Inspection Report Summary
Most inspections found no deficiencies, with several complaint investigations determined to be unsubstantiated. The most recent report from June 5, 2025, cited deficiencies related to medication administration errors, hot water temperature exceeding regulatory limits, and incomplete documentation on residents’ medication self-administration abilities. Earlier reports showed some medication errors and a serious incident where a resident left the facility unassisted, posing an immediate risk, but no fines or enforcement actions were listed in the available reports. Complaint investigations generally did not substantiate allegations of abuse or neglect. The facility’s record shows some recurring issues with medication management and environment safety, with no clear overall trend of improvement or decline.
Deficiencies (last 5 years)
Deficiencies (over 5 years)
1 deficiencies/year
Deficiencies are regulatory violations found during state inspections.
75% better than California average
California average: 4 deficiencies/yearDeficiencies per year
4
3
2
1
0
Census
Latest occupancy rate
58% occupied
Based on a June 2025 inspection.
Census over time
Inspection Report
Annual Inspection
Census: 92
Capacity: 160
Deficiencies: 3
Jun 5, 2025
Visit Reason
The inspection was an unannounced Required 1-Year Annual inspection conducted to evaluate compliance with licensing requirements at the facility.
Findings
The facility was generally found to be clean, well-maintained, and compliant in many areas including resident rooms, kitchen, common areas, and emergency equipment. However, deficiencies were cited related to medication administration errors, hot water temperature exceeding regulatory limits, and incomplete documentation regarding residents' medication self-administration abilities.
Severity Breakdown
Type A: 1
Type B: 2
Deficiencies (3)
| Description | Severity |
|---|---|
| The licensee did not ensure 3 medications were correctly administered to 1 of 5 residents (R1), posing an immediate health, safety or personal rights risk. | Type A |
| Hot water temperature was measured above 120°F in 8 of 10 random rooms, exceeding the allowed range of 105°F-120°F, posing a potential health, safety or personal rights risk. | Type B |
| The licensee did not ensure R2's physician had stated in writing that the resident is able to determine and communicate his/her need for medication, while a pillbox with medication was observed in R2's room, posing a potential health, safety or personal rights risk. | Type B |
Report Facts
Residents present: 92
Total licensed capacity: 160
Rooms inspected: 10
Medication errors: 3
Rooms with hot water above 120°F: 8
Residents reviewed for medication self-administration documentation: 5
Staff personnel records reviewed: 6
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Flavio Silva | Executive Director | Met with Licensing Program Analyst during inspection and involved in plans of correction |
| Kiran Jain | Licensing Program Analyst | Conducted the inspection and authored the report |
| April Cowan | Licensing Program Manager | Oversaw the licensing program and signed the report |
Inspection Report
Census: 88
Capacity: 160
Deficiencies: 0
Apr 2, 2025
Visit Reason
The visit was an unannounced Case Management - Incident inspection regarding a death report for Resident 1 (R1) received by the department on March 25, 2025.
Findings
The inspection found that R1 had a fall on March 18, 2025, was transported to the hospital, and subsequently passed away. The facility had submitted an Unusual Incident Report timely. No deficiencies were cited during the visit.
Report Facts
Facility census: 88
Facility capacity: 160
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Flavio Silva | Executive Director | Met with Licensing Program Analyst during the inspection and provided information about the incident |
| Kiran Jain | Licensing Program Analyst | Conducted the inspection visit |
Inspection Report
Complaint Investigation
Census: 104
Capacity: 160
Deficiencies: 1
Jan 2, 2025
Visit Reason
The inspection was a Case Management – Incident visit regarding three separate incidents involving medication errors and resident falls that occurred on 12/23/2024, 12/22/2024, and 11/27/2024.
Findings
The investigation found that resident R1 was given the wrong medication and resident R2 was not given medication on 12/23/2024. Resident R3 was found with unexplained bruises on 12/22/2024, and resident R4 had multiple fall incidents reported on 11/27/2024. A deficiency was cited related to medication administration errors.
