Laurel Crest Manor

Allegation investigated: Facility unlawfully evicted resident

Licensing Program Analyst (LPA) Monter conducted an unannounced complaint inspection to deliver the findings on the above allegations. LPA met with Staff Luzviminda Obillo. (LPA contacted ADM. LPA went over report via phone call. ADM stated Staff Luzviminda Obillo could sign on her behalf. On April 21, 2026, the Department received a complaint alleging Facility unlawfully evicted resident April 23, 2026, the Department interviewed Witness W1. W1 clarified that he/she was not the person who was informed about the potential eviction. W1 stated he/she was informed about conversation between R1’s responsible party and the licensee. W1 stated based on those conversations, it seems as if they are trying to evict R1. W1 stated, based on his/her conversation with the responsible party, it seemed like a verbal eviction. Page 1 Out of 2. Unfounded On April 23, 2026, Licensing Program Analyst Manuel Monter interviewed resident R1. R1 stated he/she isn’t aware of anything regarding an eviction. On April 23, 2026, Licensing Program Analyst Manuel Monter interviewed Administrator (ADM) Merle Laurel. ADM stated he/she has not evicted any resident, including R1. ADM stated no verbal or written evictions have been given. ADM stated she did tell the payee that R1 will probably need to go to a higher level of care since there has been some decline to R1’s cognition. On May 14, 2026, Licensing Program Analyst Manuel Monter interviewed R1’s Responsible Party, referred to R1RP. R1RP stated R1 wasn’t and isn’t being evicted. R1RP stated both he/she and the Administrator were in agreement, that due to R1 rate of decline, R1 will need to eventually move to another home with a higher level of care. R1RP stated he/she and the ADM agreed this eventual transfer would occur, but he/she would need sometime to find a new home to transfer. R1RP stated reiterated that R1 wasn’t evicted. R1RP stated ADM never mentioned an eviction. R1RP stated the administrator did not evict R1 or imply she was going to evict R1. The Department has completed the investigation of the above allegations. Based on interviews conducted and records review, the department has found that the above allegations were UNFOUNDED, meaning that the allegations were false, could not have happened and/or are without a reasonable basis. Page 2 Out of 2. End of Report. On April 23, 2026, Licensing Program Analyst Manuel Monter interviewed residents R1-R5. R1 stated he/she hasn’t had any falls in the home. 2 Out of 5 residents (R2 - R3) stated, there are not aware of other residents in the home sustaining a fall. R4 stated he/she has seen his/her roommate fall. R4 stated he/she thinks R1 did fall down a week ago. R4 stated he/she doesn’t remember exactly or when this fall occurred. R4 stated he/she thinks R1 has fallen in the home a total of 4-5 times. (R4 stated he/she isn’t aware or remember where and what time these falls occurred. ) 4 Out of 5 residents (R1-R4) they haven’t seen any time when a resident who needed help, was not provided assistance by staff. Resident R5 declined to be interviewed and did not provide any relevant information regarding the allegations. On April 23, 2026, Licensing Program Analyst Manuel Monter interviewed staff S1 and S2. S1 stated there was an incident that occurred weeks ago. S1 stated around 1-2pm, he/she was cooking in the kitchen and R1 was in the living room watching kitchen. S1 stated he/she had seen R1 in the living room, 15-30 minutes prior. S1 stated as he/she was cooking in the kitchen, he/she heard a sound, like something falling. S1 stated he/she doesn’t think R1 fell. S1 stated R1 was found sitting next to the chair on his/her bottom. S1 stated he/she thinks R1 just lost his/her balance and sat on the ground. S1 stated he/she didn’t actually observe the “fall”. S1 stated he/she checked R1 and did not note any injuries. S1 stated the next day he/she did see a little redness, which went away the following day after. S1 stated besides the incident noted above, there hasn’t been other falls in the home. S2 stated, from his/her memory, there hasn’t been any falls in the home in the past 3 months. On April 23, 2026, Licensing Program Analyst Manuel Monter interviewed ADM/Licensee Merle Laurel. ADM stated there hasn’t been any recent falls at the facility. ADM stated based on what was reported to her, R1 may have hit his/her head when he/she got up. ADM stated R1 may have been reaching for his/her shoes and may have accidentally hit him/herself. ADM stated this event was not witnessed. ADM stated R1 didn’t experience a fall. ADM stated R1 did not sustain any bruising or injury. Page 2 Out of 3. On May 14, 2026, Licensing Program Analyst Manuel Monter interviewed Witness W2. W2 stated he/she was visiting the home, the following day when the alleged incidents occurred. W2 stated that based on the observations of the bruise and marks, W2 characterized them as small and barely noticeable. W2 stated he/she is aware of R1’s alleged fall on February 2026. W2 stated he/she is also aware of R1 sustaining an injury on his/her face in March 2026. W2 stated he/she and the ADM discussed both of the incidents and concluded that it wasn’t an issue since R1 didn’t sustain any injuries. W2 stated he/she has not observed any instance where staff neglected / did not help a resident requesting for help. W2 stated during the times he/she visited the home, he/she did not observe any instance where a resident was neglected. W2 stated he/she didn’t observe any sign of neglect. On May 26, 2026, Licensing Program Analyst Manuel Monter interviewed staff S3. S3 stated he/she does recall an incident where R1 sustained a fall. S3 stated he/she was doing laundry at the time. S3 stated sometime, over a month ago, R1 had fallen in the living room, sometime around lunch. S3 stated she and S1 left R1 in the living room watching television. S3 stated R1 was found on the ground, next to the chair in the living room. S3 stated R1 was found by S1, who was in the kitchen at the time. S3 stated R1 sustained a mark on his/her face but not a bruise. S3 stated the mark on R1’s face was smaller than a penny. The Department reviewed Resident R1’s Progress Notes. Note dated March 20, 2026, states, R1 was out of balance and he/she “hit in the chair” but not bruised. Based on investigation, records reviewed, and interviews conducted, the Department found that the above allegations are UNSUBSTANTIATED. An unsubstantiated finding indicates that although the allegation may have happened or is valid, there is not a preponderance of evidence to prove that the allegations did or did not occur. Page 3 Out of 3. End of Report.the state’s words, verbatim · CDSS document, May 27, 2026 · control 26-AS-20260421160204

