Facility Evaluation Report

On 4/1/425 Licensing Program Analyst (LPA) Javina George made an unannounced visit to the facility to conduct a 1yr required inspection. LPA met with Administrators Anna Wilson and John Wilson where LPA explained the purpose of the visit. During today's visit LPA verified facility contact information, the facility is currently in the process of undergoing a change of ownership. The facility is licensed to have 1 bedridden resident whom resides in bedroom #11. The facility currently has (3) residents receiving hospice services.

LPA conducted a tour of the interior and exterior areas of the facility. The facility was observed to be clean and clutter free. Each resident has their own bathroom, and bedroom. LPA observed for there a rectangle shape cut out form the ceiling by the kitchen sink due to the facility getting upgraded fire sprinklers. The facility was advised by the Fire Marshall to not put the dry wall up until the final fire system inspection is completed. LPA inquired about the annual fees that are due by 4/24/25, and the payment will be mailed today per Administrator Anna.

The smoke and carbon monoxide detectors were observed to be operable. There are no pools or bodies of water on the premises. The facility is conducting drills at minimum of a quarterly basis with the last drill was completed on 4/5/25. All staff present were observed to have criminal record clearance, and to be associated to the facility. All staff CPR certification was observed to have expired in March 2025, the upcoming class is scheduled for 4/24/25. Deficiency cited. The food supply was sufficient. The medications, sharps and chemicals were observed to be locked and inaccessible to residents in care. The resident file had medical assessments, and admissions agreements. Based on today's inspection a citation will be issued in accordance with the California Code of Regulations (Title 22, Division 6, Chapter 8). An exit interview was conducted and a copy of this report, 809D, appeal rights, LIC9098-Proof of Corrections form was reviewed and provided to Anna Wilson, Administrator.