Inspection Report Summary
Most inspections before September 15, 2025, found no deficiencies, showing a generally clean record early on. However, starting mid-September 2025, several inspections identified serious issues including an immediate health risk from inadequate staffing and an unsanitary kitchen with pest infestations. Additional deficiencies involved missing staff training and health screening records, lack of an infection control plan, incomplete resident records, and unqualified staff administering injections. The most recent report from October 8, 2025, continued to cite deficiencies related to infection control, staff documentation, pest problems, and hospice care planning. While some complaint investigations were unsubstantiated, the facility has shown a pattern of environmental and staffing concerns that have not yet been fully resolved.
Deficiencies (last 2 years)
Deficiencies (over 2 years)
8 deficiencies/year
Deficiencies are regulatory violations found during state inspections.
100% worse than California average
California average: 4 deficiencies/yearDeficiencies per year
8
6
4
2
0
Census
Latest occupancy rate
83% occupied
Based on a October 2025 inspection.
This facility has shown a steady increase in demand based on occupancy rates.
Census over time
Inspection Report
Annual Inspection
Census: 5
Capacity: 6
Deficiencies: 5
Date: Oct 8, 2025
Visit Reason
The Licensing Program Analyst made an unannounced visit to deliver deficiencies identified through the comprehensive annual licensing inspection that commenced on September 15, 2025, continuing the annual inspection process.
Findings
Four Type B deficiencies were cited related to personnel health screenings, lack of an infection control plan, missing personnel training records, and a pest infestation in the kitchen. Additionally, one deficiency was cited for lack of an appropriate hospice care plan for one resident.
Deficiencies (5)
Staff S1 and S2 did not have Health Screening forms on file, posing a potential health risk to residents.
The facility did not have an infection control plan, posing a potential safety risk to residents.
Staff S1 through S10 did not have records of required training on file, posing a potential health and safety risk to residents.
The facility had a pest infestation in the kitchen, posing a potential health or personal rights risk to residents.
The licensee did not have an appropriate hospice care plan on file for one resident, posing a potential health risk.
Report Facts
Deficiencies cited: 5
Census: 5
Total Capacity: 6
Plan of Correction Due Dates: Due dates range from 2025-10-08 to 2025-11-05 depending on deficiency.
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Zayden Chen | Administrator/Director | Facility administrator named in the report header. |
| Bartolome | Med-Tech | Met with Licensing Program Analyst during inspection. |
Inspection Report
Annual Inspection
Census: 5
Capacity: 6
Deficiencies: 4
Date: Oct 1, 2025
Visit Reason
An unannounced continuation of the comprehensive required annual inspection commenced on September 15, 2025, was conducted to evaluate compliance with licensing requirements.
Findings
The inspection revealed multiple deficiencies including lack of staff training documentation, missing required staff records, absence of disaster drill participation, no infection control plan, and lack of current liability insurance. The facility kitchen was found unsanitary with dead pests and in need of deep cleaning. Medication administration records showed residents missing heart medication refills. The facility had adequate food supplies, proper storage of sharps and medications, and required safety equipment was operable and up to date.
Deficiencies (4)
No documentation on staff training and missing required staff records.
Staff had never participated in a disaster drill, no infection control plan, and no current liability insurance.
Facility kitchen unsanitary with dead pests in cabinets/drawers and in need of deep cleaning.
Resident Medication Administration Records showed residents missing heart medication refills.
Report Facts
Number of residents present: 5
Facility capacity: 6
Medication refill delay days: 77
Medication refill delay days: 2
Food supply duration: 2
Food supply duration: 7
Inspection start time: 940
Inspection end time: 1800
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Allan Bartalome | Med Tech | Met with during inspection and involved in inspection process |
| Yasar | Staff member present during inspection and involved in exit interview | |
| Zayden Chen | Administrator/Director | Facility Administrator named in report header |
| Debbie Correia | Licensing Program Analyst | Conducted the inspection |
| Robyn Clark | Licensing Program Manager | Named as Licensing Program Manager overseeing the inspection |
Inspection Report
Annual Inspection
Census: 5
Capacity: 6
Deficiencies: 0
Date: Sep 29, 2025
Visit Reason
An unannounced continuation of the annual licensing inspection commenced on September 15, 2025, was conducted to evaluate the facility's compliance with licensing requirements.
Findings
No deficiencies were cited during the visit. The inspection included a staff records review and a partial facility tour, with a resident records review conducted earlier on September 15, 2025.
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Debbie Correia | Licensing Program Analyst | Conducted the unannounced annual licensing inspection visit. |
| April Magat | Caregiver | Met with the Licensing Program Analyst during the inspection. |
| Zayden Chen | Administrator/Director | Facility Administrator contacted and joined the inspection. |
Inspection Report
Census: 5
Capacity: 6
Deficiencies: 0
Date: Sep 16, 2025
Visit Reason
An unannounced case management visit was conducted to check on the health and safety of residents in care.
Findings
No immediate health and/or safety violations were observed during the visit. No deficiencies were issued.