Complaint Details
The visit was complaint-related involving three incidents: medication errors on 12/23/2024, unexplained bruises on 12/22/2024, and multiple falls on 11/27/2024. The medication errors were substantiated with a cited deficiency.
Severity Breakdown
Type A: 1
Deficiencies (1)
| Description | Severity |
|---|---|
| Failure to ensure resident R1 was given the right medication and dosage on 12/23/2024 morning, and resident R2 was not given medication on 12/23/2024 morning despite MAR showing medication was given. | Type A |
Report Facts
Incidents reported: 3
Census: 104
Total capacity: 160
Plan of Correction due date: Jan 3, 2025
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Flavio Silva | Executive Director | Interviewed regarding incidents and findings |
| Kiran Jain | Licensing Program Analyst | Conducted inspection and interviews |
| April Cowan | Licensing Program Manager | Supervisor of the inspection |
| Resident Services Director | Staff member involved in medication administration during incident |
Inspection Report
Complaint Investigation
Census: 105
Capacity: 160
Deficiencies: 0
Dec 10, 2024
Visit Reason
The inspection visit was an unannounced complaint investigation triggered by a complaint received on 2023-09-11 regarding allegations that staff were not returning authorized representative's calls and did not seek timely medical care for a resident.
Findings
The investigation found both allegations to be unsubstantiated. Facility staff demonstrated they had contacted the authorized representative after an incident, and there was no proof of delay in performing CPR on the resident as alleged.
Complaint Details
The complaint involved two allegations: 1) staff not returning authorized representative's calls, and 2) staff not seeking timely medical care for a resident. Both allegations were investigated and deemed unsubstantiated due to lack of evidence supporting the claims.
Report Facts
Capacity: 160
Census: 105
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Flavio Silva | Executive Director | Met with Licensing Program Analyst during the complaint investigation |
| Komal Charitra | Licensing Program Analyst | Conducted the complaint investigation |
| Cowan April | Licensing Program Manager | Reviewed and signed the complaint investigation report |
Inspection Report
Annual Inspection
Census: 98
Capacity: 160
Deficiencies: 0
Jun 25, 2024
Visit Reason
An unannounced Required 1 Year visit was conducted to evaluate the facility's compliance with regulations.
Findings
The inspection found no deficiencies cited per California Code of Regulations, Title 22. A technical violation was provided during the visit. The facility was toured including resident bedrooms, kitchen, and safety equipment, all found in compliance.
Report Facts
Food supply duration: 2
Food supply duration: 7
Fridge temperature: 40
Freezer temperature: 0
Water temperature range: 118.9
Water temperature range: 119.8
Fire extinguisher inspection date: Jan 31, 2024
Smoke and carbon monoxide detectors inspection date: Jan 31, 2024
Last disaster drill date: May 19, 2024
Staff records reviewed: 5
Resident records reviewed: 5
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Flavio Silva | Administrator | Met with Licensing Program Analyst during inspection and discussed findings |
| Simranjit Rai | Licensing Program Analyst | Conducted the inspection visit |
Inspection Report
Complaint Investigation
Census: 88
Capacity: 160
Deficiencies: 0
Feb 29, 2024
Visit Reason
The inspection was an unannounced complaint investigation visit triggered by an allegation that staff caused an injury to a resident while in care due to abuse.
Findings
The investigation found no preponderance of evidence to prove the alleged abuse occurred. Interviews and records review indicated the resident felt safe, and staff denied any abuse. The allegation was determined to be unsubstantiated.
Complaint Details
The complaint alleged that a staff member caused an injury to a resident by applying enough pressure during a transfer to leave a bruise. Interviews with the resident and staff, as well as records review, did not substantiate the allegation.
