Most inspections found no deficiencies, including the most recent annual inspection on October 9, 2025, which was completely clean. There was one substantiated complaint in June 2025 involving a medication management issue where timely physician orders were not obtained for two medications, resulting in a medication gap for a resident. Other complaint investigations from earlier in 2025 were unsubstantiated, including allegations about resident communication and record access. No fines, enforcement actions, or severe deficiencies were reported in any inspection. The facility’s record shows improvement, with the latest report free of deficiencies after the isolated medication management issue.
An unannounced required 1-year inspection visit was conducted to evaluate compliance with licensing requirements for the Residential Care for Elderly (RCFE) facility.
Findings
The facility was found to be in compliance with all applicable regulations, including infection control, operational requirements, physical plant safety, staffing, personnel records, resident records, food service, and disaster preparedness. No deficiencies were cited during this inspection.
The inspection was an unannounced complaint investigation visit conducted to investigate the allegation that staff were mismanaging a resident's medication.
Findings
The investigation found that staff failed to obtain timely physician orders for two medications for resident R1, resulting in a medication gap from May 17 to May 30, 2025. The allegation was substantiated based on record reviews and interviews, with no other health and safety concerns observed.
Complaint Details
The complaint alleged that the facility failed to obtain two physician orders for blood pressure medication Amlodipine 2.5 mg and antibiotic Macrobid 100 mg for resident R1. The allegation was substantiated based on evidence that staff did not document follow-up or communicate issues obtaining physician orders, and medications were not available at the facility from May 17 to May 30, 2025.
Severity Breakdown
Type A: 1
Deficiencies (1)
Description
Severity
Failure to develop and implement a plan for incidental medical and dental care, including assistance with self-administered medications, resulting in a medication gap for resident R1.
Type A
Report Facts
Capacity: 74Census: 62Deficiency count: 1Plan of Correction due date: Jun 20, 2025Staff training submission due date: Jun 23, 2025
Employees Mentioned
Name
Title
Context
Noemi Galarza
Licensing Program Analyst
Conducted the complaint investigation
Lisa Hicks
Licensing Program Manager
Named in report and responsible for oversight
Leticia Garcia
Health Services Director
Interviewed during investigation and involved in exit interview
The visit was an unannounced complaint investigation to examine the allegation that staff did not allow a resident in care to communicate with their family member.
Findings
The investigation found no health or safety concerns and determined there was insufficient evidence to substantiate the allegation that staff prevented the resident from communicating with family. Interviews with residents, staff, and family members indicated that residents have access to phone calls and staff did not prevent communication.
Complaint Details
The complaint alleged that a resident's family member was not allowed to speak to the resident due to staff following a directive from the resident's authorized representative. Interviews and record reviews showed no written document or restraining order prohibiting family contact. The allegation was unsubstantiated due to insufficient evidence.
The inspection was conducted as a complaint investigation following allegations of a questionable death of a resident and failure to provide resident records to the responsible party as necessary.
Findings
The investigation found insufficient evidence to substantiate the allegations. The resident's death was due to COVID-19 as confirmed by the death certificate, and there was no evidence that the facility failed to provide records to the authorized representative.
Complaint Details
The complaint alleged a questionable death of a 97-year-old Memory Care resident who died after being transferred to the hospital, and that the licensee did not provide resident records to the responsible party despite requests. The investigation included interviews with staff and review of records. The allegations were found unsubstantiated due to lack of evidence.
Inspection Report Original LicensingCensus: 56Capacity: 74Deficiencies: 0Sep 17, 2024
Visit Reason
The inspection was conducted as a pre-licensing evaluation following an application submitted for a Change of Ownership for a Residential Care Facility for the Elderly.
Findings
The facility was found to be in compliance with no items of correction needed. The physical plant, safety systems, food service, and staff and resident files were all inspected and found satisfactory. Fire clearance was granted for 74 residents with specific allowances for non-ambulatory and bedridden residents.
Report Facts
Capacity: 74Census: 56Hospice residents: 8Dementia unit residents: 19Fire clearance date: Jul 10, 2024Administrator certificate expiration: Aug 5, 2025Liability insurance per occurrence: 1000000Liability insurance aggregate: 3000000
Employees Mentioned
Name
Title
Context
Kimberly Sanchez
Executive Director
Met with Licensing Program Analysts during the pre-licensing evaluation and participated in exit interview
Noemi Galarza
Licensing Evaluator
Conducted the inspection and signed the report
Lisa Hicks
Supervisor
Named as supervisor on the report
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