Inspection Report Summary
Most inspections found no deficiencies, with the facility consistently clean, well-maintained, and compliant with health and safety standards. Several complaint investigations were unsubstantiated, including allegations about medical attention and a serious claim of sexual assault. The most recent report from January 23, 2025, showed no deficiencies and confirmed that safety equipment and resident records were properly maintained. Earlier reports also noted good infection control practices and no violations of resident rights. There is no indication of fines, enforcement actions, or severe issues in the available records.
Deficiencies (last 5 years)
Deficiencies (over 5 years)
0 deficiencies/year
Deficiencies are regulatory violations found during state inspections.
Same as California average
California average: 4 deficiencies/yearDeficiencies per year
4
3
2
1
0
Census
Latest occupancy rate
75% occupied
Based on a January 2025 inspection.
Census over time
Inspection Report
Annual Inspection
Census: 79
Capacity: 106
Deficiencies: 0
Jan 23, 2025
Visit Reason
An unannounced annual inspection was conducted by Licensing Program Analyst Leizl de la Cerra to evaluate the facility's compliance with regulatory standards.
Findings
The facility was found to be clean and well-maintained with functional appliances and fixtures. Resident bedrooms, common areas, laundry rooms, and outdoor areas were in good condition. Resident records, staff files, and medications were reviewed and found complete and updated. Safety equipment such as fire extinguishers and alarms were current and operational.
Report Facts
Hospice waiver residents: 15
Resident bedrooms inspected: 8
Staff files reviewed: 5
Resident records reviewed: 10
Centrally stored medications reviewed: 3
Fire extinguisher last serviced: Aug 2, 2024
Fire drill last conducted: Dec 20, 2024
Fire alarms and detectors last tested: Jul 1, 2024
Hot water temperature range: 107.5
Hot water temperature range: 110.7
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Ericka Rivas | Business Office Director | Met with Licensing Program Analyst during inspection and disclosed reason for visit |
| Alfonso Marron | Maintenance Director | Accompanied Licensing Program Analyst during facility tour |
| Samantha Orduna | Health and Wellness Director | Reviewed centrally stored resident medications with Licensing Program Analyst |
| Desiree Kitagawa | Administrator/Director | Named as facility administrator/director |
| Leizl de la Cerra | Licensing Program Analyst | Conducted the inspection |
| Naira Margaryan | Licensing Program Manager | Named in report header and signature section |
Inspection Report
Complaint Investigation
Census: 70
Capacity: 106
Deficiencies: 0
Apr 23, 2024
Visit Reason
The visit was an unannounced complaint investigation conducted in response to an allegation that staff did not seek medical attention for a resident.
Findings
The investigation revealed that the resident had developed a cough that did not heal, but the family representative, home health agency, and primary physician were notified, prescriptions were ordered, and a chest x-ray was performed. The allegation was deemed unsubstantiated due to insufficient evidence.
Complaint Details
The complaint alleged that staff did not seek medical attention for resident #1. The allegation was investigated and found to be unsubstantiated.
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Tuesday Cabiness | Licensing Program Analyst | Conducted the complaint investigation visit. |
| Erika Riva | Business Office Director | Met with the Licensing Program Analyst during the investigation. |
Inspection Report
Annual Inspection
Census: 69
Capacity: 106
Deficiencies: 0
Jan 2, 2024
Visit Reason
The inspection was an unannounced Required – Annual Continuation Inspection to ensure compliance with Title 22 Regulations and to verify the facility's health and safety standards.
Findings
The facility was found to be in compliance with regulations, with no deficiencies cited. The physical plant, resident rooms, bathrooms, kitchen, and safety equipment were all inspected and found to be in good condition. Staff and resident records were reviewed and found complete and current.