Type of visit: POC

Licensing Program Analyst Manuel Monter conducted a POC case management visit to clear deficiencies cited on December 11, 2025 during an annual inspection. LPA met with Staff Josephine Daguro and explained the purpose of the visit. The facility was cited the following Type A deficiencies on December 11, 2025 87307 Personal Accommodations and Services (d)(6), POC due date December 12, 2025 The facility was cited the following Type B deficiencies on December 11, 2025. 87412 Personnel Records (c)(2)(D), POC due date December 18, 2025 87463 Reappraisals (a), POC due date December 18, 2025 LPA received plan of corrections by POC date. Deficiencies cleared during todays visit. POC cleared letter provided to ADM. No deficiency was cited during todays visit. This report was reviewed with Staff Josephine Dagurothe state’s words, verbatim · CDSS document, Dec 22, 2025

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Manuel Monter conducted an unannounced annual inspection visit, and met with Staff Luzviminda Obillo (S1). During the visit, LPA observed 6 residents and 2 staff. LPA explained the purpose of the visit. LPA toured the facility inside out with S1 which included the Living room, kitchen, dining room, 3 restrooms and 3 residents bedrooms. The staff area of the facility was also inspected. The front yard and backyard were inspected. While touring bedroom #4, LPA observed the sliding glass door leading to the backyard, had a stick blocking its track, preventing the door from being opened. Staff S1 stated she placed the stick there because resident R1 has wandering behaviors. S1 stated at least once a week R1 will attempt to wander at night. Two-day perishable food supplies and seven day nonperishable food supplies were observed. LPA observed the medication storage area, knives storage area, and cleaning product storage area as locked and inaccessible to residents in care. Room temperature was at 70 degrees F, and hot water temperature was measured at 115 degrees F in resident bathrooms. Fire extinguisher was serviced in January 13, 2025. The facility was equipped with smoke and carbon monoxide detectors. Smoke detectors was tested by S1, and were functional. LPA observed facility first aid kit and facility fire/earthquake drill log. The facility's last drill was on December 5, 2025. Page 1 Out of 2. LPA reviewed 3 resident medications and centrally stored medication records. LPA reviewed facility records for 3 staff and 3 residents. LPA reviewed R1's Appraisal Needs & Services Plan dated March 19, 2025. During todays visit, Staff S1 informed LPA that R1 has wandering behaviors. LPA reviewed R1's file, which notes that R1 has a neurocognitive disorder. R1's Appraisal Needs & Services Plan dated March 19, 2025 does not address R1's wandering behaviors or provide any details regarding R1's plan of care. Furthermore, R1 and R3's Appraisal Needs and services plans do not provide background information about the resident such as but not limited to: brief description of residents medical history/emotional, behavior and physical problems, functional limitations, physical and mental capabilities. LPA requested to review resident R2's Appraisal Needs and Services Plan. Staff S1 could not find a copy of R2's Appraisal Needs and Services Plan. LPA reviewed staff training records. LPA noted the staff training records do not indicate the Number of training hours dedicated to each subject. Deficiencies cited during today's visit, see LIC809-D. This report was reviewed with Staff Luzviminda Obillo and a copy of the signed report was provided. Appeal rights were provided. Page 2 Out of 2. END OF REPORT.the state’s words, verbatim · CDSS document, Dec 11, 2025

