The facility is licensed to serve 206 elderly residents who are ambulatory and non-ambulatory, age 60 and above. Non-ambulatory rooms are rooms #101-#140 (excludes room # 110) and rooms #201-#267 (excludes room# 221, 222, 243). The facility is a two-story building located in a residential neighborhood. It consist of several resident bedrooms in both floors, a lobby seating area, offices, a dining room, a coffee bar, a studio dining room, a commercial kitchen, a medication room, a common shower, an activity room, a family room, a parlor, a courtyard in the first floor, a conference room, a TV room, a library, a laundry room, and patio in the second floor.

Today’s inspection consisted of applying CARE tool, conducting physical plant tour, reviewing staff/residents records, checking residents’ food supply/medication, and interviewing staff/residents.

Infection Control:

The facility maintains current infection control plan, dated 4/1/26. Hand sanitizer and proper sanitation were observed during the visit throughout the facility. There is a responsible person and emergency training was provided to staff. Personal protective equipment was observed. Staff have TB test clearances on file. (CONTINUED ON LIC 809C)

• Type A deficiencies are violations of licensing requirements that, if not corrected, have a direct and immediate risk to the health, safety, or personal rights of persons in care.

• Type B deficiencies are violations of licensing requirements that, without correction, could become a risk to the health, safety, or personal rights of persons in care, a recordkeeping violation that could impact the care of said persons and/or protection of their resources, or a violation that could impact those services required to meet the needs of persons in care.

A plan of operation is maintained. Facility has a current liability insurance policy which covers from 08/01/2025 to 08/01/2026. Facility is operating within the license.

Physical Plant/Environmental Safety:

Physical plant was conducted with Jacqueline Hernandez and observed the following: Facility was observed clean and in good repair indoors and outdoors.

First Floor: Main entrance, lobby, family room, TV room, dining room, coffee bar, beauty parlor, outdoor areas were clean and in good repair. Fireplaces were adequately screened. Carbon monoxide detectors were tested and operable. Fire extinguishers were mounted on the wall in the kitchen and last checked was on 07/08/2025. Smoke detectors were monitored by ADR Security System, which was a fire prevention company and the recent service was done today 04/06/26. Ramps, exit doors, and passageways are free of debris and obstructions. Kitchen was observed clean. Storage rooms, Med room, laundry room and maintenance office were inaccessible to residents. Common shower across from the elevator has skid flooring. Five (5) resident rooms were randomly selected for a physical plant tour. Call system was tested and the response time was in a range of 5 – 10 minutes. Resident bedrooms were observed clean, tidy and in compliance. The residents’ bathrooms were clean and in working condition with grab bars, and skid mats. Hot water temperatures were measured in a range from 108.1 degree F to 111.6 degree F, which was in compliance within the required 105-120 degrees F. The courtyard or outdoor area had a small bodily of water which was secured with fence and inaccessible to the residents. Shaded seating area was provided to residents. Delay egress exits and auditory devices were operable.

Second Floor: Library's fireplace is adequately screened. Library, conference room, and sensory room were observed clean and in good repair. Five (5) resident rooms were randomly selected for a physical plant tour. Call system was tested and the response time was in a range of 5 – 10 minutes. Resident bedrooms were observed clean, tidy and in compliance.

(CONTINUED ON LIC 809C)

Staffing:

Current CPR/First Aid training were on file. There were four (4) available night staff, whom have been provided emergency training. Sufficient staff were observed.

Personnel Records/Staff Training: Administrator certificate for Annabelle Argenal is current and the expiration date is 04/21/2027. Staff records were available for review. Six (6) staff files were reviewed. Staff records and in service training were current.

Resident Rights/Information:

Adequate signage including Personal Rights, Let Us No poster (PUB 475), and Local Ombudsman posters were observed in the lobby.

Planned Activities:

LPA observed residents were doing activities/exercises after breakfast. Activity materials were observed. The facility has a library and a sensory area to stimulate neurological skills.

Food Service:

Sufficient food supplies were observed of perishables for at least two (2) days and non-perishables for at least seven (7) days. Residents’ dietary list was posted in the kitchen near the food tray preparation area. Pest was not observed. Staff were observed using hygiene and contamination prevention methods.

Incidental Medical and Dental:

Wellness room and medication carts were locked. Wellness room / med room stored in house medications, refrigerated medications, and surplus medications. Medication carts were located in the studio dining room. Medications were kept in their original containers. (CONTINUED ON LIC 809C)

Residents records were available for review. Six (6) resident files were reviewed which contained medical assessment, TB clearance, admission agreement, an appraisal, a needs and care plan.

Disaster Preparedness:

Emergency Disaster plan (LIC 610E 3/19), it has been reviewed within a year. The last emergency drill was conducted on 03/20/26 which was done quarterly. Emergency evacuation chairs were observed at the top of each exit door.

Residents with Special Health Needs:

Postural support/bed rails were observed and physician's requests were observed in residents files who are under hospice. Facility followed dementia regulations. All delay egress exit doors were tested and operable. Facility keeps hospice plan on file.

Exit:

No deficiencies were noted during this visit per California Code of Regulations, Title 22, Division 6. Exit interview was conducted with Administrator and LIC 809s were provided.