Inspection Report Summary
Most inspections found deficiencies primarily related to safety and medication management, especially during the facility’s initial licensing process in early 2025. Early reports cited issues such as unlocked medications accessible to residents, improper food storage, and missing safety equipment, which delayed licensure. More recent inspections showed some improvement, but a June 20, 2025, report noted a deficiency for allowing a resident to leave unassisted, posing a safety risk. The latest report from September 11, 2025, was clean with no deficiencies, indicating progress in addressing prior concerns. Several complaint investigations were substantiated, mainly involving safety risks, but no fines or enforcement actions were listed in the available reports.
Deficiencies per Year
8
6
4
2
0
Moderate
Unclassified
Census Over Time
Census
Capacity
Inspection Report
Census: 78
Capacity: 80
Deficiencies: 0
Sep 11, 2025
Visit Reason
An unannounced Case Management visit was conducted regarding a self-reported incident that occurred on 2025-08-04 involving an altercation between two residents.
Findings
The facility conducted an internal investigation and has been in contact with the responsible party of Resident 1. No deficiencies were noted during the visit. The facility was requested to submit updated appraisal needs and care plans for Resident 1 by 2025-09-25.
Report Facts
Caregiver hours: 2
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Divina Fernandez | Administrator | Met with Licensing Program Analysts during the visit and involved in the internal investigation of the incident. |
Inspection Report
Complaint Investigation
Census: 78
Capacity: 80
Deficiencies: 2
Aug 14, 2025
Visit Reason
The inspection was conducted as a result of a priority 2 complaint to assess health and safety conditions at the facility.
Findings
The inspection found that the facility had an expired fire extinguisher service tag and food was not properly labeled and stored, both posing potential safety risks to residents.
Complaint Details
The visit was triggered by a priority 2 complaint. The complaint was investigated and deficiencies were cited.
Severity Breakdown
Type B: 2
Deficiencies (2)
| Description | Severity |
|---|---|
| Fire extinguisher was last serviced on 08/09/2024, posing an immediate health and safety risk. | Type B |
| Food was not properly labeled and stored, posing a potential safety risk to persons in care. | Type B |
Report Facts
Capacity: 80
Census: 78
Deficiencies cited: 2
Plan of Correction Due Dates: 08/22/2025 for fire extinguisher deficiency and 08/28/2025 for food labeling and storage deficiency
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Divina Fernandez | Administrator | Met with Licensing Program Analyst during inspection |
| Patricia Manalo | Licensing Program Analyst | Conducted the inspection and authored the report |
| Yvonne Flores-Larios | Licensing Program Manager | Named as Licensing Program Manager on the report |
Inspection Report
Census: 74
Capacity: 80
Deficiencies: 1
Jun 20, 2025
Visit Reason
An unannounced Case Management visit was conducted regarding a self-reported incident that occurred on 2025-06-14, where a resident was allowed to leave the facility unassisted, contrary to physician's orders.
Findings
The facility was found deficient for allowing Resident 1 to leave unassisted, posing a potential health and safety risk. The deficiency was cited under California Code of Regulations, Title 22, Section 87468.2(a)(4).
Severity Breakdown
Type B: 1
Deficiencies (1)
| Description | Severity |
|---|---|
| The licensee did not comply with the requirement to provide care, supervision, and services that meet individual needs by allowing Resident 1 to leave the facility unassisted, posing a potential health and safety risk. | Type B |
Report Facts
Capacity: 80
Census: 74
Plan of Correction Due Date: Jul 1, 2025
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Divine Fernandez | Administrator | Met with Licensing Program Analyst during the visit |
| Patricia Manalo | Licensing Program Analyst | Conducted the inspection visit |
| Yvonne Flores-Larios | Licensing Program Manager | Named in report as Licensing Program Manager |
Inspection Report
Census: 68
Capacity: 80
Deficiencies: 0
May 30, 2025
Visit Reason
The visit was an unannounced case management inspection to conduct Component III with licensees/applicants, including a PowerPoint presentation and providing contact information.