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Manuel Monter conducted an unannounced annual inspection visit, and met with Lead Staff Luzviminda Obillo (S1). During the visit, LPA observed 5 residents and 2 staff. LPA explained the purpose of the visit. LPA toured the facility inside out with S1 which included the Living room, kitchen, dining room, 3 restrooms and 4 residents bedrooms. The staff area of the facility was also inspected. LPA toured the facility garage, which is being used as a storage space/Laundry area. The front yard and backyard were inspected. There was no obstruction to block the walkways. Two-day perishable food supplies and seven day nonperishable food supplies were observed. LPA observed the medication storage area, knives storage area, and cleaning product storage area as locked and inaccessible to residents in care. Room temperature was at 70 degrees F, and hot water temperature was measured at 110 degrees F in both resident bathrooms. Fire extinguisher was serviced in January 22, 2024. The facility was equipped with smoke and carbon monoxide detectors. Smoke detectors was tested by S1, and were functional. LPA observed facility first aid kit and facility fire/earthquake drill log. The facility's last drill was on December 15, 2024. LPA reviewed facility records for 3 staff and 3 residents. LPA reviewed 3 resident medications and centrally stored medication records. LPA conducted interviews with 2 residents. LPA provided ADM with CDSS Flyer, "Important updates to Dementia Care and Miscellaneous Changes, effective January 1, 2025." No deficiencies cited during today's visit, A technical assistance was provided. This report was reviewed with Lead Staff Luzviminda Obillo and a copy of the signed report was provided.the state’s words, verbatim · CDSS document, Jan 8, 2025

Allegation investigated: Staff did not immediately provide required information to paramedics causing delay in medical care to resident

Licensing Program Analyst (LPA) Monter conducted an unannounced complaint inspection to deliver the findings on the above allegations. LPA met with Lead Luzviminda "Minda" Obillo. On August 29, 2022, the department received a complaint alleging Staff did not immediately provide required information to paramedics causing delay in medical care to resident R1. On September 8, 2022, LPA Christine Dolores interviewed S1. S1 stated called emergency services for resident (R1). S1 was helping R1 while on the phone with 911 and did not have time to make copies of the other information. S1 stated the paramedics requested for R1’s medical history and information, which S1 did not have a copy of the records readily available to medical personnel. S1 states this took maybe an additional 5 more minutes. Page 1 Out of 2. Unsubstantiated On September 8, 2022, LPA Christine Dolores interviewed ADM. ADM stated the necessary paperwork was the 602 (physicians report) with the client's medical information. ADM states they normally don't give the paramedics the 602 and they only hand over the Vial of L.I.F.E form. Staff had given the Vial of L.I.F.E form to the paramedic but because the paramedic requested the 602, which then her staff had to go back to make copies. On September 5, 2024, LPA interviewed resident R1. Resident R1 stated he/she does not remember what had occurred on August 28, 2022 and does not remember interacting with the paramedics. On September 14, 2024, LPA interviewed Staff S2. Staff S2 stated he/she has trouble remembering the details of the event but stated they provided the paramedics with the documents they requested. S2 stated it took about 2 minutes to provide copies of R1's physician report and medication list. LPA interviewed Witness W1. W1 stated August 28, 2022, staff on site were unable to provide any information regarding resident R1. W1 stated it took facility staff 10-15 minutes to provide the information regarding R1. Based on investigation, records reviewed, and interviews conducted, the Department found that the above allegations are UNSUBSTANTIATED. An unsubstantiated finding indicates that although the allegation may have happened or is valid, there is not a preponderance of evidence to prove that the allegations did or did not occur. No deficiencies cited, an exit interview conducted with Lead Luzviminda "Minda" Obillo and a copy of the report was provided. Page 2 Out of 2. END OF REPORTthe state’s words, verbatim · CDSS document, Sep 14, 2024 · control 26-AS-20220829154416

