Inspection Report
Annual Inspection
Census: 86
Capacity: 140
Deficiencies: 0
Oct 20, 2025
Visit Reason
The visit was an unannounced required comprehensive annual inspection of the Residential Care Facility for Elderly (RCFE) to assess compliance with licensing requirements.
Findings
The facility was found to be operating within its approved capacity, clean, in good repair, and safe for residents. No deficiencies were cited during the inspection based on observations and record reviews.
Report Facts
Resident files reviewed: 5
Staff files reviewed: 5
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Cheryl Stevenson | Facility Administrator | Met with Licensing Program Analyst during inspection and received the report. |
| Paola Guerrero | Licensing Program Analyst | Conducted the unannounced annual inspection visit. |
| Efren Malagon | Licensing Program Manager | Named as Licensing Program Manager on the report. |
Inspection Report
Annual Inspection
Census: 81
Capacity: 140
Deficiencies: 0
Sep 18, 2024
Visit Reason
The visit was an unannounced required comprehensive annual inspection of the Residential Care Facility for Elderly (RCFE).
Findings
The facility was found to be operating within the approved capacity and in safe, clean, and good repair conditions. No deficiencies were cited during the inspection.
Report Facts
Resident files reviewed: 6
Staff files reviewed: 7
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Cheryl Stevenson | Facility Administrator | Met with Licensing Program Analysts during inspection and participated in exit interview |
| Paola Guerrero | Licensing Program Analyst | Conducted the inspection and signed the report |
| Beena Singh | Licensing Program Analyst | Conducted the inspection |
| Efren Malagon | Licensing Program Manager | Named in the report as Licensing Program Manager |
Inspection Report
Complaint Investigation
Census: 81
Capacity: 140
Deficiencies: 0
Jul 27, 2023
Visit Reason
An unannounced complaint investigation visit was conducted in response to allegations that staff did not ensure the facility had electricity and did not follow safe food handling practices.
Findings
The investigation found that the facility experienced a power outage due to an external utility issue, not staff negligence, and that food handling practices met regulatory standards with no complaints from residents. Both allegations were determined to be unsubstantiated.
Complaint Details
The complaint investigation was unsubstantiated, meaning there was not a preponderance of evidence to prove the alleged violations occurred.
Report Facts
Capacity: 140
Census: 81
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Paola Guerrero | Licensing Program Analyst | Conducted the complaint investigation |
| Brandy Herrera | Facility Health Service Director | Met with Licensing Program Analyst during investigation |
| Efren Malagon | Licensing Program Manager | Named in report as Licensing Program Manager |
Inspection Report
Census: 86
Capacity: 140
Deficiencies: 0
Mar 8, 2023
Visit Reason
An unannounced case management visit was conducted to follow up on a resident's death that occurred on 2023-03-05.
Findings
No deficiencies were cited during this visit. Staff interviews and documentation related to the resident's death were collected and reviewed.
Report Facts
Resident death date: Mar 5, 2023
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Cheryl Stevenson | Administrator | Met with Licensing Program Analyst during the visit and advised regarding death certificate submission |
| Paola Guerrero | Licensing Program Analyst | Conducted the unannounced case management visit and interviews |
| Efren Malagon | Licensing Program Manager | Named in report header |
Inspection Report
Complaint Investigation
Census: 82
Capacity: 140
Deficiencies: 0
Feb 2, 2023
Visit Reason
This unannounced visit was conducted to investigate a complaint alleging that a resident fell multiple times due to staff neglect and that staff did not notify the resident's authorized representative of the incidents in a timely manner.
Findings
The investigation reviewed multiple incident reports, resident care notes, assessments, and interviews, finding that the resident's responsible party was notified after each fall. The evidence did not support the allegations, and the complaint was found to be unfounded and dismissed.
Complaint Details
Complaint allegations included resident falls due to staff neglect and failure to notify the resident's authorized representative timely. The complaint was found to be unfounded after review and investigation.