Report Facts
Capacity: 160
Census: 88
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Grace Donato | Licensing Program Analyst | Conducted the complaint investigation visit and delivered findings |
| Byron Perryman | Administrator | Facility administrator named in the report header |
| Cathy Platon | Resident Services Director | Met with Licensing Program Analyst during the investigation |
| Jackie Jin | Licensing Program Manager | Named as Licensing Program Manager overseeing the investigation |
Inspection Report
Complaint Investigation
Census: 67
Capacity: 160
Deficiencies: 0
Apr 4, 2023
Visit Reason
The inspection was an unannounced complaint investigation visit triggered by an allegation of financial abuse of a resident.
Findings
The investigation found the complaint allegation to be unfounded after interviews with residents, staff, and a family member, and review of records. No evidence of financial abuse or theft was observed or reported by staff or residents.
Complaint Details
The complaint alleged that a resident was being financially abused. The investigation included interviews with residents R1-R6, staff S1-S9, and R1's family member FM1. Resident R1 reported fraudulent bank charges after responding to a pop-up alert, but the agency found no evidence that the facility staff were involved. The complaint was determined to be unfounded.
Report Facts
Capacity: 160
Census: 67
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| David Marrufo | Licensing Program Analyst | Conducted the complaint investigation visit |
| Kris Waluszko | Regional Vice President | Met with the Licensing Program Analyst during the investigation |
| Flavio Silva | Administrator | Facility administrator named in the report |
| Sarah Yip | Licensing Program Manager | Named as Licensing Program Manager on the report |
Inspection Report
Annual Inspection
Census: 95
Capacity: 160
Deficiencies: 0
Jun 10, 2022
Visit Reason
An unannounced infection control site visit was conducted as part of the required 1-year inspection.
Findings
The facility was found to be in compliance with infection control standards, with adequate PPE supplies, proper food storage and preparation, and clean, well-stocked restrooms. No deficiencies were cited during the visit.
Report Facts
Capacity: 160
Census: 95
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Byron Perryman | Executive Director | Met with Licensing Program Analysts during the inspection |
| Mandeep Kaur | Licensing Program Analyst | Conducted the inspection |
| David Marrufo | Licensing Program Analyst | Conducted the inspection |
| Sarah Yip | Licensing Program Manager | Named in report header |
Inspection Report
Complaint Investigation
Capacity: 160
Deficiencies: 1
Jun 10, 2022
Visit Reason
The visit was an unannounced Case Management follow-up to an incident report submitted by the facility regarding a resident who was missing from the facility but returned the same day.
Findings
A deficiency was cited because the facility did not ensure that resident R1, who is not permitted to leave unassisted, was provided necessary assistance to prevent leaving the facility unassisted, posing an immediate risk to the resident's health and safety.
Complaint Details
The visit was triggered by a complaint/incident report that resident R1 was missing from the facility on 06/02/2022 and returned the same day. The resident is not permitted to leave unassisted according to their care plan and physician's report.
Deficiencies (1)
| Description |
|---|
| Licensee did not ensure that resident R1, who cannot leave the facility unassisted, was provided the necessary assistance to ensure R1 did not leave the facility unassisted, posing an immediate risk to the health and safety of the resident in care. |
Report Facts
Capacity: 160
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Byron Perryman | Administrator | Met with Licensing Program Analysts during the visit and discussed the incident |
| David Marrufo | Licensing Program Analyst | Conducted the inspection and authored the report |
| Mandeep Kaur | Licensing Program Analyst | Conducted the inspection |
| Jackie Jin | Licensing Program Manager | Supervisor of the licensing evaluation |
Inspection Report
Complaint Investigation
Census: 94
Capacity: 160
Deficiencies: 0
Oct 12, 2021
Visit Reason
An unannounced complaint investigation was conducted following a complaint received on 08/24/2020 alleging lack of supervision resulting in residents being assaulted by another resident.
Findings
The investigation included interviews with staff and review of police and staff schedule records. The allegation was found to be unsubstantiated due to lack of preponderance of evidence, with staff denying lack of supervision and confirming timely response to the incident.
Complaint Details
The complaint alleged lack of supervision resulting in residents being assaulted by another resident. The investigation included interviews with 1 resident and 6 staff, review of police report, and staff schedules. The police report noted the case was inactive due to dementia diagnoses of involved residents. The allegation was determined to be unsubstantiated.