Findings
The report documents the unannounced visit and the presentation of Component III to the licensees/applicants. No deficiencies or violations are explicitly stated in the report.
Report Facts
Capacity: 80
Census: 68
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Lulin Wu | Administrator/Director | Named as facility administrator/director |
| Wendy Wong | Met with during the inspection | |
| Olive Manalastas | Met with during the inspection | |
| P. Manalo | Licensing Program Analyst | Conducted the inspection |
| L. Fontanilla | Licensing Program Analyst | Conducted the inspection |
| Yvonne Flores-Larios | Licensing Program Manager | Named as Licensing Program Manager |
Inspection Report
Original Licensing
Census: 68
Capacity: 80
Deficiencies: 0
May 30, 2025
Visit Reason
Unannounced prelicensing inspection to verify corrections made with the facility sketch as required from the 5/7/2025 prelicensing inspection.
Findings
LPAs observed that the facility is ready to be licensed pending final approval by the Centralized Application Bureau (CAB). The facility is not yet licensed and additional requirements may still be required.
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Wendy Wong | Licensee/Applicant met during the inspection. | |
| Olive Manalastas | Licensee/Applicant met during the inspection. | |
| Lulin Wu | Administrator/Director | Named as facility administrator/director. |
Inspection Report
Original Licensing
Census: 69
Capacity: 80
Deficiencies: 3
May 7, 2025
Visit Reason
Unannounced pre-licensing inspection conducted for a change of ownership and initial licensing of the facility.
Findings
The facility was toured and found to have adequate safety features such as grab bars, non-skid mats, operational smoke detectors, and fire extinguishers. However, the facility is not ready to be licensed due to outstanding corrections including the need for a facility sketch verified by the fire department and unsecured medications accessible to residents.
Deficiencies (3)
| Description |
|---|
| Facility sketch must identify all rooms and purposes and be verified with the fire department. |
| TUMS found unlocked in a drawer in room #43. |
| Lysol wipes observed in the front office accessible to residents. |
Report Facts
Hot water temperature: 107
Hot water temperature: 116.2
Hot water temperature: 109.8
Fire extinguisher last serviced: Aug 9, 2024
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Divina Fernandez | Administrator | Met with Licensing Program Analyst during inspection and authorized signing of report |
| Patricia Manalo | Licensing Program Analyst | Conducted the pre-licensing inspection |
| Wendy Wong | Licensee/Applicant present during inspection | |
| Olive Manalasta | Licensee/Applicant present during inspection |
Inspection Report
Original Licensing
Census: 68
Capacity: 80
Deficiencies: 8
Mar 20, 2025
Visit Reason
The visit was a pre-licensing inspection conducted due to a change of ownership at the facility.
Findings
The facility was toured and several deficiencies were observed including unlocked medication carts, lack of thermostat in freezer, improper food storage, insufficient emergency food, damaged window screens, clutter in courtyard, lack of emergency flashlights, presence of cleaning chemicals in resident rooms, and incomplete resident records. The facility was determined not ready for licensure pending correction of these issues.
Deficiencies (8)
| Description |
|---|
| Med cart unlocked and medications found in multiple rooms |
| Freezer did not have a thermostat inside |
| Food not properly stored in containers |
| Not enough emergency food |
| Window screens with holes and clutter outside in courtyard |
| Staff did not have emergency flashlights available |
| Lysol cleaning wipes and cleaning sprays found in resident rooms |
| Residents' records found to be incomplete |
Report Facts
Facility capacity: 80
Census: 68
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Wendy Wong | Licensee/Applicant | Met with Licensing Program Analysts during inspection |
| Olive Manalasta | Licensee/Applicant | Met with Licensing Program Analysts during inspection |
| Divina Fernadez | Administrator | Met with Licensing Program Analysts during inspection |
| Patricia Manalo | Licensing Program Analyst | Conducted the inspection |
| K. Nguyen | Licensing Program Analyst | Conducted the inspection |
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