facility sketch and has no fire clearance. Facility will review deficiencies on the 809D document. Civil penalties will be assessed for repeated deficiencies.

LPA during interviews of Administrator, two Staff, Resident#4 was in the living room in a gerry chair as a restraint with no exception from Community Care Licensing which is a personal rights violation.LPA will cite the facility with a Type A deficiency of violating the personal rights of Resident#4. Facility will review deficiency on the 809D document.

An exit interview was conducted, and this report was discussed and provided to William Lee - Administrator.