Facility Evaluation Report

Licensing Program Analyst (LPA) Valeria Conway conducted an unannounced visit at the facility in conjunction with an investigation of complaint control # 29-AS-20260112144756.

During the investigation, LPA observed deficiencies unrelated to the complaint allegations.

During the physical plant tour conducted at approximately 11:00 A.M., the LPA observed Resident #1’s (R1’s) bed was equipped with full bed rails. Interviews reflected that upon R1’s admission to the facility, R1 was receiving hospice services; however, hospice services discontinued on 03/17/2023. Review of R1’s Physician’s Report dated September 3, 2025, documents an order for half bed rails for mobility assistance.

Furthermore, during the medication audit LPA observed suppositories were not stored in their original packaging, which lacked a pharmacy label identifying the resident to whom the medication was prescribed. Administrator stated that the packaging was discarded.

Pursuant to Title 22, California Code of Regulations and/or CA Health and Safety Code, the following deficiencies were cited (refer to LIC 809.) Administrator was informed that failure to correct the deficiencies may result in civil penalties.

Exit interview conducted, appeal rights discussed, and a copy of this report and appeal rights were provided.