Report Facts
Incident reports reviewed: 7
Resident falls documented: 4
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Amy Goldenberg | Licensing Program Analyst | Conducted the complaint investigation visit and authored the report. |
| Samuel De Guzman | Administrator | Facility administrator met with the investigator during the visit. |
| Nedra Brown | Licensing Program Manager | Named as Licensing Program Manager overseeing the investigation. |
Inspection Report
Complaint Investigation
Census: 80
Capacity: 140
Deficiencies: 0
Nov 4, 2022
Visit Reason
Unannounced complaint investigation visit conducted due to multiple allegations including resident deaths after medication administration, resident fracture, dirty vents, overflowing garbage, and unmet resident needs.
Findings
The investigation found all allegations to be unsubstantiated after interviews with staff and residents, review of records, and facility inspection. No evidence supported the claims of resident deaths due to medication, dirty vents, overflowing garbage, or unmet resident needs. One resident's fracture was determined to be from a car accident, not a fall at the facility.
Complaint Details
The complaint investigation was unsubstantiated. Allegations included residents dying after medication administration, a resident sustaining a fracture, dirty vents, overflowing garbage, and residents not having their needs met. Interviews and record reviews did not support these allegations.
Report Facts
Capacity: 140
Census: 80
Complaint Control Number: 18-AS-20210112114309
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Samuel De Guzman | Executive Director | Met with Licensing Program Analysts during investigation |
| Natalie Ibarra | Licensing Program Analyst | Conducted complaint investigation |
| Efren Malagon | Licensing Program Manager | Named in report as Licensing Program Manager |
Inspection Report
Complaint Investigation
Capacity: 140
Deficiencies: 0
Sep 16, 2022
Visit Reason
The inspection was an unannounced complaint investigation visit triggered by an allegation that staff do not ensure that residents' special dietary needs are met.
Findings
Based on interviews with staff and residents, and review of facility menus and records, the allegation was found to be unsubstantiated as there was no preponderance of evidence to prove the alleged violation occurred.
Complaint Details
The complaint alleged that staff do not ensure that residents' special dietary needs are met. The investigation included interviews with staff and residents and records review. The allegation was determined to be unsubstantiated.
Report Facts
Facility capacity: 140
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Natalie Ibarra | Licensing Program Analyst | Conducted the complaint investigation visit |
| Samuel de Guzman | Facility representative met during the investigation and exit interview | |
| Efren Malagon | Licensing Program Manager | Named in report signature |
Inspection Report
Annual Inspection
Census: 87
Capacity: 140
Deficiencies: 0
Sep 6, 2022
Visit Reason
The visit was conducted as a required annual inspection with an emphasis on infection control due to the COVID-19 pandemic.
Findings
The facility was found to have sufficient hand hygiene supplies, cleaning and disinfecting provisions, and a limited supply of PPE. No deficiencies were cited during the inspection.
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Samuel De Guzman | Executive Director | Met with during the inspection. |
| Hollie Shuler | Health Service Director | Met with during the inspection. |
| Amy Goldenberg | Licensing Program Analyst | Conducted the inspection. |
| Nedra Brown | Licensing Program Manager | Named in the report. |
Inspection Report
Annual Inspection
Census: 93
Capacity: 140
Deficiencies: 0
Jul 14, 2021
Visit Reason
An unannounced annual inspection was conducted with emphasis on infection control measures at the facility.
Findings
The inspection found that the facility had adequate infection control measures in place, including sufficient PPE supplies, trained staff, and proper COVID-19 protocols. No deficiencies were cited during the visit.
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Erika Lemon | Administrator | Met with Licensing Program Analyst during inspection and accompanied the tour. |
| Natalie Gayoso | Licensing Program Analyst | Conducted the unannounced annual inspection. |
| Karen Clemons | Licensing Program Manager | Named in the report as Licensing Program Manager. |
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