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Shamila Yasar | Administrator | Met with Licensing Program Analyst during the visit. |
| Bartolome | Caregiver | Participated in exit interview and was informed about the report and licensee rights. |
Inspection Report
Annual Inspection
Census: 4
Capacity: 6
Deficiencies: 0
Date: Sep 15, 2025
Visit Reason
Licensing Program Analyst Debbie Correia made an unannounced visit to conduct the required annual inspection of the facility.
Findings
Resident records were complete and up to date. Smoke and carbon monoxide detectors were present and operable, fire extinguishers were present and current on inspection, and the facility has a landline. No deficiencies were cited during the visit.
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Debbie Correia | Licensing Program Analyst | Conducted the annual inspection visit. |
| April Magat | Staff member who greeted the Licensing Program Analyst and discussed the report. |
Inspection Report
Complaint Investigation
Census: 5
Capacity: 6
Deficiencies: 2
Date: Sep 15, 2025
Visit Reason
The inspection was an unannounced complaint investigation visit triggered by complaints alleging the facility was unsanitary with a cockroach infestation and understaffed, as well as a complaint that hospice resident needs were not met.
Complaint Details
The complaint investigation was substantiated for allegations that the facility was unsanitary and understaffed, with evidence of cockroach infestation and insufficient staff to meet resident needs. The allegation that hospice resident needs were not met was unsubstantiated.
Findings
The investigation substantiated that the facility was unsanitary due to dead and live cockroaches in the kitchen cupboards and that staffing was inadequate to meet resident needs, posing an immediate health risk to one resident. The allegation that hospice resident needs were not met was unsubstantiated as staff notified the hospice agency, which addressed the issue.
Deficiencies (2)
Facility did not have adequate staff to meet Resident 1 needs, posing an immediate health risk to one out of five residents in care.
Facility kitchen was not clean or sanitary, with dead and live pests found in kitchen cupboards, posing a potential health and personal rights risk to five residents.
Report Facts
Residents present: 5
Total capacity: 6
Deficiency count: 2
Plan of Correction due dates: 1
Plan of Correction due dates: 1
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Debbie Correia | Licensing Program Analyst | Conducted the complaint investigation |
| April Magat | Caregiver | Staff member interviewed during investigation |
| Zayden Chen | Administrator | Facility administrator who agreed to corrective actions |
Inspection Report
Plan of Correction
Census: 5
Capacity: 6
Deficiencies: 0
Date: Aug 29, 2025
Visit Reason
An unannounced case management visit was conducted to verify clearance of previously issued deficiencies and civil penalties as part of a Plan of Correction.
Findings
The Licensing Program Analyst confirmed that the deficiencies were cleared, verified medication training documentation, confirmed a licensed professional will attend to medical needs three times daily, and ensured hazardous materials were secured.
Report Facts
Frequency of licensed professional visits: 3
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Amy Rodgers | Licensing Program Analyst | Conducted the unannounced case management visit for Plan of Correction clearance |
| Zayden Chen | Licensee and Administrator | Met with Licensing Program Analyst during visit |
| Shamila Yasar | Administrator | Met with Licensing Program Analyst during visit |
Inspection Report
Complaint Investigation
Census: 5
Capacity: 6
Deficiencies: 3
Date: Aug 28, 2025
Visit Reason
An unannounced case management deficiencies visit was conducted to assess compliance with licensing requirements, including review of resident records and staff background clearances.
Complaint Details
The visit was complaint-related focusing on case management deficiencies, including staff background clearance issues and incomplete resident records. Civil penalties were assessed and noted.
Findings
The inspection found incomplete resident records for five residents and issues with staff background clearances, including staff working without proper clearance or transfer of clearance, posing immediate health, safety, and personal rights risks to all residents in care.
Deficiencies (3)
Licensee did not ensure a criminal record clearance transfer was complete for 1 of 7 staff members (S5) prior to working in the facility.
Licensee did not ensure that a criminal record clearance was obtained for 2 of 7 staff members (S4 and S6) prior to working in the facility.
Resident records were incomplete for 5 residents (R1-R5).
Report Facts
Residents with incomplete records: 5
Staff without proper clearance: 3
Dates staff worked without clearance: 8
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Evangeline Pingul | Staff | Met with Licensing Program Managers during inspection. |
| Jerry Romero | Licensing Program Manager | Conducted the inspection and signed the report. |
| Robyn Clark | Licensing Program Analyst | Conducted the inspection and signed the report. |
| Rivera | Staff | Participated in exit interview at conclusion of visit. |
Inspection Report
Census: 5
Capacity: 6
Deficiencies: 2
Date: Aug 28, 2025
Visit Reason
An unannounced case management deficiencies visit was conducted to assess compliance with licensing requirements.
Findings
The inspection found that an unqualified staff member administered injections to a resident, and hazardous items such as rubbing alcohol, injection needles, and Lysol were left unattended and accessible to residents, posing immediate health and safety risks.
Deficiencies (2)
An unqualified staff member administered injections to a resident, posing an immediate health, safety, and personal rights risk.
