Deficiencies (last 6 years)
Deficiencies (over 6 years)
4.7 deficiencies/year
Deficiencies are regulatory violations found during state inspections.
18% worse than California average
California average: 4 deficiencies/yearDeficiencies per year
16
12
8
4
0
Occupancy
Latest occupancy rate
98% occupied
Based on a March 2026 inspection.
Occupancy rate over time
Inspection Report
Annual Inspection
Census: 52
Capacity: 53
Deficiencies: 1
Date: Mar 26, 2026
Visit Reason
An unannounced annual inspection was conducted to evaluate compliance with licensing requirements at the assisted living facility.
Findings
The facility was generally clean, safe, and well-maintained with proper furnishings and safety measures. However, deficiencies were noted related to broken or ripped window screens in some resident rooms and the second floor dining room.
Deficiencies (1)
CCR 87303(a) Maintenance and Operation: Resident rooms and the second floor dining room had window screens in disrepair, posing a potential health, safety, or personal rights risk to persons in care.
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Juliet Pacaldo | Administrator | Met with Licensing Program Analyst during inspection and discussed findings. |
| Komal Curley | Licensing Program Analyst | Conducted the inspection and authored the report. |
| April Cowan | Licensing Program Manager | Named in the report as Licensing Program Manager. |
Inspection Report
Complaint Investigation
Census: 49
Capacity: 53
Deficiencies: 1
Date: Jan 13, 2026
Visit Reason
The visit was an unannounced case management follow-up on an incident that occurred on 2026-01-01 involving a resident who left the facility unsupervised and was missing.
Complaint Details
The visit was complaint-related, following an incident where Resident 1 eloped from the facility on 2026-01-01. The resident is still missing. The complaint was substantiated with a deficiency cited and a civil penalty assessed.
Findings
The facility failed to provide adequate care and supervision to Resident 1, who left the facility without staff awareness and has not returned, posing an immediate health and safety risk. A deficiency was cited and a civil penalty of $250.00 was assessed for a repeat violation.
Deficiencies (1)
CCR 87464(f)(1) Basic services shall include care and supervision. Resident 1 left the facility unassisted and staff were unaware, posing an immediate health and safety risk.
Report Facts
Civil penalty amount: 250
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Paula Madrigal | Assistant Administrator | Interviewed during the visit regarding Resident 1's elopement |
| Komal Curley | Licensing Program Analyst | Conducted the inspection visit |
| April Cowan | Licensing Program Manager | Named in report as Licensing Program Manager |
Inspection Report
Follow-Up
Census: 51
Capacity: 53
Deficiencies: 1
Date: Nov 19, 2025
Visit Reason
The visit was an unannounced case management follow-up on an incident that occurred on 10/24/25 involving a resident leaving the facility unassisted.
Findings
The facility failed to prevent a resident from leaving unassisted despite staff awareness, and night shift caregivers did not call 911 when the resident did not return, posing an immediate health and safety risk. A deficiency was cited and a civil penalty of $1,000 was assessed for a repeat violation.
Deficiencies (1)
CCR 87464(f)(1) Basic services shall include care and supervision. Resident 1 left the facility unassisted on 10/23/25 despite staff awareness, and night shift caregivers did not call 911 when the resident did not return, posing an immediate health and safety risk.
Report Facts
Civil penalty amount: 1000
Repeat violation count: 3
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Gabriel Mendoza | Assistant Administrator | Met with Licensing Program Analyst during inspection and involved in incident report |
Inspection Report
Complaint Investigation
Census: 50
Capacity: 53
Deficiencies: 0
Date: Nov 12, 2025
Visit Reason
The visit was an unannounced case-management inspection related to an incident where a resident left the facility without signing out and did not return overnight.
Complaint Details
The investigation was triggered by a complaint regarding Resident 1 leaving the facility unassisted and not returning overnight. The complaint remains under further investigation with no substantiation status provided.
Findings
The resident left the facility unassisted despite physician restrictions and was later found at a medical center. Documentation showed staff awareness of the resident's absence and instructions to call police if the resident did not return, but there was no evidence police were contacted. Further investigation is required.
Report Facts
Capacity: 53
Census: 50
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Gabriel Mendoza | Assistant Administrator | Interviewed during the inspection and provided information about the incident |
Inspection Report
Complaint Investigation
Census: 50
Capacity: 53
Deficiencies: 2
Date: Nov 12, 2025
Visit Reason
An unannounced case-management visit was conducted in relation to an incident on 2025-09-24 where Resident 1 (R1) was found outside the facility unassisted, raising concerns about supervision and safety.
