Inspection Report
Annual Inspection
Capacity: 150
Deficiencies: 0
Jan 14, 2025
Visit Reason
This was an unannounced required annual inspection visit to evaluate the facility's compliance with licensing regulations.
Findings
The inspection found no deficiencies. Several updates were requested to be submitted by the end of the month, including personnel schedule, emergency disaster plan, and designation of administrative responsibility.
Report Facts
Facility capacity: 150
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Grayson Tynes | Executive Director | Met with during the inspection and mentioned in the narrative |
Inspection Report
Annual Inspection
Capacity: 150
Deficiencies: 0
Feb 21, 2024
Visit Reason
The inspection was an unannounced Required-1 Year Inspection conducted to evaluate the health and safety conditions of the facility and ensure compliance with licensing requirements.
Findings
The inspection found the facility to be in compliance with all regulations, including clean and sanitary conditions, proper medication storage and administration, operable safety equipment, and appropriately trained staff. No deficiencies were cited during the inspection.
Report Facts
Resident files reviewed: 6
Staff records reviewed: 4
Fire extinguisher last serviced: Jan 25, 2024
Fire drill last conducted: Jan 18, 2024
Hot water temperature: 112
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Grayson Tynes | Executive Director | Met with Licensing Program Analyst during inspection and named in report |
| Sarena Keosavang | Licensing Program Analyst | Conducted the inspection |
| Troy Ordonez | Licensing Program Manager | Named in report |
Inspection Report
Annual Inspection
Census: 75
Capacity: 150
Deficiencies: 0
Feb 22, 2023
Visit Reason
An unannounced annual inspection was conducted to ensure the health and safety of residents in care at the facility.
Findings
The facility was found to be in substantial compliance with no immediate health, safety, or personal rights violations observed. No deficiencies were cited during this inspection.
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Grayson Tynes | Administrator | Met with Licensing Program Analyst during the inspection and involved in infection control domain completion. |
| Bethany Mirlohi | Licensing Program Analyst | Conducted the annual inspection and infection control domain evaluation. |
| Troy Ordonez | Licensing Program Manager | Named as Licensing Program Manager on the report. |
Inspection Report
Capacity: 150
Deficiencies: 0
Dec 20, 2022
Visit Reason
The visit was an unannounced case management visit to confirm orders for immediate exclusion of an individual from all facilities.
Findings
The facility was informed of an immediate exclusion effective 12/20/2022 for an individual (S1), who is not allowed to work, live in, or have contact with clients in any residential facility licensed by the California Department of Social Services.
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Grayson Tynes | Administrator | Met with Licensing Program Analyst during the visit and acknowledged the immediate exclusion order. |
Inspection Report
Annual Inspection
Census: 86
Capacity: 150
Deficiencies: 0
Dec 8, 2021
Visit Reason
The inspection was an unannounced required annual inspection combined with a 14-day follow-up regarding COVID-19 protocols.
Findings
The inspection found no deficiencies; the facility was in compliance with Title 22 Regulations, Division 6. COVID-19 protocols were followed, no positive residents were present, and safety equipment and supplies were adequate.
Report Facts
Perishable food supply: 2
Non-perishable food supply: 7
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Grayson Tynes | Executive Director | Met with Licensing Program Analyst during inspection and received exit interview |
| DeAnna Williams-Lyons | Licensing Program Analyst | Conducted the inspection and signed the report |
| Laura Munoz | Licensing Program Manager | Named in the report as Licensing Program Manager |
Inspection Report
Complaint Investigation
Capacity: 150
Deficiencies: 0
Jun 7, 2021
Visit Reason
The inspection was an unannounced complaint investigation visit triggered by allegations received on 2020-08-04 that staff were not meeting residents' needs and not cleaning resident rooms.
Findings
The investigation included interviews with the administrator, staff, and residents, and review of resident files and policies. The findings concluded that hydration and assistance with cleanliness were provided as required, and housekeeping services were maintained. The allegations were determined to be unsubstantiated due to lack of preponderance of evidence.
Complaint Details
The complaint alleged that staff were not meeting residents' needs, including hydration, and were not cleaning resident rooms. After investigation, including interviews and document review, the allegations were found unsubstantiated.
Report Facts
Facility capacity: 150
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Grayson Tynes | Administrator | Met with during investigation and interviewed regarding allegations |
| Donna Gurriere | Licensing Program Analyst | Conducted the complaint investigation |
| Rayna L Bryson | Licensing Program Manager | Named as Licensing Program Manager on report |
Inspection Report
Complaint Investigation
Census: 77
Capacity: 150
Deficiencies: 0
Jun 7, 2021
Visit Reason
An unannounced complaint investigation was conducted due to allegations that facility staff were not meeting the needs of a resident.
Findings
The investigation included interviews with the administrator, staff, and residents, and review of relevant documents. Although the allegations may have occurred or be valid, there was not a preponderance of evidence to prove the violation, and the findings were unsubstantiated.
Complaint Details
The complaint alleged that facility staff were not meeting the needs of a resident. The findings were unsubstantiated.
Report Facts
Complaint Control Number: 27
Complaint Control Number Suffix: 20201231110109
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Donna Gurriere | Licensing Program Analyst | Conducted the complaint investigation |
| Grayson Tynes | Administrator | Interviewed during the investigation |
| Rayna L Bryson | Licensing Program Manager | Named in report signature section |
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