Inspection Report
Complaint Investigation
Census: 74
Capacity: 86
Deficiencies: 0
Jul 2, 2025
Visit Reason
An unannounced complaint investigation visit was conducted to investigate allegations that staff did not properly assess a resident, prevent a resident from wandering from the facility, and provide adequate care and supervision to a resident.
Findings
The investigation found that staff properly assessed the resident, prevented the resident from wandering outside the facility unattended, and provided adequate care and supervision. The allegations were determined to be unsubstantiated due to lack of preponderance of evidence.
Complaint Details
The complaint alleged staff did not properly assess Resident R1, did not prevent Resident R1 from wandering from the facility, and did not provide adequate care and supervision to Resident R1. After interviews and review of records, the allegations were found unsubstantiated.
Report Facts
Capacity: 86
Census: 74
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Linda Nguyen | Executive Director | Met with during the investigation and interviewed regarding allegations |
| James Sampair | Licensing Program Analyst | Conducted the complaint investigation |
| Harpreet Humpal | Licensing Program Manager | Named in report as Licensing Program Manager |
Inspection Report
Complaint Investigation
Census: 68
Capacity: 86
Deficiencies: 0
Apr 24, 2025
Visit Reason
An unannounced complaint investigation visit was conducted to investigate allegations that staff did not allow a resident to participate in decision making regarding their care, did not provide resident copies of their records, and did not safeguard resident's personal items.
Findings
The investigation found that the allegations were not supported by the data collected and were determined to be unfounded. Interviews and record reviews showed no evidence of the alleged issues.
Complaint Details
The complaint was investigated and found to be unfounded. Allegations included staff not allowing resident participation in care decisions, not providing copies of records, and not safeguarding personal items. The data collected did not support any of these allegations.
Report Facts
Capacity: 86
Census: 68
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Linda Nguyen | Executive Director | Met during investigation and interviewed regarding allegations |
| James Sampair | Licensing Program Analyst | Conducted the complaint investigation visit |
| Harpreet Humpal | Licensing Program Manager | Named as Licensing Program Manager on report |
Inspection Report
Annual Inspection
Census: 72
Capacity: 86
Deficiencies: 0
Mar 13, 2025
Visit Reason
The inspection was an unannounced Required Annual Inspection conducted by Licensing Program Analysts to evaluate the facility's compliance with regulations.
Findings
The facility was inspected inside and outside with no obstructions found. Safety measures such as temperature control, lighting, food storage, and fire safety equipment were all in compliance. Records for residents and staff were complete, and no citations were issued.
Report Facts
Nonperishable food supply: 7
Perishable food supply: 2
Records reviewed: 5
Records reviewed: 5
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Linda Thuong Nguyen | Executive Director | Met with Licensing Program Analysts during inspection |
| James Sampair | Licensing Program Analyst | Conducted the inspection |
| Y. Brown | Licensing Program Analyst | Conducted the inspection |
| Harpreet Humpal | Licensing Program Manager | Named in report header |
Inspection Report
Original Licensing
Census: 71
Capacity: 86
Deficiencies: 1
Mar 7, 2025
Visit Reason
This was a post licensing inspection conducted unannounced to evaluate compliance with licensing requirements following initial licensing.
Findings
The inspection found the facility generally compliant with safety and operational standards, including adequate food supplies, locked medication and cleaning supply storage, and functioning smoke and carbon monoxide detectors. However, one Type-A citation was issued related to criminal record clearance noncompliance, along with a $500 civil penalty.
Severity Breakdown
Type A: 1
Deficiencies (1)
| Description | Severity |
|---|---|
| Licensee did not comply with criminal record clearance requirements in 1 of 5 records reviewed, posing an immediate health, safety, or personal rights risk. | Type A |
Report Facts
Civil penalty amount: 500
Number of resident records reviewed: 5
Number of staff records reviewed: 5
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Linda Nguyen | Executive Director | Met with during inspection and named in report |
| James Sampair | Licensing Program Analyst | Conducted the inspection and signed the report |
| Harpreet Humpal | Licensing Program Manager | Named as supervisor and licensing program manager |
Inspection Report
Complaint Investigation
Census: 71
Capacity: 86
Deficiencies: 1
Mar 6, 2025
Visit Reason
The inspection was an unannounced complaint investigation visit conducted to investigate an allegation that staff did not ensure a resident was allowed visitors while in care.
Findings
The allegation was substantiated based on facility documentation and an email from the Executive Director confirming visitation restrictions for Resident R1, limiting visits to common areas and a maximum of 20 minutes per visit.