Complaint Details
The complaint investigation was substantiated as the facility failed to prevent Resident 1 from eloping despite known wandering behavior and inadequate door alarm systems.
Findings
The facility failed to provide adequate care and supervision to R1, a resident with dementia and wandering behavior, resulting in R1 eloping from the facility unnoticed. Several exit doors lacked alarms or had alarms turned off, posing immediate health and safety risks.
Deficiencies (2)
CCR 87464(f)(1): The facility failed to provide necessary care and supervision to R1, who eloped from the facility unassisted despite being identified as a wanderer with dementia. Staff did not observe R1 leaving, creating an immediate health and safety risk.
CCR 87705(d): The facility failed to ensure exit doors had functioning auditory alarms to monitor residents at risk of elopement. Observations found 3 doors without alarms, 3 with alarms turned off, and 1 non-working alarm, posing immediate health and safety risks.
Report Facts
Civil penalty amount: 1000
Number of exit doors without alarms: 3
Number of exit doors with alarms turned off: 3
Number of exit doors inspected: 11
Staff on duty during incident: 6
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Gabriel Mendoza | Assistant Administrator | Interviewed during inspection and involved in incident review |
| Komal Curley | Licensing Program Analyst | Conducted the inspection and authored the report |
| April Cowan | Licensing Program Manager | Oversaw licensing program and review |
Inspection Report
Complaint Investigation
Census: 53
Capacity: 53
Deficiencies: 1
Date: Sep 3, 2025
Visit Reason
The visit was an unannounced complaint investigation triggered by an allegation that the facility has pests, specifically mice and mice droppings in residents' bedrooms and drawers.
Complaint Details
The complaint was substantiated based on observations, record review, and interviews. The facility had mice and mice droppings in resident rooms despite weekly pest control visits. The pest problem was linked to a three-week lapse in trash service.
Findings
The investigation substantiated the complaint that the facility has pests despite weekly pest control services. The facility did not ensure it was free from pests, posing an immediate health and safety risk to residents. A civil penalty was assessed for a repeat citation related to personal rights of residents.
Deficiencies (1)
CCR 87468.1(a)(2) Personal Rights of Residents in All Facilities: The facility failed to provide safe, healthful, and comfortable accommodations as pests were present due to lack of trash service for three weeks and ineffective pest control measures.
Report Facts
Civil penalty amount: 250
Capacity: 53
Census: 53
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Paula Madrigal | Administrator | Met with Licensing Program Analyst during the complaint investigation. |
| Komal Curley | Licensing Program Analyst | Conducted the complaint investigation visit. |
Inspection Report
Complaint Investigation
Census: 51
Capacity: 53
Deficiencies: 0
Date: Aug 26, 2025
Visit Reason
An unannounced complaint investigation visit was conducted in response to allegations that staff did not seek medical attention for a resident and that staff mismanaged the resident's medications.
Complaint Details
The complaint investigation was unsubstantiated. Allegations included failure to seek medical attention for a resident in pain and mismanagement of medication dosage documentation. The resident refused medical attention, and medication was administered correctly despite documentation errors.
Findings
The investigation found that the resident did not notify staff of pain despite being in pain for approximately six days, and staff checked on the resident when notified by a third party. The medication dosage for Olanzapine was incorrectly documented in the electronic system but was administered correctly as prescribed. The allegations were determined to be unsubstantiated due to lack of preponderance of evidence.
Report Facts
Capacity: 53
Census: 51
Olanzapine dosage incorrect documentation: 40
Olanzapine correct dosage: 2.5
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Komal Charitra | Licensing Program Analyst | Conducted the complaint investigation |
| Paula Madrigal | Administrator | Met with Licensing Program Analyst during the investigation |
Inspection Report
Complaint Investigation
Census: 48
Capacity: 53
Deficiencies: 0
Date: Jun 5, 2025
Visit Reason
The visit was an unannounced case management inspection conducted in relation to an incident that occurred on 2025-05-26 involving inappropriate behavior between two residents.
Complaint Details
The complaint involved an incident where Resident 1's hand was inside Resident 2's clothes. Resident 3 witnessed the event. Resident 1 denied touching Resident 2. Resident 2 has dementia and inappropriate behaviors. Staff intervened immediately and redirected the residents. No further incidents occurred since the date of the incident.
Findings
The investigation found that Resident 1's hand was inside Resident 2's clothes but no injury or distress was observed. Resident 1 denied the behavior, and staff intervened promptly. No citations were issued and in-service training was provided to staff.
