Inspection Report
Annual Inspection
Census: 93
Capacity: 185
Deficiencies: 0
Apr 17, 2025
Visit Reason
The inspection was conducted as a subsequent annual inspection visit to complete the annual evaluation of the facility's compliance with licensing requirements.
Findings
The facility was found to be in compliance with licensing requirements with no deficiencies observed. Observations included proper safety measures, medication storage, staff training, infection control practices, and maintenance of resident records.
Report Facts
Personnel records reviewed: 5
Resident records reviewed: 8
Licensed capacity: 185
Current census: 93
Non-ambulatory residents: 20
Non-ambulatory residents: 32
Non-ambulatory residents: 33
Hospice residents limit: 8
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Diana Medina | Administrator | Facility Administrator met during inspection and mentioned in staffing and certification |
| Kimberly Ramirez | Licensing Program Analyst | Conducted the inspection and signed the report |
| Tony Vasallo | Supervisor | Supervisor named in the report |
Inspection Report
Annual Inspection
Census: 93
Capacity: 185
Deficiencies: 2
Mar 25, 2025
Visit Reason
The inspection was an unannounced required annual inspection visit conducted to assess compliance with licensing requirements and regulations.
Findings
Two Type A deficiencies were identified related to water temperature controls exceeding regulatory limits, posing immediate health and safety risks. A $250 civil penalty was issued due to a repeat violation from the previous year's annual inspection.
Severity Breakdown
Type A: 2
Deficiencies (2)
| Description | Severity |
|---|---|
| Water temperatures in sinks used for grooming were above 120 degrees F, exceeding the maximum allowed temperature. | Type A |
| Water in the laundry room sink was above 125 degrees F without warning signs indicating high temperature. | Type A |
Report Facts
Civil penalty amount: 250
Residents on hospice: 2
Licensed capacity: 185
Current census: 93
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Kimberly Ramirez | Licensing Program Analyst | Conducted the annual inspection and identified deficiencies |
| Diana Medina | Administrator | Facility administrator involved in plan of correction agreements |
| Tony Vasallo | Licensing Program Manager | Named as licensing program manager on the report |
Inspection Report
Complaint Investigation
Census: 168
Capacity: 185
Deficiencies: 0
Aug 8, 2024
Visit Reason
An unannounced complaint investigation visit was conducted regarding an allegation that staff financially abused a resident by withdrawing large amounts of money from the resident's 401k account and giving it to the facility.
Findings
The investigation found that the resident resides in an independent living accommodation and does not receive care or supervision from the facility. Based on records and interviews, the complaint was found to be unfounded and was dismissed.
Complaint Details
The complaint alleged staff financially abused a resident. The investigation was unannounced and conducted by Licensing Program Analyst Kimberly Ramirez. The complaint was found to be unfounded, meaning the allegation was false or without reasonable basis.
Report Facts
Facility capacity: 185
Census: 168
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Kimberly Ramirez | Licensing Program Analyst | Conducted the complaint investigation visit |
| Diana Medina | Administrator | Met with investigator during the visit |
| Tony Vasallo | Licensing Program Manager | Named in report as Licensing Program Manager |
Inspection Report
Annual Inspection
Census: 162
Capacity: 185
Deficiencies: 1
Apr 16, 2024
Visit Reason
The inspection was an unannounced annual visit conducted using the full Care Compliance and Regulatory Enforcement (CARE) Tools to complete the required yearly inspection of the facility.
Findings
The facility was generally found to be in good repair with adequate staffing, training, and care plans. However, a deficiency was noted where hot water temperatures in 4 out of 28 resident rooms were below the required minimum of 105 degrees Fahrenheit, posing a potential health and safety risk.
Deficiencies (1)
| Description |
|---|
| Hot water temperature in 4 resident rooms was below the required minimum of 105 degrees Fahrenheit. |
Report Facts
Residents present: 162
Total licensed capacity: 185
Resident rooms with low hot water temperature: 4
Resident rooms reviewed for water temperature: 28
Full-time staff: 167
Staff files reviewed: 8
Resident files reviewed: 8
Hospice waiver capacity: 8
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Diana Medina | Administrator | Facility administrator met during inspection and responsible for compliance |
| Erik Zaragoza | Licensing Evaluator | Conducted the inspection and authored the report |
| David Sicairos | Supervisor | Supervisor overseeing the licensing evaluation |
Inspection Report
Annual Inspection
Census: 162
Capacity: 185
Deficiencies: 0
Apr 4, 2024
Visit Reason
The inspection was an unannounced required 1-year visit to evaluate compliance with care and regulatory standards at the facility.
Findings
The inspection covered 12 CARE tool domains including infection control, physical plant safety, staffing, and resident rights. The facility was found to have adequate staffing, proper fire clearance, and clean food service areas. Due to time constraints, the annual inspection was not completed and will be continued at a later date.
