Inspection Report Summary
Most inspections found no deficiencies, and several complaint investigations were unsubstantiated, indicating generally good compliance with regulations. The most recent report from October 9, 2025, was clean with no deficiencies noted, showing improvement from some earlier issues. Past deficiencies mainly involved failure to update resident records and supervision lapses that allowed residents to leave unassisted, which posed health and safety risks; one such incident resulted in a $500 fine in August 2024. Other isolated issues included delayed family notification after a resident fall and failure to submit required reports, but no severe enforcement actions like license suspensions were reported. Overall, the facility’s record shows progress with fewer recent deficiencies and no ongoing serious problems.
Deficiencies (last 5 years)
Deficiencies (over 5 years)
2.2 deficiencies/year
Deficiencies are regulatory violations found during state inspections.
45% better than California average
California average: 4 deficiencies/yearDeficiencies per year
4
3
2
1
0
Census
Latest occupancy rate
85% 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: 52
Capacity: 61
Deficiencies: 0
Date: Oct 9, 2025
Visit Reason
An unannounced annual inspection visit was conducted to evaluate compliance with licensing requirements for the Residential Care Home for the Elderly.
Findings
The facility was found to be clean, odor-free, and in good repair with no health or safety concerns. No deficiencies were cited during the inspection. All reviewed resident and staff files were in order, and safety equipment was up to date.
Report Facts
Hot water temperature: 117.3
Room temperature range: Measured between 71 and 75 degrees Fahrenheit inside the facility
Facility capacity: 61
Census: 52
Fire extinguisher last serviced date: Jun 25, 2025
Last disaster drill date: Jul 1, 2024
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Damion E. Anderson | Executive Director | Met with Licensing Program Analysts during inspection |
| Cynthia Tamayo | Licensing Program Analyst | Conducted the inspection |
| Arvin Villanueva | Licensing Program Analyst | Conducted the inspection |
Inspection Report
Follow-Up
Census: 52
Capacity: 61
Deficiencies: 1
Date: Jun 27, 2025
Visit Reason
The visit was an unannounced case management deficiency follow-up to investigate the AWOL incident involving resident Sally Ebersole (R1) on 2025-06-12.
Findings
The facility failed to prevent resident R1 from leaving unassisted, contrary to the physician's report (LIC 602) stating R1 cannot leave unassisted. The resident eloped without staff knowledge, posing an immediate health and safety risk. The facility has taken steps including elopement training and plans to install additional alarms by 2025-07-27.
Deficiencies (1)
Facility did not comply with the requirement to be aware of the resident's general whereabouts, allowing R1 to leave unassisted, posing an immediate health and safety risk.
Report Facts
Civil penalty amount: 500
Plan of Correction due date: Jun 30, 2025
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Damion E Anderson | Administrator | Met with Licensing Program Analyst during inspection and involved in discussion of findings. |
| Cynthia Tamayo | Licensing Program Analyst | Conducted the unannounced case management deficiency visit and authored the report. |
| Czarrina A Camilon-Lee | Licensing Program Manager | Named as Licensing Program Manager on the report. |
Inspection Report
Complaint Investigation
Census: 52
Capacity: 61
Deficiencies: 1
Date: Mar 11, 2025
Visit Reason
The inspection was an unannounced follow-up complaint investigation visit conducted to address multiple allegations received on 2024-11-12 regarding staff aggression towards residents, staffing adequacy, staff training, safety practices, and updating resident records.
Complaint Details
The complaint investigation addressed allegations of staff aggression towards residents, inadequate staffing, insufficient staff training, failure to follow safety practices, and failure to update resident records. The allegations of aggression, staffing, training, and safety practices were unsubstantiated or unfounded, while the failure to update resident records was substantiated.
Findings
The investigation found no substantiated evidence of staff aggression towards residents or inadequate staffing and training, and staff were observed following safety practices. However, it was substantiated that the facility failed to update resident records, including physician reports and life history documentation.
Deficiencies (1)
Facility staff did not update resident records, including outdated Physician's Reports and Life Story Books.
