Plc 7125 Main

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Talwinder Bains arrived on 11/19/25 to conduct the annual inspection. LPA met with staff, Sevrena Miller (S1) and explained the purpose of today's visit. During today's annual inspection, the Compliance and Regulatory Enforcement Tool was used. LPA checked the medications for four (4) residents and no errors were identified. LPA reviewed four (4) residents files and two (2) staff files. LPA and S1 toured the facility together to ensure the health and safety of residents in care. The areas toured included resident rooms, bathrooms, kitchen, and common areas and outside area. The food supply is within compliance, 2 days of perishable and 7 days worth of non-perishable food items. Grab bars were present at the toilet and in the shower. All exits were unobstructed. LPA checked the kitchen area for the ability to prepare and store food. LPA observed the area used for medication to be locked and inaccessible to residents. LPA observed smoke detectors and carbon monoxide detector at the care home are operational. Fire Extinguisher was last serviced on 04/06/25 and was ready for emergency use. Inside temperature was 70 degree F during visit. Facility was conducting fire and disaster drills per requirement. Several topics were discussed. LPA requested a copy of the LIC308, LIC 500, LIC610E and current liability insurance to be sent to the Department by 11/30/25. Deficiencies were observed and cited per Title 22, CCR Regulations as listed on LIC 809-D. Civil penalties shall be assessed if facility does not comply with POC requirements which were issued today. Exit interview conducted. Copy of this report and appeal rights were provided.the state’s words, verbatim · CDSS document, Nov 19, 2025

The state marks this report as 5 pages; the online copy we transcribed has 3. You can request the full file from the county licensing office.

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Talwinder Bains arrived on 12/04/24 to conduct the annual inspection. LPA met with Staff, Sevrena Miller and explained the purpose of today's visit. During today's annual inspection, the Compliance and Regulatory Enforcement Tool was used. LPA reviewed two residents (2) and two staff files (2). Staff files have required paperwork. LPA found missing documents in residents (R1,R2) files and citation has been issued as indicated on LIC809D. LPA and staff toured the facility together to ensure the health and safety of residents in care. The areas toured included resident rooms, bathrooms, kitchen, and common areas and outside area. The food supply is within compliance, 2 days of perishable and 7 days worth of non-perishable food items. Grab bars were present at the toilet and in the shower. All exits were unobstructed. There is a side gate for emergency access. LPA checked the kitchen area for the ability to prepare and store food. Knives and Sharp objects found to be locked. LPA observed the area used for medication to be locked and inaccessible to residents. LPA observed smoke detectors and carbon monoxide detector at the care home are operational. Hot water temperature was observed to be 118 degrees F, which is within the regulation range of 105-120 degree. Fire extinguisher was serviced on 03/15/24 and was ready for emergency use. LPA audit medications for residents, R1,R2. During record review, LPA found multiple medications management issues for R2 and citation has been issued as indicated on LIC809D. LPA requested a copy of the LIC 500, LIC610E and current liability insurance to be sent to the Department by 12/31/24 . Deficiencies are cited on LIC809D per Title 22 Regulations. Exit interview conducted. Appeal Rights and copy of this report left at facility.the state’s words, verbatim · CDSS document, Dec 4, 2024

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Talwinder Bains arrived on 12/14/23 to conduct the annual inspection. LPA met with Facility staff- Julene Anderson (S1) and explained the purpose of today's visit. During today's annual inspection, the Compliance and Regulatory Enforcement Tool was used. LPA reviewed resident (2) and staff files (2). All residents files have required paperwork. LPA observed incomplete paperwork (LIC503 and TB) for staff (S1,S2) files as mentioned in 809D. LPA and S1 toured the facility together to ensure the health and safety of residents in care. The areas toured included resident rooms, bathrooms, kitchen, and common areas and outside area. The food supply is within compliance, 2 days of perishable and 7 days worth of non-perishable food items. Grab bars were present at the toilet and in the shower. All exits were unobstructed. There is a side gate for emergency access. LPA checked the kitchen area for the ability to prepare and store food. Knives and Sharp objects found to be locked. LPA observed the area used for medication to be locked and inaccessible to residents. LPA observed smoke detectors and carbon monoxide detector at the care home are operational. Hot water temperature was observed to be 120 degrees F, which is within the regulation range of 105-120 degree. Fire extinguisher was ready for emergency use. LPA audit centrally store log for medications for residents (R1,R2). R2 medication log was found to be accurate. For R1 medication log audit, LPA observed that prescription medications were not matching the dosage, refill dates with original bottle/container and also found 4 PRN medications with expired dates for R1. LPA requested a copy of the LIC 500, LIC610E and current liability insurance to be sent to the Department by 12/31/23 . Deficiencies are cited on LIC809D per Title 22. Exit interview conducted. Appeal Rights and copy of this report left at facility.the state’s words, verbatim · CDSS document, Dec 14, 2023

The state marks this report as 4 pages; the online copy we transcribed has 3. You can request the full file from the county licensing office.