Inspection Report Summary
Most inspections found no deficiencies, and several complaint investigations were unsubstantiated, indicating generally good compliance with regulations. The most recent report from May 1, 2025, had one minor deficiency related to staff not having up-to-date first aid and CPR certifications. Earlier reports showed some issues with staffing levels, communication, and inadequate resident activities, which were substantiated but did not result in fines or enforcement actions. The facility also had a substantiated complaint in May 2024 regarding the alert system and resident monitoring, but improvements were noted in subsequent investigations. Overall, the facility appears to be maintaining compliance with only isolated and mostly minor issues over time.
Deficiencies per Year
4
3
2
1
0
Moderate
Unclassified
Census Over Time
Census
Capacity
Inspection Report
Annual Inspection
Census: 56
Capacity: 128
Deficiencies: 1
May 1, 2025
Visit Reason
An unannounced annual required inspection visit was conducted to evaluate compliance with licensing requirements at the facility.
Findings
The facility was generally found to be clean, sanitary, and appropriately furnished with no major physical plant issues. However, a Technical Advisory was issued due to three of six staff members not having up-to-date first aid/CPR certifications.
Deficiencies (1)
| Description |
|---|
| Three of six staff members did not have the required first aid/CPR certifications up to date. |
Report Facts
Staff files reviewed: 7
Resident files reviewed: 6
Medication administration records audited: 6
Staff without up-to-date first aid/CPR certifications: 3
Fire/Disaster Drills last conducted: Apr 30, 2025
Perishable food supply: 5
Non-perishable food supply: 7
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Bernadette Allen | Licensing Program Analyst | Conducted the inspection visit. |
| Richard Pacheco | Maintenance Director | Met with Licensing Program Analyst during inspection and assisted with physical plant tour. |
| Amanda Monroy | Administrator | Met with Licensing Program Analyst and assisted with inspection; received exit interview. |
Inspection Report
Complaint Investigation
Census: 62
Capacity: 128
Deficiencies: 0
Mar 5, 2025
Visit Reason
The inspection was an unannounced complaint investigation visit conducted in response to allegations that staff do not respond timely to residents' calls for assistance, do not ensure residents are provided with planned daily activities, and do not maintain a facility activities calendar.
Findings
Based on interviews with staff and residents, review of records including staff rosters, activity calendars, and in-service trainings, and direct observations, there was insufficient evidence to substantiate any of the allegations. The staff were found to respond timely to calls, planned daily activities were provided, and the facility maintained an activities calendar. No citations were issued.
Complaint Details
The complaint alleged that staff do not respond timely to residents' calls for assistance, residents must wait up to one hour for help, planned daily activities are not provided due to lack of an activities director, and the facility does not maintain an activities calendar. Interviews with staff (S1-S4) and residents (R1-R8) mostly denied these allegations, with the majority confirming timely assistance and presence of planned activities and calendar. The investigation concluded the allegations were unsubstantiated.
Report Facts
Capacity: 128
Census: 62
Resident interviews: 8
Staff interviews: 4
Resident denials of allegation #1: 5
Resident denials of allegation #2: 7
Resident denials of allegation #3: 7
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Paloma Keitelman | Business Office Manager | Met with during investigation and participated in exit interview |
| Perry Scott | Licensing Program Analyst | Conducted the complaint investigation |
| Janae Hammond | Licensing Program Manager | Oversaw the complaint investigation |
Inspection Report
Complaint Investigation
Census: 66
Capacity: 128
Deficiencies: 0
Sep 11, 2024
Visit Reason
The inspection was conducted as a complaint investigation following allegations that the facility did not provide comfortable accommodations, quality food, and the correct refund amount.
Findings
The investigation found no evidence to support the allegations. Resident and staff interviews, as well as record reviews, indicated that noise complaints were addressed appropriately, food quality was maintained despite temporary use of Styrofoam containers, and refund amounts were correctly applied as credits to resident accounts. All allegations were unsubstantiated.
Complaint Details
The complaint investigation was unsubstantiated. Allegations included uncomfortable accommodations due to noise from pipe repairs, poor food quality linked to use of Styrofoam containers causing gout and hospitalization, and incorrect refund amounts. After interviews and document reviews, no violations were found.
