Facility Evaluation Report

Licensing Program Analyst (LPA) Cuadra arrived unannounced to conduct a Required Annual Inspection and met with Toni Pump, back up administrator. Annual fees are current. Required postings observed.

LPA/back up administrator toured the facility inside, outside and made the following observations: Facility was a comfortable temperature with thermostat reading at 70 degrees F. Passageways were free from obstructions. Resident rooms were furnished per regulation. Water temperature in resident's bathrooms measured at 131 and 131.4 which are not within allowable range of 105 to 120 degrees F in faucets used by residents. Extra hygiene products and linens were available. Bathrooms had required bath mats and grab bars. Cleaning supplies were not accessible to residents in care. Facility has at least two days of perishable and one week of non-perishable foods. Medications were centrally stored and locked. Fire extinguisher was last inspected May 2025. Smoke and Carbon Monoxide detectors were tested during inspection and operational. Exit doors have auditory alert system that were functional at time of visit. The facility have been conducted a disaster drill within the last quarter. Medications and medication records were reviewed.

LPA initiated file review at 9:30 am. Five resident and three staff files were reviewed. All five residents medical assessments, needs appraisals/needs and services plans are updated. Staff have required First aid and CPR certificates and required additional training hours completed per regulation. Administrator Certificate for Sharita Harris 6035200740 expires on 5/27/26. Back up administrator agrees to submit updates of the following documents by 9/16/2025: Designation of Administrative Responsibility (LIC308), Personnel Report (LIC500) and Copy of Liability Insurance Certificate.

Deficiencies are cited from the California Code of Regulations (CCRs), and/or the Health and Safety Code. Failure to correct the cited deficiency, on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment. Appeal rights given. Exit interview was conducted with Back up administrator and a copy of this report was given.