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Gabriel Mendoza | Assistant Administrator | Met with Licensing Program Analyst during the visit and provided information about the incident. |
| Komal Charitra | Licensing Program Analyst | Conducted the unannounced case management visit and investigation. |
| April Cowan | Licensing Program Manager | Named in the report as Licensing Program Manager. |
Inspection Report
Complaint Investigation
Census: 51
Capacity: 53
Deficiencies: 0
Date: May 14, 2025
Visit Reason
An unannounced complaint investigation visit was conducted in response to an allegation that staff touched a resident inappropriately.
Complaint Details
The complaint alleged that Staff 1 inappropriately touched Resident 1's private parts during diaper changes. Interviews with residents and staff, and review of records, found no witnesses to the first two incidents and denial of the allegation by involved staff. The allegation was unsubstantiated.
Findings
The investigation found no evidence to prove or disprove the allegation of inappropriate touching by staff. The allegation was determined to be unsubstantiated due to lack of preponderance of evidence.
Report Facts
Capacity: 53
Census: 51
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Komal Charitra | Licensing Program Analyst | Conducted the complaint investigation |
| Gabriel Mendoza | Assistant Administrator | Met with investigator during the visit |
| Juliet Pacaldo | Administrator | Facility administrator named in report header |
Inspection Report
Census: 51
Capacity: 53
Deficiencies: 0
Date: May 14, 2025
Visit Reason
An unannounced case management visit was conducted to follow up on an incident reported on 2025-05-01 involving a staff member receiving cash from a resident to fix the resident's bed.
Findings
The investigation found that the resident's bed was broken and took three days to be fixed by a third-party vendor. The resident insisted on paying a staff member to fix the bed, but the staff member returned the money as they could not fix it. The bed was observed to be fixed and in good working condition. No citations were issued during the visit.
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Gabriel Mendoza | Assistant Administrator | Met with during the visit and involved in the incident investigation. |
| Komal Charitra | Licensing Program Analyst | Conducted the unannounced case management visit. |
Inspection Report
Census: 48
Capacity: 53
Deficiencies: 0
Date: Apr 16, 2025
Visit Reason
An unannounced case-management visit was conducted to follow up on an annual inspection that occurred on 2025-03-27.
Findings
The visit included a facility tour and review of changes in room use from resident rooms to staff rooms. No citations were issued during the visit, but the facility was reminded to submit an updated floor plan to the licensing agency.
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Gabriel Mendoza | Assistant Administrator | Met with Licensing Program Analyst during the inspection visit. |
Inspection Report
Annual Inspection
Census: 44
Capacity: 53
Deficiencies: 5
Date: Mar 27, 2025
Visit Reason
The inspection was an unannounced annual visit conducted to evaluate compliance with licensing requirements at the assisted living facility.
Findings
The facility was generally clean and well-maintained, but several deficiencies were observed including unsigned admission agreements, presence of flies in the kitchen area, excessively high water temperature, maintenance issues such as a broken hot water faucet and door disrepair, and medication storage concerns with keys left on the medication room door.
Deficiencies (5)
CCR 87507(c) Admission agreements were not signed by the resident or responsible party in 2 of 5 reviewed records, posing an immediate health, safety, or personal rights risk.
CCR 87555(b)(27) Flies were observed outside and inside the kitchen with no barriers preventing their entry, posing an immediate health, safety, or personal rights risk.
CCR 87303(e)(2) Water temperature throughout the facility measured between 130-135 degrees F, exceeding the allowed maximum and posing a potential health, safety, or personal rights risk.
CCR 87303(a) The door near the kitchen was in disrepair, a hot water faucet in a resident's room was broken, and a chemical storage room had no door knob and a hole in the wall secured only by a tie, posing potential health, safety, or personal rights risks.
CCR 87465(h)(2) Medication was stored in a nurses' station with the key attached to the door knob and no staff present, posing an immediate health, safety, or personal rights risk. A civil penalty of $250 was assessed for a repeat violation.
Report Facts
Civil penalty amount: 250
Resident records reviewed: 5
Staff records reviewed: 5
Water temperature range: 130
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Juliet Pacaldo | Administrator | Met with Licensing Program Analyst during inspection |
| Komal Charitra | Licensing Program Analyst | Conducted the inspection and authored the report |
| April Cowan | Licensing Program Manager | Named in report as overseeing licensing program |
Inspection Report
Complaint Investigation
Census: 51
Capacity: 53
Deficiencies: 1
Date: Feb 11, 2025
Visit Reason
An unannounced case management visit was conducted regarding an incident on January 29, 2025, where a resident eloped from the facility and was found injured.