Allegation investigated: Facility staff neglected to provide care for resident injury Facility did not report resident injury to Licensing Facility did not notify resident's family or responsible party of injury

Licensing Program Analyst (LPA) Monter conducted an unannounced complaint inspection to deliver the findings on the above allegations. LPA met with staff Lead Luzviminda "Minda" Obillo. On July 26, 2022, the department received a complaint alleging facility staff neglected to provide care for resident injury. On August 3, 2022, LPA Dolores interviewed staff S1 and S2. S1 stated he/she saw a bruise on R1’s chest and swelling on the clavicle on July 18, 2022. S1 stated R1 did not express pain and thought it was only R1’s Arthritis. S1 stated he/she massaged R1's chest and clavicle area and put Salonpas on the areas of concern. S1 stated on July 21, 2022, S1 called On Lok (R1's medical provider) to check on R1 because R1's face expressed a little pain. S1 stated staff can tell when R1 has pain thru his/her facial expressions. S1 stated on July 22, 2022, around 10:00am, On Lok picked up R1. Page 1 Out of 3. Unfounded Staff S2 stated he/she noticed the swelling on July 18, 2022. S2 talked to S1 about the swelling and S1 was putting Salonpas on the affected area. S2 stated when R1 felt better he/she said "ok, ok”. S2 stated he/she thought it was R1’s arthritis and R1 never expressed pain. S2 stated the facility staff can tell when R1 is in pain through her facial expressions. Staff S1 and S2 stated they did not observe R1 fall or sustain an injury. On August 11, 2022, LPA interviewed ADM. ADM was notified by staff on July 21, 2022 that R1 had slight swelling but was able to still move around. ADM stated she observed the swelling and informed staff S1 to call On Lok to schedule an appointment with R1’s doctor to be evaluated. ADM stated R1 was still able to hold onto his/her walker, go to the bathroom, move his/her arms and legs. ADM stated when she asked R1 how he/she was doing R1 verbalized a little bit that it was hurting but R1 was not grimacing. Based on a review of R1’s Physicians Report, dated July 21, 2022, R1 is able to follow instructions and is able to communicate needs, via cueing. Based on a review of R1’s Needs and Services Plan, dated January 1, 2022, resident R1 will respond if asked and speaks basic English. Based on a review of R1’s discharge summary, dated July 26, 2022, CT scans were done on R1 and R1 had no signs of fracture. The discharge summary also stated the bruises on R1’s chest is more likely pigmentation. The summary also states R1 has a neurocognitive disorder and is nonverbal mostly. The Department has completed the investigation of the above allegations. Based on interviews conducted and records review, the department has found that the above allegations were UNFOUNDED, meaning that the allegations were false, could not have happened and/or are without a reasonable basis. No deficiencies cited, an exit interview conducted with Lead Luzviminda "Minda" Obillo and a copy of the report was provided. Page 2 Out of 3. Facility did not report resident injury to Licensing/Facility did not notify resident's family or responsible party of injury On July 26, 2022, the department received a complaint alleging Facility did not report resident’s injury to licensing. It has also been alleged, the facility did not notify the resident’s family or responsible party of injury. Based on interview and record review, on July 18, 2022, resident R1 was observed with swelling. On August 11, 2022, LPA Dolores interviewed ADM. ADM stated he/she called late Friday afternoon and left a voicemail for Community Care Licensing main line. ADM also states to have sent an incident report to Licensing. On October 11, 2022, LPA Dolores interviewed R1’s Responsible Party. (R1RP) R1RP stated he/she was informed by facility staff the day R1 was sent out (July 22, 2022). R1RP stated he/she was informed by the facility that they noticed some swelling on R1’s chest and they called On Lok. Based on record review, the Department received an incident report dated July 22, 2022. The incident Report was sent by the ADM. The incident report states staff called on LOK Clinic to report R1 had slight swelling on R1’s Clavicle and bruise in the breast area, with no fall or injury noted. The Department received this incident report on July 25, 2022. The Department has completed the investigation of the above allegations. Based on interviews conducted and records review, the department has found that the above allegations were UNFOUNDED, meaning that the allegations were false, could not have happened and/or are without a reasonable basis. No deficiencies cited, an exit interview conducted with Lead Luzviminda "Minda" Obillo and a copy of the report was provided. Page 3 Out of 3. END OF REPORT.the state’s words, verbatim · CDSS document, Sep 14, 2024 · control 26-AS-20220726140626

Allegation investigated: Resident is being financially abused.