Report Facts
Capacity: 61
Census: 52
Date complaint received: Nov 12, 2024
Date of last Physician's Report: Jul 21, 2020
Date of annual visit citation: Nov 17, 2024
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Damion E. Anderson | Executive Director/Administrator | Met with Licensing Program Analyst during investigation |
| Arvin Villanueva | Licensing Program Analyst | Conducted the complaint investigation visit |
| Stephen Richardson | Licensing Program Manager | Oversaw complaint investigation |
| S1 | Staff Member | Interviewed regarding training and resident records |
| S2 | Staff Member | Interviewed regarding training and communication with residents |
| S3 | Staff Member | Interviewed regarding training |
| S5 | Staff Member | Interviewed regarding staff behavior, staffing, and training |
| S7 | Staff Member | Interviewed regarding staff behavior |
| S9 | Staff Member | Interviewed regarding staffing and safety practices |
Inspection Report
Complaint Investigation
Census: 81
Capacity: 61
Deficiencies: 0
Date: Jan 7, 2025
Visit Reason
The visit was an unannounced complaint investigation conducted in response to allegations received on 2024-04-02 regarding questionable death, pressure injury due to neglect, failure to seek timely medical attention, and unexplained injuries sustained by a resident.
Complaint Details
The complaint involved multiple allegations including questionable death, resident sustained pressure injury due to neglect, staff did not seek timely medical attention, and resident sustained unexplained injuries. The investigation found no evidence to substantiate these allegations.
Findings
The investigation reviewed records and conducted interviews but was unable to corroborate any of the allegations. The complaint allegations were found to be unsubstantiated due to lack of preponderance of evidence.
Report Facts
Capacity: 61
Census: 81
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Pang Lee | Licensing Program Analyst | Conducted the complaint investigation and authored the report |
| Czarrina A Camilon-Lee | Licensing Program Manager | Oversaw the complaint investigation |
| Alvin Gaoat | Resident Services Director | Met with Licensing Program Analyst during the investigation |
Inspection Report
Annual Inspection
Census: 50
Capacity: 61
Deficiencies: 1
Date: Nov 14, 2024
Visit Reason
The inspection was an unannounced annual inspection visit conducted to evaluate compliance with licensing requirements and ensure health and safety standards at the facility.
Findings
The facility was found to be clean, odor-free, and in good repair with adequate food supplies and proper storage. However, a deficiency was cited for failure to have an updated Physician's Report for resident R5, posing a potential health and safety risk.
Deficiencies (1)
Resident R5 did not have an updated Physician's Report on file; the last report was dated 7/21/2020, which poses a potential health, safety, or personal rights risk to persons in care.
Report Facts
Capacity: 61
Census: 50
Plan of Correction Due Date: Nov 21, 2024
Fire extinguisher last serviced: Jun 7, 2024
Last disaster drill: Oct 2, 2024
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Damion E. Anderson | Executive Director | Met with Licensing Program Analyst during inspection; discussed renewal of Administrator Certification and plan of correction |
| Arvin Villanueva | Licensing Program Analyst | Conducted the annual inspection visit and authored the report |
| Stephen Richardson | Licensing Program Manager | Supervisor overseeing the inspection |
Inspection Report
Complaint Investigation
Census: 50
Capacity: 61
Deficiencies: 1
Date: Oct 8, 2024
Visit Reason
The inspection was an unannounced complaint investigation visit conducted in response to allegations received on 2024-04-02 regarding staff not following proper reporting requirements, failure to meet residents' incontinence needs timely, and giving residents discontinued medications.
Complaint Details
The complaint investigation was substantiated for failure to follow proper reporting requirements. The allegations regarding unmet incontinence needs and administration of discontinued medications were unsubstantiated.
Findings
The investigation substantiated the allegation that staff did not follow proper reporting requirements, citing failure to report several incidents involving a resident. The allegations that staff did not meet incontinence needs timely and gave discontinued medications were found unsubstantiated based on interviews and records review.
Deficiencies (1)
Failure to submit required reports to the licensing agency as required by CCR 87211(a)(1), posing a potential health and safety risk to residents.
Report Facts
Capacity: 61
Census: 50
Deficiencies cited: 1
Plan of Correction Due Date: Oct 22, 2024
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Tung Truong | Licensing Program Analyst | Conducted the complaint investigation and authored the report |
| Czarrina A Camilon-Lee | Licensing Program Manager | Oversaw the complaint investigation |
| Alvin Gaoat | Resident Services Director | Met with Licensing Program Analyst during investigation |
| Damion E. Anderson | Administrator | Facility administrator named in the report |
Inspection Report
Follow-Up
Census: 51
Capacity: 61
Deficiencies: 1
Date: Aug 23, 2024
Visit Reason
The visit was an unannounced case management follow-up regarding an incident report received on 2024-08-16 about a resident eloping from the facility on 2024-08-12.
