Facility Evaluation Report

On 06/12/2026, Licensing Program Analyst (LPA) K. Kaur arrived unannounced at the above facility to conduct an Annual Inspection. LPA introduced self, stated the purpose of the visit, and was granted entry to the facility by staff. Staff contacted Licensee Jose Pira, who arrived a short time later.

All pathways, entrances and exits were clear from obstructions. LPA toured four resident bedrooms which were observed to be furnished with required furniture and adequate lighting. 1 resident was present during inspection; 3 were at day program. Linen supply is kept in the hallway closet. Cleaning supplies and chemicals are kept locked in laundry room. Medications are kept locked in the Kitchen cabinet. LPA observed a 7-day supply of non-perishable foods and a 2-day supply of perishable foods. Freezer temperature was maintained at 0 degrees F and refrigerator temperature was maintained at 30 degrees F. Fire extinguisher in kitchen was last serviced on 3/25/2025 and was fully charged. Tour continued to the living room which has sufficient seating. Residents have their own specialized wheelchairs that are used while in the living room. Carbon Monoxide and smoke alarm detectors were observed operational. LPA observed covered patio area in the back of the facility. Fire drill conducted 3/13/2026. LPA reviewed resident’s medication with the MARs and Centrally Stored Log. Resident's records contained signed Admission Agreement, Personal Rights. Staff files were reviewed for good health. Staff files had First Aid training. LPA observed all residents to be above age 60 and in need of age exceptions. Residents Physician's Assessment Reports were 3 to 4 years old.

Deficiencies is being cited on the attached 809D in accordance with California Code of Regulations, Title 22, Division 6.