Facility Evaluation Report

LIcensing Program Analyst (LPA) Maria (Mita) Partoza, conducted an unannounced visit to continue the facility required 1-year inspection, met with the licensee/administrator (LIC/ADM) Thelma Llanes and stated the purpose of the visit.

The purpose of today's visit is to issue citations based on the deficiencies that was observed during last visit that was conducted on 10/17/2025. Based on record review 4 out of 4 resident record is missing personal rights, 2 out of 4 has no TB on record, 2 out of 4 are missing medical assessment, 4 out of 4 are missing pre-admission appraisal forms, 1 out of 4 is missing the Centrally Stored Medication and Destruction Record (CSMDR), 4 out of 4 is missing the personal valuable list. 2 Out of 4 resident does not have an updated appraisal needs and services plan. 4 Out of 4 does not have the emergency identification sheet. 4 Out of 4 does not have the consent form to release medical information in the event of an emergency.

Based on record review LIC/ADM could not provide proof of the emergency preparedness and disaster training. 1 out of 2 does not have a 1st Aid/CPR training 1 out of 2 does not have on boarding training, 2 out of 2 have does not possess an updated training for care of residents with dementia. Last training was administered on June 2019 for facility staff.

Deficiencies were cited during today's visit based on California Code of Regulations (CCR) Title 22. See LIC9099-D. An exit interview was conducted with LIC/ADM Thelma Llanes, a copy of the report was provided.