Complaint Details
The visit was complaint-related due to an incident where Resident 1 eloped from the facility on January 29, 2025. The complaint was substantiated as the facility failed to provide required supervision.
Findings
The facility failed to provide adequate care and supervision to Resident 1, who eloped from the facility unsupervised and suffered a fall while in a wheelchair. A deficiency was cited and a civil penalty assessed for a repeat violation.
Deficiencies (1)
CCR 87464(f)(1) Basic services require care and supervision. The facility failed to provide necessary supervision to Resident 1, who left the facility unassisted and without staff escort, resulting in injury.
Report Facts
Civil penalty amount: 1000
Repeat violation date: Oct 30, 2024
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Paula Madrigal | Administrator | Met with Licensing Program Analyst during inspection and discussed incident |
| Komal Charitra | Licensing Program Analyst | Conducted the unannounced case management visit |
Inspection Report
Complaint Investigation
Census: 51
Capacity: 53
Deficiencies: 3
Date: Jan 17, 2025
Visit Reason
Unannounced complaint investigation visit conducted in response to multiple allegations including pest infestation, unkempt and malodorous facility conditions, inadequate laundry service, and resident dignity concerns.
Complaint Details
The complaint investigation was substantiated for pest infestation, unkempt and malodorous conditions, and inadequate laundry services. The allegation that a resident was not accorded dignity and respect was unsubstantiated due to lack of sufficient evidence.
Findings
The investigation substantiated allegations of pest infestation, unclean and malodorous conditions, and inadequate laundry services. One allegation regarding lack of resident dignity was unsubstantiated due to insufficient evidence. Observations included cockroaches on resident food and belongings, mice sightings, strong urine odor, and dirty laundry accumulation.
Deficiencies (3)
CCR 87468.1(a)(2) Personal Rights of Residents: Facility failed to provide safe, healthful, and comfortable accommodations as evidenced by pest infestation including cockroaches and mice despite bi-monthly pest control services.
CCR 87303(a) Maintenance and Operation: Facility was not clean, safe, sanitary, or in good repair as evidenced by urine odor, dirty towels, mouse traps, and clutter in resident's room.
CCR 87307(a)(3)(C) Personal Accommodations and Services: Facility failed to provide adequate clean linen and laundry services as evidenced by large bags of dirty clothing and towels and delayed delivery of clean laundry to resident.
Report Facts
Capacity: 53
Census: 51
Pest control visits: 2
Laundry frequency: 2
Laundry frequency: 7
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Paula Madrigal | Administrator | Met during investigation and named in findings discussion |
| Komal Charitra | Licensing Program Analyst | Conducted the complaint investigation visit |
Inspection Report
Complaint Investigation
Census: 53
Capacity: 53
Deficiencies: 2
Date: Dec 26, 2024
Visit Reason
The visit was an unannounced complaint investigation triggered by allegations of staff mismanaging resident's medication and failing to ensure centrally stored medication was inaccessible to residents.
Complaint Details
The complaint investigation was substantiated. Allegations included staff mismanaging medication by listing incorrect dosages and failing to secure centrally stored medications. The investigation confirmed medication list inaccuracies and unsecured medications accessible to residents.
Findings
The investigation substantiated that the facility failed to maintain accurate medication lists matching doctor's orders and did not secure centrally stored medications, leaving them accessible to residents. These deficiencies posed potential health and safety risks.
Deficiencies (2)
CCR 87465(h)(2): Centrally stored medicines were not kept in a safe and locked place, as medications were found unlocked and accessible to residents in the nursing station. This poses an immediate health and safety risk.
CCR 87465(h)(6)(C): The facility failed to maintain accurate records of centrally stored prescription medications, as the medication administration record and medication list did not match the doctor's orders for a resident's Trazodone dosage.
Report Facts
Capacity: 53
Census: 53
Civil penalty: 250
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Juliet Pacaldo | Licensee/Administrator | Named in relation to findings and discussions during the complaint investigation |
| Paula Madrigal | Administrator | Met with Licensing Program Analyst during investigation |
| Komal Charitra | Licensing Program Analyst | Conducted the complaint investigation visit |
| April Cowan | Supervisor | Supervisor overseeing the investigation |
Inspection Report
Plan of Correction
Census: 50
Capacity: 53
Deficiencies: 1
Date: Nov 12, 2024
Visit Reason
The visit was an unannounced plan of correction (POC) inspection to verify that the facility corrected a previously issued citation regarding medication security.
Findings
The facility was found to be in compliance with the citation issued on 2024-10-30 for unlocked and accessible medications. Medication carts were observed locked and inaccessible, and security measures such as locked gates and new door locks were in place.