Report Facts
Refund amount allegedly not reimbursed: 810
Refund amounts paid: 3853
Refund amounts paid: 3043
Resident hospitalization duration: 11
Rehabilitation duration: 28
Residents interviewed: 8
Residents living at facility Aug-Sept 2023: 4
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Regina Cloyd | Licensing Program Analyst | Conducted complaint investigation and interviews |
| Mia Nakanatzu | Executive Director II | Met with Licensing Program Analyst during investigation and exit interview |
| Ralph Balbin | Administrator | Facility administrator named in report header |
| Ulysses Coronel | Licensing Program Manager | Named as Licensing Program Manager on report |
| Paloma Keitelman | Administrator | Met with Licensing Program Analysts during initial complaint investigation |
Inspection Report
Annual Inspection
Census: 57
Capacity: 128
Deficiencies: 0
Jun 26, 2024
Visit Reason
An unannounced annual required visit was conducted to assess compliance with licensing regulations and infection control practices.
Findings
The facility was found to be sanitary, appropriately furnished, and compliant with Title 22 regulations. No deficiencies were cited during this inspection visit.
Report Facts
Licensed capacity: 128
Current census: 57
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| David España | Licensing Program Analyst | Conducted the inspection and risk assessment |
| Mia Nakamatzu | Facility staff member who accompanied the Licensing Program Analyst during the visit | |
| Stephanie Cifuentes | Licensing Program Manager | Named in report as Licensing Program Manager |
Inspection Report
Complaint Investigation
Census: 56
Capacity: 128
Deficiencies: 0
Jun 6, 2024
Visit Reason
An unannounced complaint investigation visit was conducted in response to multiple allegations received on 05/17/2024 regarding staff record-keeping, monitoring of resident condition changes, resident care related to incontinence, and restrictions on resident removal by responsible parties.
Findings
The investigation found insufficient evidence to substantiate any of the allegations. Staff and resident interviews, document reviews, and observations indicated that while some concerns were raised, there was no preponderance of evidence to prove violations occurred. All allegations were determined to be unsubstantiated.
Complaint Details
The complaint investigation addressed four main allegations: 1) staff not maintaining accurate records, 2) staff not monitoring a resident's change in condition, 3) resident left in soiled diapers for extended periods, and 4) staff not allowing resident's responsible party to remove the resident from the facility. Each allegation was investigated through interviews and document review, and all were found unsubstantiated due to lack of sufficient evidence.
Report Facts
Facility capacity: 128
Resident census: 56
Staff interviewed: 6
Residents interviewed: 6
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Felisa Shirley | Licensing Program Analyst | Conducted the complaint investigation visit and interviews |
| Stephanie Cifuentes | Licensing Program Manager | Oversaw the complaint investigation |
| Mia Nakamatzu | Executive Director | Facility representative met during the investigation |
| Ralph Balbin | Administrator | Facility administrator named in the report |
Inspection Report
Complaint Investigation
Census: 57
Capacity: 128
Deficiencies: 2
May 16, 2024
Visit Reason
An unannounced complaint investigation was conducted in response to allegations that the facility's signal system did not produce an auditory signal loud enough to summon staff and that there was a lack of supervision of residents.
Findings
The investigation substantiated both allegations. It was found that the facility's alert pendant system and phone system were not reliably summoning staff, causing delays in resident assistance. Additionally, a fall risk resident was not adequately monitored overnight, resulting in the resident waiting several hours for help after a fall.
Complaint Details
The complaint investigation was substantiated. The facility failed to provide an auditory signal loud enough to summon staff when residents pressed their medical alert pendants, and failed to adequately supervise a resident who fell during the night and waited several hours for assistance.
Severity Breakdown
Type B: 2
Deficiencies (2)
| Description | Severity |
|---|---|
| Facilities shall have signal systems which shall transmit a visual and/or auditory signal to a central staffed location or produce an auditory signal at the living unit loud enough to summon staff. This regulation was not met as staff did not ensure resident’s alert pendant signaled to staff to summon them to provide assistance. | Type B |
| Every facility shall provide basic services including monitoring the activities of residents to ensure their health, safety, and well-being. This regulation was not met as a fall risk resident was not monitored through the night. | Type B |
Report Facts
Capacity: 128
Census: 57
Deficiency count: 2
Plan of Correction Due Date: May 30, 2024
Resident wait time: 3
Resident wait time: 4
Resident wait time: 8.5
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Wendy Gibbs | Licensing Program Analyst | Conducted the complaint investigation and authored the report |
| Milca Osorio | Health and Wellness Director | Met with Licensing Program Analyst during exit interview |
| Ralph Balbin | Administrator | Named in relation to facility operations and plan of correction |
Inspection Report
Complaint Investigation
Census: 60
Capacity: 128
Deficiencies: 0
Feb 2, 2024
Visit Reason
The visit was an unannounced complaint investigation to determine whether facility staff failed to provide a resident's representative with a statement itemizing all separate charges incurred.
