Facility Evaluation Report

On 10/25/2025 Licensing Program Analyst (LPA) M. Garza completed a case management visit. LPA met with Medical Technician, Kimberly Reyes explained reason for visit and was permitted entry into the facility. Resident Care Coordinator, Brittany Polman arrived some time later and stated the Executive Director, Mandy Rancour was unavailable. LPA completed a health and safety check on residents in care and toured the facility. Residents were observed in common areas and in rooms.

This case management visit is being conducted for deficiencies observed during complaint visits conducted for complaint #24-AS-20250605163501 on 6/10/25 and 10/25/25. The following issues were observed: gate with lock to kitchenette preventing access to food/drink and posing a tripping hazard observed in memory care. Required postings are not posted in the facility. The complaint poster for RCFE facilities (PUB 475) was not posted. Incident reports reviewed disclosed R3 had an allergic reaction on 5/14/25 and R1 had medication in their room unlocked and accessible on 5/15/25 both posing hazards to residents in care. Deficiencies cited per California Code of Regulations, Title 22. If not corrected, deficiencies cited will pose a direct impact to residents in care.

Exit interview completed with Resident Care Coordinator, Brittany Polman. A plan of correction was developed by Brittany and reviewed by LPA. A copy of this report, deficiencies and appeal rights were provided.