Hazardous items including rubbing alcohol, injection needles, and Lysol were left unattended and accessible to residents, posing an immediate health, safety, and personal rights risk.
Report Facts
Residents present: 3
Residents in care: 5
Plan of Correction Due Date: 1
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Evangeline Pingul | Staff | Met with Licensing Program Managers during inspection |
| Zayden Chen | Administrator/Director | Facility Administrator named in report and recipient of report |
Inspection Report
Census: 5
Capacity: 6
Deficiencies: 0
Date: Aug 28, 2025
Visit Reason
The visit was an office meeting to discuss the current licensee status during the change of ownership process for the facility.
Findings
The report indicates that the Licensee, New World Opco LLC, is currently an active entity. Consultation was provided on the Change of Ownership process, and the licensee will maintain communication with the Regional Office throughout the transfer process.
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Zayden Chen | Licensee | Met during the office meeting and discussed licensee status. |
| Shamila Yasar | Administrator | Met during the office meeting and discussed licensee status. |
| Jerry Romero | Regional Manager | Conducted the office meeting and discussed licensee status. |
| Lizzette Tellez | Licensing Program Manager | Conducted the office meeting and discussed licensee status. |
| Robyn Clark | Licensing Program Analyst | Conducted the office meeting and provided consultation on the Change of Ownership process. |
Inspection Report
Census: 5
Capacity: 6
Deficiencies: 0
Date: Aug 7, 2025
Visit Reason
An unannounced Case Management visit was conducted by Licensing Program Analyst Debbie Correia to discuss the purpose of the visit and obtain signatures on amended Community Care Licensing reports.
Findings
The visit involved discussion with Caregiver Allan Bartolome and obtaining signatures on amended reports. No specific deficiencies or violations were noted in the report.
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Allan Bartolome | Caregiver | Met with Licensing Program Analyst during the visit and participated in the exit interview. |
| Debbie Correia | Licensing Program Analyst | Conducted the unannounced Case Management visit. |
Inspection Report
Complaint Investigation
Census: 5
Capacity: 6
Deficiencies: 0
Date: Jul 17, 2025
Visit Reason
An unannounced complaint investigation was conducted following allegations that the licensee hired uncleared staff, did not provide residents adequate food service, did not provide essential supplies, and did not meet residents' care needs.
Complaint Details
The complaint was unsubstantiated based on evidence from interviews and record reviews. The preponderance of evidence was not met.
Findings
The investigation included staff and resident interviews and record reviews. All staff were found to have clearance through background checks. The facility had adequate food and supplies, and residents reported no concerns with food or care. The complaint allegations were determined to be unsubstantiated.
Report Facts
Capacity: 6
Census: 5
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Debbie Correia | Licensing Program Analyst | Conducted the complaint investigation |
| Robyn Clark | Licensing Program Manager | Named as Licensing Program Manager on report |
Inspection Report
Census: 6
Capacity: 6
Deficiencies: 0
Date: Oct 17, 2024
Visit Reason
Licensing Program Analyst Rebecca Ruiz conducted an unannounced collateral visit to observe residents, review facility records, and interview staff.
Findings
No deficiencies were observed or cited during the visit. An exit interview was conducted with Caregiver Nirissa Imperial.
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Rebecca Ruiz | Licensing Program Analyst | Conducted the unannounced collateral visit. |
| Nirissa Imperial | Caregiver | Met with Licensing Program Analyst during the visit and participated in the exit interview. |
Inspection Report
Original Licensing
Capacity: 6
Deficiencies: 0
Date: Aug 29, 2024
Visit Reason
An announced pre-licensing visit was conducted to observe the facility’s physical plant for compliance with Title 22, Division 6 of the California Code of Regulations and California Health & Safety Code.
Findings
The facility was found clean, sanitary, and in good repair with all required safety and operational features compliant. The applicant passed the pre-licensing inspection and the facility is approved for six residents.
Report Facts
Facility capacity: 6
Census: 0
Hot water temperature: 119.8
Hot water temperature: 119.4
Hot water temperature: 118.2
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Zayden Chen | Administrator | Applicant’s representative met during inspection and named in report |
| Ryan Fulton | Licensing Program Analyst | Conducted the pre-licensing inspection |
| Jennifer Lott | Licensing Program Manager | Named in report as Licensing Program Manager |
Inspection Report
Original Licensing
Census: 6
Capacity: 6
Deficiencies: 0
Date: Aug 2, 2024
Visit Reason
The visit was an office type inspection conducted as part of the original licensing process (Component II completion) for the facility.
Findings
The Component II licensing process was successfully completed via telephone call with the Administrator/Licensee and CAB analyst. The Administrator/Licensee demonstrated understanding of Title 22 requirements including facility operation, admission policies, staffing, restrictive health conditions, emergency preparedness, complaints, and pre-licensing readiness.
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Zayden Chen | Administrator/Licensee | Participated in Component II licensing process and confirmed understanding of Title 22. |
| Tammy Edwards | Analyst | CAB analyst who participated in Component II licensing process. |
| Darla Neeley | Licensing Program Manager | Named as Licensing Program Manager on the report. |
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