Facility Evaluation Report

Licensing Program Analysts (LPA) Alviso conducted a continued annual visit, on 6/25/25, at approximately 12:30pm, and met with James Homer, Administrator.

Facility has an approved dementia plan of operation. There is an approved hospice waiver for eighteen (18) residents. Facility has an infection control plan as required. The facility has a required emergency & disaster plan. Fire clearance is approved for one hundred fourteen (114) non-ambulatory, of which six (6) may be bedridden.

LPA reviewed six (6) resident files. All files were complete.

LPA reviewed six (6) staff files. All staff had criminal record clearance as required. LPA reviewed staff training.

Per file reviews, staff S1 and S4 lack required first aid. This deficiency will be cited, 87411(C)(1) Personnel Requirements -General, see LIC809D.

California Code of Regulations, (Title 22, Division 6, Chapter 8), is being cited. Failure to correct deficiency (s) by due date (s), may result in additional deficiency citations and/or civil penalties being assessed.

Exit interview conducted with the Administrator James Homer