Complaint Details
The visit was triggered by an incident report alleging that a resident eloped from the facility without staff knowledge. The allegation was substantiated as the facility failed to supervise the resident as required.
Findings
The facility failed to supervise a 102-year-old resident with dementia who eloped without staff knowledge, violating licensing requirements. Deficiencies were cited and an immediate civil penalty of $500 was assessed for the health and safety risk.
Deficiencies (1)
Failure to be aware of the resident's general whereabouts, allowing the resident to leave the facility unassisted, posing an immediate health and safety risk.
Report Facts
Immediate civil penalty: 500
Deficiency count: 1
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Damion E. Anderson | Administrator | Met with Licensing Program Analyst during the visit and named in relation to the incident |
| Tung Truong | Licensing Program Analyst | Conducted the case management visit and authored the report |
| Czarrina A Camilon-Lee | Licensing Program Manager | Supervisor named in the report |
Inspection Report
Follow-Up
Census: 72
Capacity: 61
Deficiencies: 0
Date: May 2, 2024
Visit Reason
The visit was an unannounced case management follow-up regarding an incident report received on 2024-04-12 involving a small fire caused by a melted plastic food tray on the stove.
Findings
During the visit, the Licensing Program Analyst toured the facility and interviewed staff. It was determined that the fire was small, caused no harm to residents, and only damaged the food tray. No deficiencies were observed during the visit.
Report Facts
Incident date: Apr 11, 2024
Incident report received date: Apr 12, 2024
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Damion Anderson | Administrator | Met with Licensing Program Analyst during the visit and involved in incident discussion |
| Tung Truong | Licensing Program Analyst | Conducted the case management visit |
Inspection Report
Annual Inspection
Census: 46
Capacity: 61
Deficiencies: 0
Date: Oct 24, 2023
Visit Reason
The Licensing Program Analyst conducted an unannounced annual inspection to evaluate compliance with regulatory requirements.
Findings
The facility was found to be clean, odor-free, and in good repair with no health or safety concerns. All required documentation and staff clearances were verified, and no deficiencies were cited during the inspection.
Report Facts
Residents files reviewed: 6
Staff files reviewed: 5
Hot water temperature: 119.1
Facility temperature: 74
Licensed capacity: 61
Current census: 46
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Damion E. Anderson | Administrator | Met with Licensing Program Analyst during inspection |
| Tung Truong | Licensing Program Analyst | Conducted the annual inspection |
| Czarrina A Camilon-Lee | Licensing Program Manager | Named in report header and narrative |
Inspection Report
Complaint Investigation
Census: 45
Capacity: 61
Deficiencies: 0
Date: Feb 22, 2023
Visit Reason
The inspection visit was an unannounced complaint investigation triggered by an allegation that the facility did not seek medical attention in a timely manner.
Complaint Details
The complaint alleged that the facility did not seek medical attention in a timely manner. The allegation was originally substantiated on 2023-01-23 but was amended to unsubstantiated after further audit and investigation.
Findings
The investigation found that although the allegation was originally substantiated, it was later amended to unsubstantiated after review. The facility responded appropriately by performing a wellness check and contacting the doctor once pain was reported, thus no preponderance of evidence supported the allegation.
Report Facts
Complaint Control Number: 27-AS-20221014152649
Facility Capacity: 61
Census: 45
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Jamie Ivey-Canady | Licensing Program Analyst | Conducted the complaint investigation and delivered findings |
| Elizabeth Cruz | Administrator | Facility administrator met with the investigator during the visit |
| Stephen Richardson | Licensing Program Manager | Named in report as Licensing Program Manager |
Inspection Report
Complaint Investigation
Census: 45
Capacity: 61
Deficiencies: 3
Date: Jan 23, 2023
Visit Reason
The inspection was an unannounced complaint investigation visit triggered by allegations that the facility did not notify a resident's responsible party of an incident in a timely manner and that a resident sustained a fracture while in care.
Complaint Details
The complaint investigation was substantiated. The allegations that the facility did not notify the resident's responsible party of an incident in a timely manner and that the resident sustained a fracture while in care were both substantiated based on interviews, medical documentation, and staff statements.
