Facility Evaluation Report

At approximately 9:35 AM Licensing Program Analyst (LPA) Stevenson arrived unannounced to CONTINUE a required 1-year annual inspection and met with Phyllicia Xiong-Assisted Living Director.

At approximately 9:45 AM LPA observed ten (10) staff files and four (4) of ten (10) staff files were missing evidence of 20 hours or training by the anniversary of the hire dates (a REPEAT- Type B citation is being issued for violation of HSC 1569.625(b)(2) and a civil penalty in the amount of $250 is being assessed) The same violation of HSC 1569.625(b)(2) occurred on 11/15/2024.

HSC 1569.625(b)(2 requires 20 hours of annual training including dementia training and training in postural supports, restricted conditions and hospice care. S ee LIC811 for details.

At approximately 11:15 AM LPA observed ten (10) random resident files from each of the three (3) assisted living buildings and determined that all 10 had the required documentation.

LPA request an updated LIC500 be sent to Community Care Licensing by 12/14/2025 to update facility file.

Deficiencies are cited from the California Code of Regulations (CCRs), and/or the Health and Safety Code. Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.

This report was reviewed with Phyllicia Xiong-Assisted Living Director and Appeal rights were giv en.