Deficiencies (1)
CCR 87465(h)(2) citation for unlocked and accessible medications was corrected. Medication carts were locked and inaccessible during the visit.
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Judith MaCalisang | General Manager | Met with Licensing Program Analyst during the inspection and discussed the plan of correction. |
Inspection Report
Complaint Investigation
Census: 51
Capacity: 53
Deficiencies: 1
Date: Oct 30, 2024
Visit Reason
An unannounced complaint investigation visit was conducted due to an allegation that staff did not ensure centrally stored medication was locked and inaccessible to residents.
Complaint Details
The complaint was substantiated based on observations and interviews. The allegation was that staff did not ensure centrally stored medication was locked and inaccessible to residents.
Findings
The investigation substantiated that medication carts on both the first and second floors were unlocked and accessible to residents, with medication bottles and pills observed unsecured. The medication cart on the second floor was in disrepair and could not be locked, posing an immediate health risk.
Deficiencies (1)
CCR 87465(h)(2) requires centrally stored medicines to be kept in a safe and locked place inaccessible to unauthorized persons. Medication carts on both floors were unlocked and accessible to residents, with medication unsecured on top, posing an immediate health risk.
Report Facts
Capacity: 53
Census: 51
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Komal Charitra | Licensing Program Analyst | Conducted the complaint investigation visit |
| Paula Madrigal | Administrator | Met with the Licensing Program Analyst during the investigation |
Inspection Report
Follow-Up
Census: 51
Capacity: 53
Deficiencies: 1
Date: Oct 30, 2024
Visit Reason
The visit was an unannounced case management follow-up on an incident that occurred on 2024-10-19 involving a resident leaving the facility unassisted.
Findings
The facility failed to provide adequate supervision resulting in a resident leaving unassisted and staff not knowing the resident's whereabouts until the next day. An immediate civil penalty was assessed for absence of supervision.
Deficiencies (1)
CCR 87464(f)(1) Basic services shall include care and supervision. The facility failed to provide supervision, allowing a resident to leave unassisted and staff failed to check if the resident returned, posing immediate health risks.
Report Facts
Immediate Civil Penalty: 500
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Paula Madrigal | Administrator | Met with Licensing Program Analyst during inspection and involved in incident discussion |
| Komal Charitra | Licensing Evaluator | Conducted the inspection and authored the report |
| April Cowan | Supervisor | Supervisor overseeing the inspection |
Inspection Report
Complaint Investigation
Census: 53
Capacity: 53
Deficiencies: 1
Date: Oct 14, 2024
Visit Reason
The inspection was an unannounced case-management visit related to an incident involving Resident 1 who left the facility unescorted to a doctor's appointment and was later reported missing.
Complaint Details
The visit was triggered by a complaint regarding Resident 1 leaving the facility unescorted despite having Mild Cognitive Impairment. The facility was found noncompliant for failing to provide required supervision and timely notification of the missing resident.
Findings
The facility failed to ensure Resident 1, who has Mild Cognitive Impairment and requires assistance, was escorted to the doctor's appointment and failed to check on the resident's safety after the appointment. Additionally, the facility delayed notifying the police after noticing the resident was missing.
Deficiencies (1)
CCR 87464(f)(1) Basic services require care and supervision. The facility failed to escort Resident 1 to the doctor's appointment and did not immediately notify authorities when Resident 1 was missing.
Report Facts
Capacity: 53
Census: 53
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Paula Madrigal | Administrator | Met during inspection and interviewed regarding incident |
| Komal Charitra | Licensing Program Analyst | Conducted the inspection |
| April Cowan | Supervisor | Supervisor overseeing the inspection |
Inspection Report
Follow-Up
Census: 53
Capacity: 53
Deficiencies: 0
Date: Sep 10, 2024
Visit Reason
The visit was a follow-up case management inspection related to an incident reported on August 8, 2024, involving alleged physical abuse of a resident by staff.
Complaint Details
The complaint involved an allegation that staff bent a resident's fingers and slapped the resident's face. The allegation was denied by the staff member and not substantiated by witness statements or physical assessment.
Findings
The investigation found no physical abuse substantiated as there were no bruising, swelling, or complaints of pain. Staff training records were up to date and additional abuse training was provided after the incident. No deficiencies were issued during this visit.
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Paula Madrigal | Administrator | Met with Licensing Program Analyst during the visit and provided additional abuse training. |
| Komal Charitra | Licensing Program Analyst | Conducted the follow-up case management visit. |
Inspection Report
Follow-Up
Census: 50
Capacity: 53
Deficiencies: 0
Date: Aug 20, 2024
Visit Reason
The visit was an unannounced case management follow-up on an incident reported by the facility involving alleged staff misconduct.