Findings
The investigation found no evidence to support the allegation that the facility failed to provide the resident's representative with an itemized statement of charges. The allegation was determined to be unsubstantiated after interviews, record reviews, and facility inspection.
Complaint Details
The complaint alleged that resident #1's representative was not provided with an itemized statement for a $2,000 rate increase beyond the contracted basic service rate of $6,094. The investigation reviewed the Residency Agreement, assessments, account reports, and interviewed staff. It was found that itemized charges were included in the contract and acknowledged by the resident's representative. Staff interviews and documentation did not support the allegation. The complaint was unsubstantiated.
Report Facts
Capacity: 128
Census: 60
Basic Service Rate: 6505
Basic Service Rate Discount: 1626
Personal Service Rate: 1211
Personal Service Plan Maximum Rate: 7965
Community Fee before Move-In: 5000
Total Personal Service Charges: 8402
Medication Management Charge: 1101
Chronic Condition Management Charge: 1982
Nutrition Charge: 330
Service Coordinator Charge: 110
Inspection Report
Complaint Investigation
Census: 60
Capacity: 128
Deficiencies: 0
Feb 2, 2024
Visit Reason
The inspection was an unannounced complaint investigation conducted to address allegations that staff did not issue a refund.
Findings
The investigation revealed that refunds were issued according to the terms of the signed admission agreement, and interviews with residents and staff did not support the allegation. Therefore, the complaint was unsubstantiated and no deficiencies were cited.
Complaint Details
The complaint alleged that staff did not issue a refund. The investigation found that residents R1 and R2 were refunded their community fee as per the admission agreement, and accounting mailed the remaining credit balance. Interviews with staff and residents mostly disagreed with the allegation. The complaint was determined to be unsubstantiated.
Report Facts
Residents interviewed: 6
Staff interviewed: 5
Refund amount: 500
Refund percentage: 60
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Regina Cloyd | Licensing Program Analyst | Conducted the complaint investigation |
| Ashley Fernandez | Business Manager | Met with Licensing Program Analyst during investigation and named in report |
| Mia Nakamatzu | Executive Director | Interviewed via Zoom during investigation |
| Ulysses Coronel | Licensing Program Manager | Named in report as Licensing Program Manager |
Inspection Report
Complaint Investigation
Census: 65
Capacity: 128
Deficiencies: 1
Jan 25, 2024
Visit Reason
The inspection was an unannounced complaint investigation visit conducted in response to allegations received on 07/26/2023 regarding inadequate activities for residents and prevention of residents having visitors during reasonable hours.
Findings
The investigation substantiated that staff did not provide adequate activities for residents due to staffing issues and failure to follow the community activities calendar. However, the allegation that staff prevent residents from having visitors during reasonable hours was found to be unsubstantiated.
Complaint Details
The complaint investigation was substantiated for the allegation that staff do not provide adequate activities for residents, citing staffing shortages and lack of adherence to the activity calendar. The allegation that staff prevent residents from having visitors during reasonable hours was unsubstantiated.
Severity Breakdown
Type B: 1
Deficiencies (1)
| Description | Severity |
|---|---|
| Failure to ensure that the facility has an active activity planner that all residents attend, posing a potential health and safety risk. | Type B |
Report Facts
Capacity: 128
Census: 65
Deficiencies cited: 1
Plan of Correction Due Date: Feb 2, 2024
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Jose Calderon | Licensing Program Analyst | Conducted the complaint investigation and authored the report |
| Eva M Alvarez | Licensing Program Manager | Oversaw the complaint investigation |
| Ralph Balbin | Administrator | Facility administrator involved in the investigation |
| Dimple Kamdar | Operations Director | Facility operations director interviewed during investigation |
| S1 | Facility driver and activities director interviewed regarding staffing and activities |
Inspection Report
Complaint Investigation
Census: 60
Capacity: 128
Deficiencies: 0
Jan 24, 2024
Visit Reason
The visit was an unannounced complaint investigation conducted in response to allegations received on 2023-10-05 regarding staff failing to safeguard resident's personal property and financial abuse of a resident at the facility.
Findings
The investigation included interviews with residents and staff, review of relevant documents, and facility tours. No evidence was found to substantiate the allegations of theft or financial abuse. The allegations were determined to be unsubstantiated, and no deficiencies were cited during the visit.
Complaint Details
The complaint involved two allegations: 1) staff failed to safeguard resident's personal property, including theft of items, and 2) resident was being financially abused through overcharging for services. Interviews and document reviews did not find sufficient evidence to support these allegations, resulting in an unsubstantiated status.