Report Facts
Staff on duty: 3
Staff on duty: 2
Resident census: 94
Facility capacity: 160
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Yatfai Eric Ng | Licensing Program Analyst | Conducted the complaint investigation |
| Byron Perryman | Executive Director | Met with Licensing Program Analyst during investigation |
| Sarah Yip | Licensing Program Manager | Named in report as Licensing Program Manager |
Inspection Report
Complaint Investigation
Census: 92
Capacity: 160
Deficiencies: 0
Jun 8, 2021
Visit Reason
An unannounced complaint investigation was conducted in response to an allegation that facility staff were not following a resident's dietary needs.
Findings
The investigation found that the alleged victim did not reside at the facility, and the allegation was determined to be unfounded based on interviews and record review.
Complaint Details
The complaint was investigated and found to be unfounded, meaning the allegation was false, could not have happened, and/or was without a reasonable basis.
Report Facts
Capacity: 160
Census: 92
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Yatfai Eric Ng | Licensing Program Analyst | Conducted the complaint investigation visit |
| Byron Perryman | Executive Director | Met with Licensing Program Analyst during investigation |
| Flavio Silva | Administrator | Facility administrator named in report header |
| Sarah Yip | Licensing Program Manager | Named as Licensing Program Manager overseeing the investigation |
Inspection Report
Routine
Census: 93
Capacity: 160
Deficiencies: 0
May 26, 2021
Visit Reason
An unannounced infection control site visit was conducted as part of the required 1-year routine inspection.
Findings
The facility was observed to be in sanitary condition with all staff wearing masks, adequate PPE supplies, and proper COVID-19 screening procedures in place. No deficiencies were cited during the visit.
Report Facts
Capacity: 160
Census: 93
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Byron Perryman | Executive Director | Met with Licensing Program Analyst during the inspection |
| Yatfai Eric Ng | Licensing Program Analyst | Conducted the unannounced infection control site visit |
| Sarah Yip | Licensing Program Manager | Named in the report header |
Inspection Report
Complaint Investigation
Census: 93
Capacity: 160
Deficiencies: 0
Feb 5, 2021
Visit Reason
The visit was conducted as an unannounced Case Management - Incident tele-visit to respond to an incident report received on 2021-02-03 regarding inappropriate touching of resident R1 by resident R2.
Findings
The Licensing Program Analyst interviewed the Executive Director and resident R1. R1 was placed on the first floor and R2 on the second floor with escort services to ensure safety. R1 had not seen R2 since the incident and felt safe and satisfied with the facility's services. No deficiencies were cited during the visit.
Complaint Details
The incident report alleged that resident R1 was touched inappropriately by resident R2. The case management remained open pending additional reports.
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Byron Perryman | Executive Director | Met with Licensing Program Analyst during the incident investigation. |
| Yatfai Eric Ng | Licensing Program Analyst | Conducted the unannounced Case Management - Incident tele-visit. |
| Sarah Yip | Licensing Program Manager | Named in the report as Licensing Program Manager. |
Inspection Report
Census: 91
Capacity: 160
Deficiencies: 0
Jan 8, 2021
Visit Reason
The visit was a Case Management - Other tele-visit conducted via FaceTime to provide technical assistance to prevent and mitigate the spread of COVID-19 at the facility.
Findings
The Licensing Program Analyst and Health Facilities Evaluator Nurse conducted a virtual tour of the facility and observed infection control practices. Recommendations were made to improve social distancing and staff screening. No deficiencies were cited during the visit.
Report Facts
Capacity: 160
Census: 91
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Byron Perryman | Administrator | Met with Licensing Program Analyst and Health Facilities Evaluator Nurse during the visit |
| Yatfai Eric Ng | Licensing Program Analyst | Conducted the case management tele-visit |
| Veronica Nazareth | Health Facilities Evaluator Nurse | Partnered in conducting the case management tele-visit |
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