Complaint Details
The visit was triggered by a report that on August 8, 2024, staff bent a resident's fingers and slapped the resident's face. No deficiencies were cited.
Findings
No deficiencies were cited during the visit. The Licensing Program Analyst collected documents and reviewed the report with the facility manager.
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Judith MaCalisang | Manager | Met with Licensing Program Analyst during the visit and discussed the incident. |
| Murial Han | Licensing Program Analyst | Conducted the unannounced case management visit. |
| April Cowan | Supervisor | Supervisor named in the report. |
Inspection Report
Complaint Investigation
Census: 50
Capacity: 53
Deficiencies: 1
Date: Jul 23, 2024
Visit Reason
The visit was an unannounced complaint investigation conducted in response to allegations that staff were not maintaining complete records for residents.
Complaint Details
The complaint was substantiated. The allegation that staff were not maintaining complete resident records was confirmed after review of MARs and interviews with staff.
Findings
The investigation found many omissions on the Medication Administration Records (MARs) for residents #1 and #2 during May and July 2024, with no explanations for missed medication administrations. The allegation was substantiated based on observations, interviews, and record reviews.
Deficiencies (1)
CCR 87465(a)(6): The facility failed to maintain complete Medication Administration Records for residents #1 and #2, posing a potential health and safety risk. The administrator/licensee must develop a plan to ensure compliance including staff education by 07/30/2024.
Report Facts
Capacity: 53
Census: 50
Plan of Correction Due Date: Jul 30, 2024
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Murial Han | Licensing Program Analyst | Conducted the complaint investigation |
| Judith MaCalisang | Manager | Assisted with the complaint investigation |
| Ivy Hautea | Medication Technician | Met with evaluator and assisted with investigation |
| Authur Santos | Medication Technician | Assisted with the complaint investigation |
Inspection Report
Complaint Investigation
Census: 50
Capacity: 53
Deficiencies: 1
Date: Jul 23, 2024
Visit Reason
The visit was an unannounced complaint investigation triggered by an allegation that staff were not ensuring a resident was taking medication as prescribed.
Complaint Details
The complaint was substantiated. The allegation was that staff were not ensuring residents took their medications as prescribed. Interviews with five residents, three of whom confirmed the issue, supported this finding.
Findings
The investigation found that staff did not ensure residents took their medications, often leaving medications on meal trays or bedside tables. This was substantiated based on interviews with residents, staff, and record reviews.
Deficiencies (1)
CCR 87411(d)(4) Personnel Requirements - Staff lacked the required knowledge to safely assist with self-administered prescribed medications. Observations and interviews confirmed staff did not ensure residents took their medications during administration times, posing immediate health and safety risks.
Report Facts
Capacity: 53
Census: 50
Plan of Correction Due Date: Jul 24, 2024
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Murial Han | Licensing Program Analyst | Conducted the complaint investigation visit |
| Judith MaCalisang | Manager | Assisted with the investigation and acknowledged medication administration issues |
| Ivy Hautea | Medication Technician | Met with the evaluator during the visit |
| Authur Santos | Medication Technician | Assisted with the investigation visit |
Inspection Report
Annual Inspection
Census: 49
Capacity: 53
Deficiencies: 0
Date: Apr 12, 2024
Visit Reason
The visit was an unannounced case management - annual continuation inspection to review resident and staff files for currency and completeness.
Findings
All reviewed resident and staff files were complete and contained the required documents. No citations were issued during the inspection.
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Juliet Pacaldo | Administrator | Met with Licensing Program Analyst during inspection and reviewed report. |
| Jaime Vado | Licensing Program Analyst | Conducted the inspection visit. |
Inspection Report
Annual Inspection
Census: 52
Capacity: 53
Deficiencies: 0
Date: Feb 26, 2024
Visit Reason
An unannounced required 1-year annual inspection visit was conducted to evaluate compliance with licensing regulations.
Findings
The facility was toured inside and outside to ensure resident safety. The kitchen, medications, emergency equipment, resident rooms, and supplies were observed to be in compliance with regulatory standards. No citations were issued.
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Juliet Pacaldo | Administrator | Met with Licensing Program Analyst during the inspection and reviewed the report. |
| Jaime Vado | Licensing Program Analyst | Conducted the inspection visit. |
Inspection Report
Census: 50
Capacity: 53
Deficiencies: 0
Date: Dec 22, 2023
Visit Reason
The visit was an unannounced case management - incident inspection in response to a possible gas leak reported to the Department on 2023-12-20.