Report Facts
Capacity: 128
Census: 60
Number of allegations: 2
Number of residents interviewed: 6
Number of staff interviewed: 6
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Wendy Gibbs | Licensing Program Analyst | Conducted the complaint investigation visit |
| Mia Nakamatzu | Executive Director | Met with Licensing Program Analyst during investigation and exit interview |
| Ralph Balbin | Administrator | Facility administrator named in report header |
Inspection Report
Complaint Investigation
Census: 65
Capacity: 128
Deficiencies: 1
Aug 2, 2023
Visit Reason
The inspection was an unannounced complaint investigation visit conducted in response to allegations received on 07/26/2023 regarding inadequate activities for residents and prevention of residents having visitors during reasonable hours.
Findings
The investigation substantiated that the facility failed to provide adequate planned activities for residents, posing a potential health and safety risk. The allegation that staff prevent residents from having visitors during reasonable hours was found to be unsubstantiated.
Complaint Details
The complaint investigation was substantiated for the allegation that staff do not provide adequate activities for residents. The allegation that staff prevent residents from having visitors during reasonable hours was unsubstantiated based on interviews and review of residency agreements.
Severity Breakdown
Type B: 1
Deficiencies (1)
| Description | Severity |
|---|---|
| Failure to ensure that the facility has an active activity planner that all residents attend, which poses a potential health and safety risk to residents in care. | Type B |
Report Facts
Capacity: 128
Census: 65
Deficiency due date: Aug 11, 2023
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Jose Calderon | Licensing Program Analyst | Conducted the complaint investigation and authored the report |
| Dimple Kamdar | Operations Director | Interviewed during the investigation and recipient of the exit interview |
| Ralph Balbin | Administrator | Facility administrator named in the report |
Inspection Report
Complaint Investigation
Census: 62
Capacity: 128
Deficiencies: 2
Jul 25, 2023
Visit Reason
The visit was an unannounced complaint investigation conducted to investigate allegations including insufficient staff to meet residents' needs, inadequate communication with residents, failure to follow resident care plans, and delayed response to resident calls for assistance.
Findings
The investigation substantiated that the facility lacked sufficient staff and did not adequately communicate updated information to residents. However, allegations that staff were not following care plans and not responding timely to calls for assistance were unsubstantiated. The facility had staffing instability with vacancies in key positions and plans for correction were developed.
Complaint Details
The complaint investigation was substantiated for insufficient staffing and inadequate communication with residents. Allegations regarding failure to follow care plans and delayed response to calls were unsubstantiated based on resident and staff interviews and observations.
Severity Breakdown
Type B: 2
Deficiencies (2)
| Description | Severity |
|---|---|
| Facility does not have sufficient staff to meet the needs of the residents. | Type B |
| Staff are not adequately communicating with residents regarding updated information. | Type B |
Report Facts
Estimated Days of Completion: 90
Capacity: 128
Census: 62
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Mario Leon | Licensing Program Analyst | Conducted the complaint investigation and authored the report |
| Ulysses Coronel | Licensing Program Manager | Oversaw the complaint investigation |
| Mia Nakamatzu | Executive Director | Facility representative met during exit interview and report delivery |
| Dimple Kamdar | Operations Specialist | Met during complaint visit and involved in plan of correction development |
| Callie Michael | District Director of Clinical Services | Met during complaint visit |
| Ralph Balbin | Administrator | Named as facility administrator |
Inspection Report
Annual Inspection
Census: 67
Capacity: 128
Deficiencies: 1
Jun 19, 2023
Visit Reason
An unannounced annual required visit was conducted using the CARE Inspection Tool to evaluate compliance with licensing requirements and facility conditions.
Findings
The facility was found to be sanitary, appropriately furnished, and compliant with infection control practices. However, a deficiency was noted due to the absence of an administrator meeting certification or recertification requirements during the visit.
Deficiencies (1)
| Description |
|---|
| No administrator available at the facility meeting Administrator Certification or Recertification Requirements as specified in CCR 87412(d). |
Report Facts
Capacity: 128
Census: 67
Plan of Correction Due Date: Jul 3, 2023
Hot water temperature: 117.9
Hospice waiver capacity: 10
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Antonine Richard | Licensing Program Analyst | Conducted the inspection and cited deficiency |
| Julie Manzanares | Business manager met during inspection and received report | |
| Matan Burstyn | Executive Director | Joined the inspection visit |
Inspection Report
Annual Inspection
Census: 65
Capacity: 128
Deficiencies: 0
Jul 8, 2022
Visit Reason
An unannounced annual required visit was conducted with a primary focus on Infection Control measures using the CARE Inspection Tool.