Findings
The investigation substantiated that a resident sustained a displaced intertrochanteric fracture of the left femur due to an unwitnessed fall at the facility. It was also substantiated that the facility failed to notify the resident's responsible party in a timely manner, with a delay of approximately 16 hours before family notification.
Deficiencies (3)
Facility did not ensure resident's family was notified of resident fall timely, posing a potential danger to health and safety.
Facility did not ensure resident had appropriate assistance when attempting to ambulate from a laying position, posing an immediate health and safety risk.
Facility did not ensure services were provided to a resident as pertained to resident pre-admission appraisal, posing an immediate health and safety risk.
Report Facts
Capacity: 61
Census: 45
Notification delay hours: 16
Deficiencies cited: 3
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Jamie Ivey-Canady | Licensing Program Analyst | Conducted the complaint investigation and interviews |
| Stephen Richardson | Licensing Program Manager | Oversaw the complaint investigation report |
| Elizabeth Cruz | Administrator | Facility administrator met with Licensing Program Analyst during investigation |
Inspection Report
Follow-Up
Census: 46
Capacity: 61
Deficiencies: 0
Date: Nov 14, 2022
Visit Reason
An unannounced plan of correction (POC) visit was conducted to verify correction of citations issued during the case management visit on 2022-11-05.
Findings
The licensing program analyst toured the facility, reviewed submitted documents for plans of correction, and observed that the cited deficiencies under Title 22 Regulations had been cleared. The licensee complied with the terms of the POC by the due date.
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Albert Johnson | Licensing Program Analyst | Conducted the unannounced POC visit and verified correction of citations. |
| Stephenie Doub | Licensing Program Manager | Named as Licensing Program Manager on the report. |
| Elizabeth Cruz | Administrator | Facility administrator met during the visit. |
Inspection Report
Annual Inspection
Census: 46
Capacity: 61
Deficiencies: 3
Date: Nov 5, 2022
Visit Reason
The inspection was an unannounced annual inspection conducted to evaluate compliance with licensing regulations and facility standards.
Findings
The inspection found several deficiencies including hot water temperature exceeding the required range, outdated five-year riser fire system inspection, and outdated physician reports for residents. Fire safety equipment was current, and staff files were reviewed with some issues noted in resident medical documentation.
Deficiencies (3)
Hot water temperature measured at 124.5°F in residents' bathroom sinks (rooms 14 and 17), exceeding the required range of 105 to 120°F, posing immediate health and safety risks.
The five-year riser fire system inspection was outdated; last serviced in May 2017 and annual service sticker was not located, not maintaining conformity with State Fire Marshal regulations.
Residents diagnosed with dementia (R1 through R4) did not have updated annual medical assessments (LIC 602) as required.
Report Facts
Capacity: 61
Census: 46
Hot water temperature: 124.5
Fire system last serviced: 2017
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Albert Johnson | Licensing Program Analyst | Conducted the inspection and authored the report |
| Stephenie Doub | Licensing Program Manager | Supervisor overseeing the inspection |
| Elizabeth Cruz | Administrator | Facility administrator present during inspection |
| Jane Rowe | Met with Licensing Program Analyst during inspection |
Inspection Report
Capacity: 61
Deficiencies: 0
Date: Nov 5, 2022
Visit Reason
The visit was a Post Licensing evaluation conducted to complete the annual report for the facility.
Findings
The annual report was completed on 11/5/2022 with no additional findings or deficiencies noted in the report.
Inspection Report
Original Licensing
Census: 46
Capacity: 61
Deficiencies: 0
Date: Nov 2, 2021
Visit Reason
The visit was an announced pre-licensing inspection to evaluate the facility for licensing approval.
Findings
The facility was inspected thoroughly including physical plant, resident rooms, kitchen, and safety features. No deficiencies were found and the facility passed the pre-licensing inspection.
Report Facts
Fire extinguisher last check date: Jun 18, 2021
Hot water temperature range (Fahrenheit): Hot water temperature measured at 118.2, 112.7, 112.4, 111.9 degrees Fahrenheit in 4 bathrooms
Non-ambulatory residents capacity: 51
Bedridden residents capacity: 10
Residents in care: 46
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Elizabeth Cruz | Administrator | Facility Administrator present during inspection and Component III completion |
| Christina Valerio | Licensing Program Analyst | Conducted the pre-licensing inspection and authored the report |
| Stephen Richardson | Licensing Program Manager | Named as Licensing Program Manager on the report |
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