At 9:30a.m. LPA and Administrator toured the physical plant areas inside and outside to ensure there are no health and safety hazards, and facility is in compliance with Title 22 Regulations. The facility is fire cleared for one hundred eighty (180) residents of which sixty-five (65) may be non-ambulatory and has a hospice waiver for two (02). The facility is currently occupying seventy-five (75) residents. The facility is a two (02) story building in a residential community. The 1st floor consists of the following: a lobby area, administrative offices, dining area, activities room, kitchen, garden lounge, beauty shop, game room, tea room, indoor gardens with water fountains, TV areas, outdoor gardens, and residents’ rooms. The 2nd floor consists of activity area, TV areas, library lounge, Zen room, snack room, large lounge area, and residents’ rooms. The passageways and walkways are free of hazards and free from obstruction.

The facility maintains a comfortable temperature at 74°F. There are carbon monoxide detectors installed in the facility. Fire extinguishers are located all throughout the facility and last inspected on 05/13/2025. The fire extinguishers were observed to be fully charged and in compliance. The facility is equipped with emergency fire sprinkler system. Facility Fire drill was last conducted on 12/02/2025.

There is only one entrance being utilized at the facility, all required posters were posted in the hallway. During today's visit, in addition to the physical plant inspection LPA interviewed seven (07) out of seventy-five (75) residents.

Cont. on LIC 809-C

• 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 tour of the physical plant was conducted, and the following was noted:

Kitchen: The kitchen appliances and fixtures were functional. Food supplies was sufficient amount for two (02) days of perishable and seven (07) days of non-perishable was stored in covered containers at the appropriate temperatures. Knives and sharp objects were observed to be locked and inaccessible to residents. Storage areas for cleaning solutions, toxics, knives, and hazardous items were secured and made inaccessible to residents. Walls, ceiling, and floor is in good repair, ample supply of dishes, cups, glasses and utensils for the current census. Dining Area: The dining area was observed to be neat, clean and in proper order. Walls, ceiling, tables, chairs and floor is in good repair. Laundry rooms: There are laundry rooms located on each floor of the building. All toxins such as laundry detergents and cleaning agents were observed to be inaccessible to the residents in laundry rooms. Medication: Medications are centrally stored in the locked medication stations located on the first floor. The medications were observed to be locked and inaccessible to residents. There are multiple complete first aid kits in the facility. Bedrooms: LPA randomly selected resident’s apartments on each floor. Resident bedrooms were properly furnished with appropriate bedding and linens with sufficient lighting. Hygiene supplies for residents were observed, and hallways/passageways are lit. There were enough clean linen available in the closets. Each resident’s apartment has their own closet and restroom. Bathrooms: LPA randomly selected residents’ bathrooms on each floor. The bathrooms were observed to be clean properly supplied, functional fixtures and appropriate grab bars in showers and toilets. The hot water temperature measure range was between 110.1 – 115.1 degrees Fahrenheit within Title 22 Regulations. Towels and washcloths are not shared. Common Areas: LPA observed common areas on every floor. All furnishings are in good repair, lighting is good, walls, ceiling and floors are also in good repair. Surrounding Grounds: The front grounds of the facility are well landscaped with a waterfall with Koi fish and turtles which are enclosed. All passageways were observed to be clear from obstruction.

Due to time constraints, LPA had to terminate the visit and will return on a later date to complete the Required - 1 Year inspection by reviewing medication, residents and staff records.

No health and safety issues noted at the time of this visit.

An exit interview was conducted. A copy of this report was provided to the Administrator.