Inspection Report Summary
Most inspections found no deficiencies, with the facility consistently clean, well-maintained, and compliant with safety and health regulations. The most recent report from July 9, 2025, was perfect with no deficiencies noted. Earlier in 2024, one complaint investigation substantiated that staff training to administer medications was incomplete, which posed an immediate risk to resident health and safety, but other complaint allegations were unsubstantiated. A minor technical violation for an outdated resident medical assessment was also cited in mid-2024 but was promptly addressed. Overall, the facility’s record shows improvement, with recent inspections free of deficiencies and no enforcement actions or fines listed in the available reports.
Deficiencies (last 5 years)
Deficiencies (over 5 years)
0.4 deficiencies/year
Deficiencies are regulatory violations found during state inspections.
90% better than California average
California average: 4 deficiencies/yearDeficiencies per year
4
3
2
1
0
Census
Latest occupancy rate
91% occupied
Based on a July 2025 inspection.
This facility has shown a steady increase in demand based on occupancy rates.
Census over time
Inspection Report
Annual Inspection
Census: 10
Capacity: 11
Deficiencies: 0
Date: Jul 9, 2025
Visit Reason
The inspection was an unannounced required annual inspection conducted to evaluate compliance with licensing requirements for the Residential Care Facility for the Elderly.
Findings
The facility was found to be clean, in good repair, and compliant with safety and health regulations. No deficiencies or citations were issued during the visit. Medication storage, resident and staff records, and facility conditions met all requirements.
Report Facts
Resident records reviewed: 5
Staff records reviewed: 4
Fire extinguisher last inspected: Jun 3, 2024
Water temperature: 108.3
Food supply days - perishable: 2
Food supply days - non-perishable: 7
Well water system last inspected: Jun 23, 2025
Employees mentioned
| Name | Title | Context |
|---|---|---|
| James Sirokman | Administrator | Facility Administrator met with Licensing Program Analyst during inspection |
| Ethel Contreras | Licensing Program Analyst | Conducted the inspection |
| Kimberley Mota | Licensing Program Manager | Named as Licensing Program Manager on report |
Inspection Report
Complaint Investigation
Census: 10
Capacity: 11
Deficiencies: 0
Date: Sep 27, 2024
Visit Reason
The inspection was conducted unannounced regarding an incident filed on 2024-05-31.
Complaint Details
Inspection was triggered by a complaint incident filed on 05/31/2024. The staff member named in the incident report was terminated. No citations were issued.
Findings
The facility was found to be clean and well-maintained, with residents well-cared for and appropriately dressed. There were no citations issued, and the staff member named in the incident report had been terminated.
Employees mentioned
| Name | Title | Context |
|---|---|---|
| James Sirokman | Administrator | Administrator was out of town but available by phone during the inspection. |
| Heather Fish | Lead Care Staff | Met with Licensing Program Analyst during the inspection. |
| Jill Nakagawa | Licensing Program Analyst | Conducted the unannounced inspection. |
Inspection Report
Annual Inspection
Census: 10
Capacity: 11
Deficiencies: 1
Date: Jul 26, 2024
Visit Reason
An unannounced Annual Required – 1 year inspection visit was conducted to evaluate compliance with licensing regulations and facility standards.
Findings
The facility was found to be clean, safe, and compliant with regulations including fire safety, food supply, medication security, and staff training. One technical violation was issued for a resident's medical assessment needing an update. No deficiencies were cited during the visit.
Deficiencies (1)
One out of five residents (R1) needs medical assessment to be updated (technical violation issued).
Report Facts
Residents reviewed: 5
Staff files reviewed: 5
Administrator certificate expiration: 2025
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Jim Sirokman | Administrator | Met during inspection and named in report regarding facility operations and compliance |
| Marisol Cuadra | Licensing Program Analyst | Conducted the inspection visit |
| Bethany Moellers | Licensing Program Manager | Named in report as Licensing Program Manager |
Inspection Report
Follow-Up
Capacity: 11
Deficiencies: 0
Date: Jul 12, 2024
Visit Reason
The visit was an unannounced Case Management visit to clear the Plan of Correction (POC) from the previous visit on 06/03/2024.
Findings
The Licensing Program Analyst reviewed three employee files and found that training records were complete. The administrator completed the requirements for clearing the Plan of Correction. No deficiencies were cited during this visit.
Report Facts
Employee files reviewed: 3
Employees mentioned
| Name | Title | Context |
|---|---|---|
| James Sirokman | Administrator | Met with Licensing Program Analyst to discuss corrections and Plan of Correction clearance |
| Jill Nakagawa | Licensing Program Analyst | Conducted the Case Management visit and reviewed employee files |
Inspection Report
Complaint Investigation
Census: 10
Capacity: 11
Deficiencies: 1
Date: Jun 3, 2024
Visit Reason
The inspection was an unannounced complaint investigation visit triggered by allegations received on 2024-03-14 regarding staff training to administer medications, resident care practices, medication security, staff background clearance, and administrator certification.
Complaint Details
The complaint investigation was substantiated for the allegation that staff were not properly trained to administer medications. Other allegations regarding residents left in bed for extended periods, medication security, staff background clearance, and administrator certification were unsubstantiated.
Findings
The investigation substantiated that staff were not properly trained to administer medications due to incomplete training records. Other allegations including residents being left in bed for extended periods, improper medication locking, staff background clearance, and administrator certification were found to be unsubstantiated.