Licensing Program Analyst (LPA) Monter conducted an unannounced complaint inspection to deliver the findings on the above allegations. LPA met with Lead staff Luzviminda "Minda" Obillo. On March 9, 2023, the Department received a complaint alleging Resident is being financially abused. It has been alleged a staff member obtained two blank checks from R1 and one of those blank checks have not been cashed. On March 20, 2023, the Department received an email communication from R1’s Family member (FM). FM stated he/she discussed this situation with R1. FM stated R1 was concerned that he/she owed back rent and felt relief the rent would be paid by signing the checks. FM stated the two checks were paid to facility with the correct amount for the month of February and March 2023. Unfounded A review of R1’s physicians report, dated June 1, 2022, states R1 can handle his/her own cash resources. The Department has completed the investigation of the above allegations. Based on interviews conducted and records review, the department has found that the above allegations were UNFOUNDED, meaning that the allegations were false, could not have happened and/or are without a reasonable basis. No deficiencies cited, an exit interview conducted with Lead staff Luzviminda "Minda" Obillo and a copy of the report was provided. Page 2 Out of 2. END OF REPORT. On September 5, 2024, LPA Monter interviewed Staff S1 and ADM. Staff S1 stated she does not remember working that day and does not remember the details as she cannot recall. ADM stated R1 always wants to do things him/herself. ADM stated resident R1 was aware that he/she could not leave the facility unassisted but insists on going by herself to the store or doctors’ appointments. ADM stated she has discussed this with the family and had R1 sign in and out in the book. On September 14, 2024, LPA interviewed staff S2. S2 stated R1 had signed out to go for a walk to 7/11. S2 stated resident R1 insisted on walking by him/herself. S2 stated R1 had returned to the facility and told the staff that he/she had fallen. Based on a review of R1’s Physician Report dated, June 1, 2022. Resident R1 does not have a neurocognitive disorder. Resident R1 is ambulatory but cannot leave the facility unassisted. A review of R1’s Needs and Services Plan (ANS), dated January 20, 2023, states R1 uses a walker for long distances and walks around the house without an assistive device. The ANS also states R1 is more stable in his/her mobility after physical therapy completed. The ANS states R1 walks very well alone and refuses to be assisted, stating he/she wants to do things for him/herself. Based on a review of facility Unusual Incident Report, dated January 24, 2023, states on January 23, 2023, at 5:30pm, resident R1 came back home after a walk to the 7/11 and stated he/she fell. Based on a google maps search, the facility is 0.2 miles away from the 7/11. With an estimated walking time of 5 minutes. The Department was unable to interview resident R1 during the course of this investigation. Resident R1 no longer lives at the facility. Based on investigation, records reviewed, and interviews conducted, the Department found that the above allegations are UNSUBSTANTIATED. An unsubstantiated finding indicates that although the allegation may have happened or is valid, there is not a preponderance of evidence to prove that the allegations of neglect/lack of supervision did or did not occur. END OF REPORT.the state’s words, verbatim · CDSS document, Sep 14, 2024 · control 26-AS-20230309140050

Allegation investigated: Staff hit resident

Licensing Program Analyst (LPA) Monter conducted an unannounced complaint inspection to deliver the findings on the above allegations. LPA met with S3 Josephine Eaguro. Staff S3 contacted facility ADM, who stated S3 could sign on her behalf. On August 10, 2022, the department received a complaint alleging staff hit a resident. It has been alleged that 2 years ago (2020), while resident R1 was being bathed, staff S1 subsequently hit R1. On August 17, 2022, LPA Dolores interviewed residents R2-R4. 3 Out of 3 residents interview stated the staff are nice and treat them good. 3 Out of 3 residents interviewed stated the staff never hurt them and they did not observe staff hurt other residents. Page 1 Out of 2. Unsubstantiated LPA interviewed S1 & S2. S1 stated they did not observe bruising on R1 or hear complaints of pain. S1 stated R1 never complained to staff of any incidents of staff hurting R1. S2 stated he/she never hurt R1. S2 stated the staff would not hit anyone. LPA interviewed ADM. ADM stated the staff would never hit a resident. ADM stated R1 never complained of pain or that someone had hit them. Based on a review of R1’s Physician’s Report, dated January 14, 2021, R1 has a neurocognitive disorder. The Department made serval attempts to contact S1 but was unable to get in contact with him/her. S1 no longer works at the facility. The Department was unable to get to interview Resident R1. Resident R1 no longer lives at the facility. Witness did not provide additional information regarding the allegation above. Based on investigation, records reviewed, and interviews conducted, the Department found that the above allegations are UNSUBSTANTIATED. An unsubstantiated finding indicates that although the allegation may have happened or is valid, there is not a preponderance of evidence to prove that the allegations did or did not occur. No deficiencies cited, an exit interview conducted with staff S3 and a copy of the report was provided. END OF REPORT Page 2 Out of 2.the state’s words, verbatim · CDSS document, Jul 23, 2024 · control 26-AS-20220810152636