Report Facts
Staff members: 167
Staff files reviewed: 8
Resident files reviewed: 8
Resident files reviewed: 8
Food supply duration: 2
Food supply duration: 7
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Diana Medina | Administrator | Facility administrator present during inspection |
| Morris Shockley | President and CEO | Facility licensee who granted entrance to inspectors |
| Erik Zaragoza | Licensing Evaluator | Conducted the inspection |
| David Sicairos | Supervisor | Supervisor overseeing the inspection |
Inspection Report
Annual Inspection
Census: 144
Capacity: 185
Deficiencies: 0
Jun 12, 2023
Visit Reason
The inspection was an unannounced required annual visit conducted using the CARE Inspection Tool to evaluate compliance with licensing requirements for the facility.
Findings
The facility was observed to be in good repair, properly furnished, and compliant with safety and infection control standards. Resident and staff files were complete and in order. No deficiencies were found during this inspection visit.
Report Facts
Residents in hospice care: 0
Resident rooms inspected: 10
Staff files reviewed: 8
Resident files reviewed: 10
Hospice waiver beds: 8
Facility buildings: 4
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Diana Medina | Administrator | Met with Licensing Program Analyst during the inspection and participated in exit interview |
| Alma Gonzalez | Licensing Program Analyst | Conducted the inspection visit |
| Wei Siew Ho | Supervisor | Supervisor overseeing the inspection |
Inspection Report
Complaint Investigation
Capacity: 185
Deficiencies: 0
Nov 29, 2022
Visit Reason
The visit was an unannounced case management inspection triggered by an incident reported on 2022-11-02 involving a resident who fell from an exterior staircase.
Findings
The investigation found no signs of neglect or lack of supervision related to the incident. No deficiencies were issued following the review of relevant medical and facility records.
Complaint Details
The complaint involved Resident #1 who lost balance and fell from an exterior staircase. The resident was independent and fully ambulatory with no cognitive impairments. The investigation concluded no neglect or supervision issues.
Report Facts
Facility capacity: 185
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Diana Medina | Administrator | Met with Licensing Program Analyst during the visit and provided information about the incident. |
| Ashley Calderon | Licensing Program Analyst | Conducted the unannounced case management visit and authored the report. |
Inspection Report
Complaint Investigation
Census: 134
Capacity: 185
Deficiencies: 0
Nov 10, 2022
Visit Reason
The visit was an unannounced case management inspection triggered by an incident reported to Licensing on 2022-11-03 involving a resident fall.
Findings
The investigation found that Resident #1, an independent resident, fell due to missing a step and sustained a Le Fort 1 level fracture. No neglect or lack of supervision was found, and no deficiencies were issued. Preventative measures such as yellow strips on steps were implemented.
Complaint Details
The complaint involved a fall incident of Resident #1 on 2022-11-01 resulting in injury. The complaint was not substantiated as no neglect or lack of supervision was found.
Report Facts
Facility capacity: 185
Resident census: 134
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Diana Medina | Administrator | Met with Licensing Program Analyst during the visit and provided information about the incident |
| Cynthia Chan | Licensing Program Analyst | Conducted the unannounced case management visit |
Inspection Report
Annual Inspection
Census: 131
Capacity: 171
Deficiencies: 0
Apr 13, 2022
Visit Reason
An unannounced Annual Required / Infection Control visit was conducted to evaluate compliance with health and safety regulations.
Findings
The facility was found to be in good repair with no observed deficiencies. Infection control practices were properly implemented, including COVID-19 protocols, PPE availability, and resident/staff health screenings.
Report Facts
PPE supply duration: 30
Facility capacity: 171
Resident census: 131
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Diana Medina | Administrator | Met with Licensing Program Analyst during inspection and participated in exit interview |
| Alma Gonzalez | Licensing Program Analyst | Conducted the inspection visit |
| Stefanie Coronel | Supervisor | Supervisor overseeing the inspection |
Inspection Report
Census: 131
Capacity: 171
Deficiencies: 0
Apr 13, 2022
Visit Reason
The visit was conducted as a Case Management visit to evaluate the facility and discuss a requested increase in capacity from 171 to 185 residents.
Findings
The facility was toured including the memory care unit, bedrooms, bathrooms, and common areas. All areas met Title 22 regulations, emergency systems were tested and working, and no deficiencies were cited during the visit.
Report Facts
Capacity increase request: 185
Current capacity: 171
Current census: 131
Fire safety inspection date: Mar 20, 2022
Non-ambulatory residents clearance: 85
Memory care units: 21
Delayed egress doors: 5
Water temperature: 116
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Diana Medina | Administrator | Met with Licensing Program Analyst and toured facility |
| Patricia Murphy | Vice President | Toured the memory care unit with Licensing Program Analyst and Administrator |
| Alma Gonzalez | Licensing Program Analyst | Conducted the announced visit and inspection |
| Stefanie Coronel | Supervisor | Supervising Licensing Evaluator |
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