Most inspections found no deficiencies, including the complaint investigation on March 20, 2023, which was unsubstantiated, and the annual inspection on September 18, 2023, which was perfect. However, some inspections did note issues, such as an immediate safety risk in July 2021 due to unsecured medications and environmental and emergency supply concerns in July 2025. The most recent report from July 14, 2025, identified several deficiencies related to incomplete staff training, missing physician orders, and recordkeeping problems, along with initial bathroom safety issues that were later addressed. These findings suggest some challenges with documentation, staff training, and environment/safety, but no fines or enforcement actions were listed in the available reports. The facility’s record shows a mix of clean and deficient inspections without a clear pattern of improvement or decline.
Deficiencies (last 3 years)
Deficiencies (over 3 years)3 deficiencies/year
Deficiencies are regulatory violations found during state inspections.
25% better than California average
California average: 4 deficiencies/year
Deficiencies per year
86420
2021
2023
2025
Census
Latest occupancy rate83% occupied
Based on a July 2025 inspection.
This facility has shown a steady increase in demand based on occupancy rates.
An unannounced required continuation annual visit was conducted to evaluate compliance with licensing requirements at the facility.
Findings
The inspection found multiple deficiencies including incomplete annual training for three staff members, missing physician bed rail orders for three residents, incomplete Needs and Appraisal forms for all five residents reviewed, incomplete centrally stored Medication Administration Records, and missing slip mats in three bathrooms which were later provided.
Severity Breakdown
Type B: 5
Deficiencies (5)
Description
Severity
Three out of five resident records lacked a written physician order for postural support (bed rails).
Type B
Three out of three staff members did not have current required dementia care training completed.
Type B
Needs and Services Plans were incomplete for all five resident records reviewed.
Type B
Centrally stored medication records and Medication Administration Records were incomplete for all five residents.
Type B
Three out of three showers lacked slip-resistant mats at the time of initial inspection.
Type B
Report Facts
Residents interviewed: 5Staff interviewed: 1Resident files audited: 5Staff files audited: 3Deficiencies cited: 5Plan of Correction due date: Jul 22, 2025
Employees Mentioned
Name
Title
Context
Eboni Bentley
Licensing Program Analyst
Conducted the inspection and authored the report.
Lawrence Lindsey
Administrator
Facility administrator; unable to attend visit but authorized caregiver to sign.
Emelda Estrella
Caregiver
Met with Licensing Program Analyst during inspection and received report.
Lourdes Montoya
Licensing Program Manager
Named as Licensing Program Manager overseeing the inspection.
The inspection was an unannounced required 1-Year annual visit to evaluate compliance with licensing requirements using the CARE Inspection Tool.
Findings
The facility was generally sanitary, appropriately furnished, and maintained a comfortable temperature. However, deficiencies were cited for excessively high water temperatures in resident bathrooms, insufficient emergency food and water supplies, and maintenance issues with stove burners and the kitchen refrigerator.
Severity Breakdown
Type A: 1Type B: 2
Deficiencies (3)
Description
Severity
Water temperatures in three resident bathrooms measured between 132.6 to 138.2 degrees F, exceeding the allowed maximum of 120 degrees F.
Type A
Two out of four stove burners were not operational without an external ignitor and the kitchen refrigerator needed repairs.
Type B
Insufficient emergency food and water supplies in the garage; only a two-day supply of perishable food and two cases of emergency water were available, with no non-perishable emergency food supply.
The Licensing Program Analyst conducted an unannounced visit to complete an annual inspection of the facility.
Findings
The facility was found to be in compliance with all applicable regulations with no deficiencies noted. The environment was safe, well-maintained, and within capacity limits, with proper storage of medications and chemicals, operational smoke detectors, and adequate food supplies.
Unannounced complaint investigation visit conducted in response to a complaint alleging that the facility is dirty.
Findings
The Licensing Program Analyst conducted a tour, interviews, and record reviews and found the facility to be clean, in good repair, and free of odors. Seven interviews with staff and residents did not corroborate the allegation. No citations were issued, and the complaint was deemed unsubstantiated.
Complaint Details
Complaint alleging the facility is dirty was investigated and found unsubstantiated due to lack of preponderance of evidence.
Report Facts
Residents on hospice: 3Total interviews conducted: 7
Employees Mentioned
Name
Title
Context
Celine DePerio
Licensing Program Analyst
Conducted the complaint investigation visit and authored the report
Lawrence Lindsey
Administrator
Facility administrator who provided consent for staff to receive and sign report
Imelda Estrella
Caregiver
Staff on duty who received and signed the report and participated in the facility tour
Licensing Program Analyst Kimberly Lyman conducted an unannounced visit for the purpose of conducting a required annual inspection.
Findings
The facility appeared clean and sanitary with residents well cared for, but unsecured prescription and over-the-counter medications were observed in the unlocked caregiver room, posing an immediate health and safety risk.
Severity Breakdown
Type A: 1
Deficiencies (1)
Description
Severity
Unsecured prescription medications and over-the-counter medications observed in the unlocked caregiver room, posing an immediate health and safety risk to persons in care.
Type A
Report Facts
Deficiencies cited: 1Capacity: 6Census: 2
Employees Mentioned
Name
Title
Context
Kimberly Lyman
Licensing Program Analyst
Conducted the inspection and cited deficiencies
Lawrence Lindsey
Administrator
Facility administrator with certificate expiring 12/25/2021
Imelda Estrella
Caregiver
Met with LPA and involved in discussion about findings
Alisa Ortiz
Licensing Program Manager
Supervisor of the inspection
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