Report Facts
Staff records reviewed: 9
Resident records reviewed: 9
Licensed capacity: 106
Current census: 69
Hospice waiver capacity: 10
Fire extinguisher receipt date: Oct 1, 2023
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Shin Ito | Executive Director | Met with Licensing Program Analyst during inspection and received report copy |
| Christopher Alemoh | Licensing Program Analyst | Conducted the inspection |
| Eva Miller | Licensing Program Manager | Named as Licensing Program Manager on report |
| Samantha Orduna | Pharmacist | Met with Licensing Program Analyst in medication room during inspection |
Inspection Report
Annual Inspection
Census: 76
Capacity: 106
Deficiencies: 0
Jan 19, 2023
Visit Reason
An unannounced One (1) Year Required Infection Control visit was conducted to ensure compliance with Title 22 Regulations and to check for health and safety hazards.
Findings
The facility was found to be in compliance with infection control and safety regulations, including proper Covid-19 prevention signage, adequate PPE supplies, clean and unobstructed resident rooms and bathrooms, secure medication storage, and well-maintained kitchen and common areas. No deficiencies were cited.
Report Facts
Number of bathrooms observed: 10
Water temperature range: 109.8
Water temperature range: 120.4
Food supply duration: 7
Food supply duration: 2
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Desiree Kitagawa | Executive Director | Met with Licensing Program Analyst during inspection |
| Tihesha Smith | Licensing Program Analyst | Conducted the inspection visit |
| Naira Margaryan | Licensing Program Manager | Named in report header |
Inspection Report
Annual Inspection
Census: 74
Capacity: 106
Deficiencies: 0
Jan 27, 2022
Visit Reason
One Year Required - Infection Control visit for this facility to evaluate compliance with infection prevention protocols.
Findings
The facility was found to have appropriate infection control measures including mask usage, hand sanitizing stations, and signage. The physical plant was clean and safe, with proper furnishings and safety features in resident rooms. Fire safety equipment was up to date and functioning.
Report Facts
Licensed capacity: 106
Census: 74
Hot water temperature range: 109.9
Hot water temperature range: 118.8
Fire extinguisher last serviced date: Aug 5, 2021
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Desiree Kitagawa | Executive Director | Met with Licensing Program Analyst during inspection. |
| Gary Tan | Licensing Program Analyst | Conducted the inspection and authored the report. |
Inspection Report
Complaint Investigation
Census: 74
Capacity: 106
Deficiencies: 0
Jan 27, 2022
Visit Reason
The visit was an unannounced complaint investigation triggered by an allegation that a resident was sexually assaulted at the facility.
Findings
The investigation found insufficient information to substantiate the allegation of sexual assault. Interviews and record reviews indicated the resident was disoriented and had dementia, and no evidence supported the claim. The allegation was deemed unsubstantiated.
Complaint Details
The complaint alleged that three men assaulted Resident #1 at the facility. The facility reported the incident to authorities, but the investigation did not substantiate the allegation.
Report Facts
Facility capacity: 106
Resident census: 74
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Jose Gary Tan | Licensing Program Analyst | Conducted the complaint investigation and unannounced visit |
| Desiree Kitagawa | Executive Director | Met with Licensing Program Analyst during the investigation |
| Naira Margaryan | Licensing Program Manager | Named as Licensing Program Manager on the report |
Inspection Report
Complaint Investigation
Census: 66
Capacity: 106
Deficiencies: 0
Aug 31, 2021
Visit Reason
An unannounced case management visit was conducted to investigate an incident report alleging a violation of a resident's personal rights on August 27, 2021.
Findings
The Licensing Program Analyst observed no health and safety violations during the facility tour, including adequate COVID signage, PPE supplies, and safety features in resident apartments. Further investigation is needed at this time.
Complaint Details
The visit was triggered by an incident report alleging a resident's personal rights were violated on August 27, 2021. The Licensing Program Analyst interviewed the alleged victim and reviewed documentation. No violations were observed during the visit, and further investigation is ongoing.
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Melissa Spaeth | Licensing Program Analyst | Conducted the unannounced case management visit and investigation. |
| Kevin Onishi | Associate Executive Director | Met with the Licensing Program Analyst during the visit and provided resident documentation. |
| Desiree Kitagawa | Administrator | Named as the facility administrator. |
| Cassandra Harris | Licensing Program Manager | Named in the report as Licensing Program Manager. |
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