Findings
The source of the gas leak was identified as a broken water heater component. Repairs were completed on 2023-12-21 before noon. No citations were issued and the facility had no shortages of warm water, heating, or meal preparation capability during the incident.
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Judith Macalisong | LVN | Met with Licensing Program Analyst during the visit and discussed the incident. |
| Juliet Pacaldo | Administrator | Reported the timing of repairs and was the licensee. |
Inspection Report
Complaint Investigation
Census: 52
Capacity: 53
Deficiencies: 0
Date: Dec 12, 2023
Visit Reason
The visit was an unannounced complaint investigation to examine allegations received regarding the facility's financial distress and other operational concerns.
Complaint Details
The complaint alleged the facility was in financial distress and had multiple operational issues including pests, cleanliness, feeding, privacy, disrepair, supplies, safety, equipment, and temperature. The financial distress allegation was found unfounded. The other allegations were unsubstantiated due to insufficient evidence.
Findings
The investigation found the financial distress allegation to be unfounded. Other allegations related to pests, cleanliness, resident feeding, privacy, disrepair, supplies, safety, equipment, and temperature were unsubstantiated due to lack of sufficient evidence.
Report Facts
Facility Capacity: 53
Resident Census: 52
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Jaime Vado | Licensing Program Analyst | Conducted the complaint investigation visit |
| April Pacaldo | Assistant Administrator | Met with the Licensing Program Analyst during the investigation |
Inspection Report
Complaint Investigation
Census: 50
Capacity: 53
Deficiencies: 1
Date: Apr 25, 2023
Visit Reason
The visit was a complaint investigation to evaluate deficiencies related to staff compliance with criminal record clearance requirements.
Complaint Details
The visit was complaint-related and substantiated by the finding that staff #1 lacked criminal record clearance as required.
Findings
A deficiency was found regarding staff #1 who has been employed since January 2023 without evidence of criminal record clearance. This poses an immediate health, safety, or personal rights risk to clients in care.
Deficiencies (1)
CCR 87355(e)(1): Staff #1 has not obtained required criminal record clearance prior to working in the facility. This failure poses an immediate risk to client health and safety.
Report Facts
Civil penalty amount: 500
Civil penalty duration: 5
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Audrey Jeung | Licensing Evaluator | Conducted the complaint investigation and signed the report. |
| Cara Smith | Supervisor | Supervisor named in relation to the inspection. |
Inspection Report
Complaint Investigation
Census: 50
Capacity: 53
Deficiencies: 0
Date: Apr 25, 2023
Visit Reason
The visit was an unannounced complaint investigation triggered by allegations including inadequate staff communication, unmet resident needs, disrespectful treatment, poor food service, and facility disrepair.
Complaint Details
The complaint investigation was unsubstantiated. Allegations included staff communication issues, unmet resident needs, disrespectful treatment, poor food service, and facility disrepair. No evidence was found to prove violations occurred.
Findings
Based on observations and interviews, the allegations were determined to be unsubstantiated. Staff communicate in English when clients are present, emergency signal systems were operable, and food service was adequate. There was insufficient evidence to confirm the alleged violations.
Report Facts
Capacity: 53
Census: 50
Inspection Report
Complaint Investigation
Census: 53
Capacity: 53
Deficiencies: 1
Date: Mar 13, 2023
Visit Reason
The visit was an unannounced complaint investigation to address allegations including staff medically restraining a resident, residents wandering away from the facility, and facility grounds being in disrepair.
Complaint Details
The complaint investigation was unannounced and addressed allegations of staff medically restraining a resident, residents wandering away, and facility grounds in disrepair. The allegation of disrepair was substantiated, while the others were unsubstantiated.
Findings
The investigation found the allegation of facility grounds being in disrepair substantiated due to a broken window. The allegations of staff medically restraining a resident and residents wandering away were unsubstantiated due to lack of evidence.
Deficiencies (1)
CCR 87303(a) Maintenance and Operation - The facility was not in good repair due to a broken window facing Vale Street. The facility must ensure windows and screens are maintained in good repair.
Report Facts
Capacity: 53
Census: 53
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Jaime Vado | Licensing Program Analyst | Conducted the complaint investigation |
| Juliet Pacaldo | Administrator | Facility representative met during investigation |
Inspection Report
Capacity: 53
Deficiencies: 2
Date: Jan 31, 2023
Visit Reason
An unannounced case management visit was conducted regarding the facility accepting and retaining a resident with a Stage 3 pressure sore without prior approval of an exception request.