Complaint Details
The complaint was substantiated. The facility restricted visitation rights of a resident contrary to regulations. The deficiency was cited under CCR 87468.1(a)(11).
Severity Breakdown
Type B: 1
Deficiencies (1)
| Description | Severity |
|---|---|
| Personal Rights of Residents in All Facilities (a)(11) - To have their visitors during reasonable hours and without prior notice, provided that the rights of other residents are not infringed upon. This requirement was not met as evidenced by visitation restrictions imposed on Resident R1. | Type B |
Report Facts
Capacity: 86
Census: 71
Deficiency Plan of Correction Due Date: Mar 13, 2025
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Linda Nguyen | Executive Director | Named in relation to the visitation restriction finding and exit interview |
| James Sampair | Licensing Program Analyst | Conducted the complaint investigation visit |
| Harpreet Humpal | Licensing Program Manager | Named in the report as Licensing Program Manager |
Inspection Report
Complaint Investigation
Census: 71
Capacity: 86
Deficiencies: 0
Mar 6, 2025
Visit Reason
The inspection visit was an unannounced complaint investigation conducted in response to allegations that staff did not ensure a resident was utilizing medical devices and that the licensee did not obtain resident appraisal before admittance.
Findings
The investigation found no evidence to confirm the allegations. Interviews and documentation review showed the resident did not require a hearing aid and had a preadmission appraisal indicating lack of capacity for informed medical decisions. Therefore, the allegations were unsubstantiated.
Complaint Details
The complaint was unsubstantiated based on interviews with witnesses, the resident, and the Executive Director, as well as review of medical and preadmission documentation.
Report Facts
Capacity: 86
Census: 71
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| James Sampair | Licensing Program Analyst | Conducted the complaint investigation |
| Linda Nguyen | Executive Director | Met with the Licensing Program Analyst during the investigation |
| Gilbert Castro | Administrator | Facility administrator named in the report |
| Harpreet Humpal | Licensing Program Manager | Named as Licensing Program Manager on the report |
Inspection Report
Census: 71
Capacity: 86
Deficiencies: 0
Aug 2, 2024
Visit Reason
The visit was an unannounced case management inspection concerning an incident on 7/28/2024 where Resident R1 eloped from the facility.
Findings
The inspection involved interviews with the Executive Director and Health Service Director regarding the elopement incident. No citations were issued during the visit, and it was noted that R1 will be moving to a memory care unit in a different facility due to the risk of future elopement.
Report Facts
Incident date: Jul 28, 2024
Incident follow-up date: Aug 5, 2024
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Linda Nguyen | Executive Director | Interviewed regarding the elopement incident |
| Sarah Summers | Health Service Director | Interviewed regarding the elopement incident |
| James Sampair | Licensing Program Analyst | Conducted the inspection visit |
Inspection Report
Complaint Investigation
Census: 67
Capacity: 86
Deficiencies: 0
Apr 30, 2024
Visit Reason
An unannounced complaint investigation was conducted regarding the allegation that staff do not ensure the residents have hot water while in care.
Findings
The investigation found that although the allegation may have happened or be valid, there was not a preponderance of evidence to prove it; therefore, the allegation was unsubstantiated. The facility had addressed the plumbing issue promptly and provided alternative shower locations and compensation to residents during the repair period.
Complaint Details
The complaint alleged that staff did not ensure residents had hot water while in care. The allegation was unsubstantiated after investigation.
Report Facts
Resident credit amount: 100
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Gilbert Castro | Executive Director | Interviewed during complaint investigation regarding hot water issue |
| James Sampair | Licensing Program Analyst | Conducted complaint investigation |
| Harpreet Humpal | Licensing Program Manager | Oversaw complaint investigation |
Inspection Report
Original Licensing
Census: 62
Capacity: 86
Deficiencies: 0
Mar 27, 2024
Visit Reason
The inspection was an unannounced change of ownership prelicensing visit conducted to evaluate the facility for licensing approval.
Findings
The facility was found to be appropriately furnished, well maintained, and compliant with safety and care standards. No deficiencies were noted, and the facility passed the pre-licensing inspection.
Report Facts
Hot water temperature: 115.9
Fire extinguisher service date: Jan 31, 2024
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Gilbert Castro | Executive Director | Met with Licensing Program Analyst during inspection and received training |
| James Sampair | Licensing Program Analyst | Conducted the prelicensing inspection visit |
| Harpreet Humpal | Licensing Program Manager | Named as Licensing Program Manager on report |
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