Findings
The facility was found to be sanitary, appropriately furnished, and in compliance with infection control protocols. No deficiencies were cited during this inspection visit.
Report Facts
Licensed capacity: 128
Current census: 65
PPE supply: 30
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Amanda Monroy | Nurse | Met with Licensing Program Analyst during inspection and named in exit interview |
| Stephanie Cifuentes | Licensing Program Analyst | Conducted the inspection visit |
| Eva M Alvarez | Licensing Program Manager | Named in report as Licensing Program Manager |
Inspection Report
Complaint Investigation
Census: 67
Capacity: 128
Deficiencies: 0
Mar 21, 2022
Visit Reason
An unannounced complaint investigation was conducted regarding allegations that the facility did not provide adequate supervision to residents, specifically concerning Resident 1 isolating Resident 2 and soliciting funds.
Findings
Interviews with staff and residents, record reviews, and observations found no preponderance of evidence to substantiate the allegation. Residents and staff stated that Resident 1 is not isolating Resident 2 or soliciting money, and Resident 2 is engaged in other activities and aware of their rights.
Complaint Details
The complaint alleged inadequate supervision, isolation of Resident 2 by Resident 1, and solicitation of funds. The investigation found the allegation unsubstantiated due to lack of evidence.
Report Facts
Capacity: 128
Census: 67
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Jade Jordan | Licensing Program Analyst | Conducted the complaint investigation |
| Michael Cava | Licensing Program Manager | Named in report as Licensing Program Manager |
| Ralph Balbin | Administrator | Facility Administrator met during investigation |
Inspection Report
Complaint Investigation
Census: 67
Capacity: 128
Deficiencies: 0
Oct 13, 2021
Visit Reason
The visit was an unannounced complaint investigation conducted in response to a complaint received on 07/24/2020 regarding allegations of overcharging residents for unneeded services, improper resident assessments, retention of residents with unstageable pressure injuries, and retaining residents requiring a higher level of care.
Findings
The investigation included interviews with residents, staff, family members, and review of service records and facility documents. No evidence was found to support the allegations, and the complaints were determined to be unsubstantiated. No deficiencies were cited during this visit.
Complaint Details
The complaint involved four main allegations: charging residents for unneeded services, improper assessment of residents, retaining residents with unstageable pressure injuries, and retaining residents requiring a higher level of care. The investigation found no evidence to substantiate these allegations.
Report Facts
Capacity: 128
Census: 67
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Ralph Balbin | Executive Director | Met with Licensing Program Analyst during the investigation and participated in interviews |
| Ernand Dabuet | Licensing Program Analyst | Conducted the complaint investigation visit and authored the report |
| Eva M Alvarez | Licensing Program Manager | Named as Licensing Program Manager on the report |
Inspection Report
Annual Inspection
Census: 59
Capacity: 128
Deficiencies: 0
Jun 15, 2021
Visit Reason
An unannounced annual required visit was conducted with a primary focus on Infection Control measures using the new CARE Inspection Tool.
Findings
The facility was found to be sanitary, appropriately furnished, and compliant with infection control protocols. No deficiencies were cited during this inspection visit.
Report Facts
PPE supply duration: 30
Resident rooms: 92
Hospice waiver capacity: 10
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Ralph Balbin | Executive Director | Met with Licensing Program Analyst during inspection and received the report. |
| Stephanie Cifuentes | Licensing Program Analyst | Conducted the inspection and authored the report. |
| Eva M Alvarez | Licensing Program Manager | Named in the report as Licensing Program Manager. |
Inspection Report
Complaint Investigation
Census: 62
Capacity: 128
Deficiencies: 0
Feb 22, 2021
Visit Reason
The inspection was an unannounced complaint investigation initiated due to allegations that a resident sustained multiple fractures, multiple pressure injuries, and multiple falls due to lack of supervision while in care.
Findings
The investigation found no evidence to substantiate the allegations. Record reviews and interviews indicated that the resident did not sustain multiple fractures, pressure injuries, or falls while at the facility. All allegations were determined to be unsubstantiated.
Complaint Details
The complaint investigation was triggered by allegations that a resident sustained multiple fractures, multiple pressure injuries, and multiple falls due to lack of supervision. After review of hospital and facility records and interviews with staff and family, the allegations were found to be unsubstantiated.
Report Facts
Capacity: 128
Census: 62
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Ulysses Coronel | Licensing Program Analyst | Conducted the complaint investigation and delivered findings |
| Ralph Balbin | Administrator | Facility administrator interviewed during the investigation |
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