Findings
The facility accepted and retained a resident with a Stage 3 pressure sore without department approval, violating Title 22 regulations. Citations were issued for noncompliance with regulations regarding prohibited health conditions and acceptance and retention limitations.
Deficiencies (2)
CCR 87615(a)(1): The facility accepted and retained a resident with Stage 3 pressure sores without prior department approval. A plan of correction is required to prevent future occurrences.
CCR 87455(a): The facility accepted and retained a resident without meeting acceptance and retention criteria. A plan of correction is required to prevent future occurrences.
Report Facts
Capacity: 53
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Jaime Vado | Licensing Program Analyst | Conducted the unannounced case management visit |
| Tessa Marie Yee | Facility manager met during the visit | |
| Cara Smith | Supervisor overseeing the licensing evaluation |
Inspection Report
Census: 51
Capacity: 53
Deficiencies: 0
Date: Oct 14, 2022
Visit Reason
An unannounced case management visit was conducted to investigate the death of resident R1 that occurred on 2022-10-13. The visit involved discussions with the facility administrator and manager regarding the circumstances of the death.
Findings
The death occurred off site while the resident was with a familiar visitor. The facility provided requested documents and confirmed visitation frequency. The death is under investigation by the Daly City Police Department, and no citations were issued.
Inspection Report
Complaint Investigation
Capacity: 53
Deficiencies: 0
Date: Jul 1, 2022
Visit Reason
An unannounced complaint investigation visit was conducted in response to an allegation that the facility illegally evicted a resident.
Complaint Details
The complaint alleging that the facility illegally evicted a resident was investigated and found to be unfounded, meaning the allegation was false or without reasonable basis.
Findings
The investigation found that the resident was sent to the hospital due to behavioral issues and psych holds, and the facility did not illegally evict the resident. The allegation was determined to be unfounded and dismissed.
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Jaime Vado | Licensing Program Analyst | Conducted the complaint investigation visit and delivered findings. |
| Juliet Pacaldo | Administrator | Met with the Licensing Program Analyst during the investigation. |
Inspection Report
Annual Inspection
Census: 53
Capacity: 53
Deficiencies: 0
Date: Jul 8, 2021
Visit Reason
The inspection was a required unannounced annual visit to evaluate the facility's compliance with licensing regulations.
Findings
The facility was found to be in full compliance with no deficiencies cited. Infection control practices, safety measures, staff certifications, and emergency plans were all reviewed and found satisfactory.
Inspection Report
Complaint Investigation
Census: 53
Capacity: 53
Deficiencies: 1
Date: Jul 8, 2021
Visit Reason
The inspection was an unannounced case management visit in response to an unusual incident report regarding a resident who is unable to leave the facility unassisted.
Complaint Details
The visit was triggered by a self-reported unusual incident involving a resident who eloped from the facility unassisted. The complaint was substantiated by observation and investigation.
Findings
The facility was found noncompliant with CCR 87461(a)(1) for failing to properly assess and supervise a resident who tends to wander and is not allowed to leave unassisted. The door the resident exited was alarmed but it was unclear if it was operational at the time of the elopement.
Deficiencies (1)
CCR 87461(a)(1) - The facility failed to determine the amount of supervision necessary by assessing the mental status of the resident who tends to wander and is not allowed to leave unassisted.
Report Facts
Census: 53
Total Capacity: 53
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Juliet Pacaldo | Administrator | Interviewed regarding the incident and cited in the report |
Inspection Report
Complaint Investigation
Census: 49
Capacity: 53
Deficiencies: 0
Date: Apr 8, 2021
Visit Reason
The inspection was an unannounced complaint investigation triggered by allegations received on 2021-02-01 regarding the facility's failure to ensure safe accommodations for residents, maintain the physical plant, and ensure safe working conditions for staff.
Complaint Details
The complaint investigation was unsubstantiated for failure to ensure safe accommodations and failure to maintain the physical plant. The allegation regarding safe working conditions for staff was unfounded and outside the agency's jurisdiction.
Findings
The investigation found no substantiated violations. The allegation of unsafe accommodations was unsubstantiated after interviews and review of equipment maintenance procedures. The allegation of failure to maintain the physical plant was determined unfounded after a virtual tour and interviews. The allegation regarding safe working conditions for staff was beyond the agency's jurisdiction and also determined unfounded.
Report Facts
Facility Capacity: 53
Resident Census: 49
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Juliet Pacaldo | Administrator | Interviewed during complaint investigation and involved in findings delivery |
| Murial Han | Licensing Evaluator | Conducted the complaint investigation |
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