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Manuel Monter conducted an unannounced annual inspection visit, and met with Lead Staff Luzviminda Obillo (S1). During visit, LPA observed 5 residents and 2 staff. LPA toured the facility inside out with S1 which included; the Living room, kitchen, dining room, 2 restrooms and 4 residents bedrooms. The staff area of the facility was also inspected. Front yard and backyard were inspected. While touring the backyard, LPA observed the fence had an opening and several wooden planks were no longer attached to the fence, creating an opening. LPA observed the red painted wood patio flooring also has a couple of gaps in the wood planks. ADM stated she is aware of the issues and is working with her insurance company to address said issues. The facility Laurel Crest Manor has two residents who use a wheel chair. There was no obstruction to block the walkways. Two day perishable food supplies and seven day nonperishable food supplies were observed. LPA observed the medication closet, knives storage area, and cleaning product storage area as locked and inaccessible to residents in care. Room temperature was at 70 degrees F, and hot water temperature was measured at 108 degrees F in both resident bathrooms. Fire extinguisher was serviced in February 8 2023. The facility was equipped with smoke and carbon monoxide detectors. Smoke detectors was tested by S1, and were functional. LPA observed facility first aid kit and facility fire/earthquake drill log. The facility's last drill was on January 12, 2024. LPA reviewed 3 resident medications and centrally stored medication records. LPA conducted interviews with 2 staff (S1 to S2) and 2 residents (R1-R2). LPA reviewed facility records for 2 staff . Page 1 out of 2 LPA reviewed 2 resident records. According to Title 22 code of regulations, 87705 Care of Persons with Dementia (c)(5) Each resident with dementia shall have an annual medical assessment as specified in Section 87458, Medical Assessment, and a reappraisal done at least annually, both of which shall include a reassessment of the resident’s dementia care needs. While reviewing R1 files, LPA observed R1's physicians report, dated, December 17, 2020 states R1 has a neroucognetive disorder. LPA requested R1's updated physicians report. S1 stated she did not update it, not yet. Deficiencies were cited from California Code of Regulations, Title 22 during today’s visit, see LIC 809-D. This report was reviewed with ADM Merle Laurel. ADM stated S1, Luzviminda Obillo could sign on her behalf and a copy of the report was provided. Appeal Rights were provided. Page 2 out of 2the state’s words, verbatim · CDSS document, Jan 26, 2024

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Manuel Monter conducted an unannounced annual inspection visit, and met with Lead Member (S1) Luzviminda Obillo. During visit, LPA observed 5 residents and 3 staff. LPA toured the facility inside out with S1 which included; the Living room, kitchen, dining room, 2 restrooms and 4 residents bedrooms. The staff area of the facility was also inspected. Front yard and backyard were inspected. There was no obstruction to block the walkways. Two day perishable food supplies and seven day nonperishable food supplies were observed. LPA observed the medication storage area, knives storage area, and cleaning product storage area as locked and inaccessible to residents in care. Room temperature was at 70 degrees F, and hot water temperature was measured at 106 degrees F in both resident bathrooms. Fire extinguisher was serviced in February 8 2023. The facility was equipped with smoke and carbon monoxide detectors. Smoke detectors was tested by S1, and were functional. LPA observed facility first aid kit and facility fire/earthquake drill log. The facility's last drill was on May 1, 2023. LPA reviewed facility records for 3 staff and 4 residents. LPA reviewed 3 resident medications and centrally stored medication records. LPA conducted interviews with 2 staff (S1 to S2) and 3 residents (R1-R3). Deficiencies were cited from California Code of Regulations, Title 22 during today’s visit, see LIC 809-D. This report was reviewed with ADM Merle Laurel. ADM stated S1, Luzviminda Obillo could sign on her behalf and a copy of the report was provided. Appeal Rights were provided.the state’s words, verbatim · CDSS document, Oct 28, 2023