Deficiencies (1)
Personnel records did not include proof of staff training which is an immediate risk to the Health & Safety of residents in care.
Report Facts
Capacity: 11
Census: 10
Medications checked: 5
Staff background clearance: 10
Employees mentioned
| Name | Title | Context |
|---|---|---|
| James Sirokman | Administrator | Named in relation to administrator certification and during inspection |
| Jill Nakagawa | Licensing Program Analyst | Conducted the complaint investigation |
| Kimberley Mota | Licensing Program Manager | Oversaw the complaint investigation |
Inspection Report
Annual Inspection
Census: 8
Capacity: 11
Deficiencies: 0
Date: Aug 18, 2023
Visit Reason
An unannounced Annual Required 1-year inspection visit was conducted to evaluate the facility's compliance with licensing regulations.
Findings
The facility was found to be clean, well-maintained, and in compliance with safety and health regulations. No deficiencies were cited during the visit, though technical advisories were issued regarding medication destruction training and staff annual training plans.
Report Facts
Hospice waiver capacity: 6
Water temperature: 115.7
Water temperature: 120
Certification application date: Jul 7, 2023
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Jim Sirokman | Administrator | Met during inspection and named in relation to compliance and training plans |
| Dominic Tobola | Licensing Program Analyst | Conducted the inspection visit and authored the report |
| Kimberley Mota | Licensing Program Manager | Named as Licensing Program Manager on the report |
Inspection Report
Annual Inspection
Census: 9
Capacity: 11
Deficiencies: 0
Date: Sep 1, 2022
Visit Reason
An unannounced annual required infection control inspection was conducted to evaluate the infection control procedures and practices of the facility.
Findings
The facility was found to be clean, with proper infection control measures in place including PPE supplies, approved Covid Mitigation plan, and secure medication storage. No deficiencies or citations were found during the inspection.
Report Facts
Capacity: 11
Census: 9
Employees mentioned
| Name | Title | Context |
|---|---|---|
| James Sirokman | Administrator | Met with Licensing Program Analyst during inspection |
| Christopher Arnhold | Licensing Program Analyst | Conducted the inspection |
| Bethany Moellers | Licensing Program Manager | Named in report header |
Inspection Report
Census: 10
Capacity: 11
Deficiencies: 0
Date: Jun 28, 2022
Visit Reason
The visit was an unannounced collateral visit to review and obtain facility records concerning a former resident.
Findings
No deficiencies were cited during the visit. A walk-through of the facility was conducted and an exit interview was held with the administrator.
Employees mentioned
| Name | Title | Context |
|---|---|---|
| James Sirokman | Administrator | Met with Licensing Program Analyst during the collateral visit. |
Inspection Report
Census: 10
Capacity: 11
Deficiencies: 0
Date: Jun 23, 2022
Visit Reason
The visit was an unannounced collateral visit to review and obtain facility records concerning a former resident.
Findings
No deficiencies were cited during the visit. The Licensing Program Analyst met with a facility representative and discussed the report with the administrator by telephone.
Employees mentioned
| Name | Title | Context |
|---|---|---|
| James Sirokman | Administrator | Administrator available by telephone during the visit. |
| Tracy Vargas | Facility Representative | Met with Licensing Program Analyst during the visit and signed LIC-809 document. |
| Caitlynn Felias | Licensing Program Analyst | Conducted the unannounced collateral visit. |
| Kimberley Mota | Licensing Program Manager | Named in the report header. |
Inspection Report
Original Licensing
Census: 9
Capacity: 11
Deficiencies: 0
Date: Mar 24, 2022
Visit Reason
The inspection was a Post Licensing unannounced visit focused on Infection Control procedures and practices of the facility.
Findings
The facility was found to have appropriate infection control measures including visitor screening, PPE supplies, staff training, and environmental cleaning. No deficiencies were cited during the visit.
Report Facts
Capacity: 11
Census: 9
Employees mentioned
| Name | Title | Context |
|---|---|---|
| James Sirokman | Administrator | Met with Licensing Program Analyst during inspection |
Inspection Report
Original Licensing
Capacity: 11
Deficiencies: 0
Date: Aug 20, 2021
Visit Reason
The inspection was conducted as a Pre-Licensing visit to evaluate the facility prior to issuing a license.
Findings
The facility was found to be clean, organized, and in good repair with all required furnishings and safety features in place. No deficiencies were cited during the visit.
Report Facts
Water temperature measurements: 106.1
Water temperature measurements: 106.5
Water temperature measurements: 106.8
Facility capacity: 11
Census: 0
Employees mentioned
| Name | Title | Context |
|---|---|---|
| James Sirokman | Applicant / Future Administrator | Met during Pre-Licensing inspection and risk assessment |
| Katrina Walters | Licensing Program Analyst | Conducted the Pre-Licensing inspection |
| Hope DeBenedetti | Licensing Program Manager | Named as Licensing Program Manager on report |
Inspection Report
Original Licensing
Capacity: 11
Deficiencies: 0
Date: Aug 16, 2021
Visit Reason
Initial licensing evaluation conducted via telephone call with the applicant/administrator to verify identity and confirm understanding of Title 22 regulations and facility operation requirements.
Findings
The applicant/administrator successfully completed Component II of the licensing process, demonstrating understanding of facility operation, staff qualifications, program policies, and application document requirements.
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