Vip Senior Living

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Quoc Huynh arrived at the facility unannounced to conduct a required annual visit at 9:51AM. The LPA met with Staff Merle Pacada. The Licensee Jeffrey Alvarez arrived at 1:01PM. Entrance interview conducted. Beginning at 10:19AM, the LPA and Staff toured the physical plant areas inside and outside to ensure there were no health and safety hazards, and the facility is in compliance with Title 22 Regulations. The following was observed: KITCHEN: Knives were stored inaccessible in a locked drawer near the sink with cleaning supplies stored inaccessible and locked under the sink. Kitchen appliances were in operable condition. The facility had a supply of perishable and non-perishable food. Food in the refrigerator and freezer were observed to be properly stored and labeled. The LPA observed an unsecured pair of scissors in a drawer and cockroaches in the kitchen. The Staff explained that Staff spray the kitchen when they see cockroaches. COMMON AREAS: At the time of the visit, the facility had two (2) living rooms, a dining room, and a den with furniture observed to be in good condition. Dining room cabinets contained unsecured medication pills in a cup. Required postings were in the entryway hallway and the dining room. The LPA observed emergency water stored near the second living room and emergency food stored in a cabinet. Report Continued on LIC 809-C The hallway closet contained extra linens, and the closet doors were in disrepair as they were leaning and not aligned with the closet tracks. The facility maintained a comfortable temperature throughout the visit. BEDROOMS/RESTROOMS: There were six (6) total bedrooms: two (2) staff rooms and four (4) resident rooms. Bedroom #5 had a direct exit to the outside and was approved for one (1) bedridden resident. One (1) staff room was not secured and contained laundry detergent and staff medications that were accessible to residents. Bedrooms were furnished appropriately with clean linens, appropriate furnishings and sufficient lighting. Full bed rails were observed on four (4) resident beds. There were four (4) total restrooms in the facility: two (2) staff restrooms, one (1) private resident restroom, and one (1) shared resident restroom in the hallway. Restrooms were relatively clean and sanitary and in operating condition with grab bars and non-slip surfaces. All restrooms were sufficiently stocked with soap, paper products, and displayed hand washing signs. The shared resident restroom contained a closet with extra linens. Hot water was tested and measured between 138.4 degrees F and 139.5 degrees F, which was not in the required range of 105 degrees F and 120 degrees F. Window screens were observed to be in disrepair or missing from the windows in resident rooms and restrooms. OUTDOOR AREA: The surrounding grounds had one (1) shaded patio areas equipped with furniture in good condition for residents and visitors to use. There were two (2) manual driveway gates, and two (2) self-latching gates used for emergencies. No bodies of water noted, and exits were free of obstructions. The rear had laundry machines that were observed to be operational with a nearby garage. The garage contained general storage and was inaccessible. RECORDS: Record review began at 11AM. Resident records were reviewed for, but not limited to care plans, physician's report, admissions agreement, and consent forms. Three (3) residents’ Appraisal/Needs and Services Plans were not signed. Report Continued on LIC 809-C Record review also revealed that one (1) resident who had full bed rails were not on hospice. Personnel records were reviewed for, but not limited to health assessments, criminal record clearances, first aid/CPR training, and the appropriate training. Staff training was missing two (2) hours of dementia, two (2) hours of medication, and the required restricted health conditions, hospice, and postural support topics. INFECTION CONTROL/EMERGENCY DISASTER PLAN: During today's visit, LPA reviewed the facility's emergency disaster plan and infection control plan. Both plans were not reviewed annually. Emergency disaster drills are conducted quarterly, with the last documented drill on 07/17/2026. Smoke and carbon monoxide detectors were tested at 11:55AM and were operational at the time of the visit. Two (2) fire extinguishers were observed throughout the facility and were last serviced on 05/27/2026. MEDICATIONS: Medication review began at 12:17PM. Medications were centrally stored and kept inaccessible in the hallway cabinet located between the staff room and staff restroom. Medications were observed for two (2) residents. Medications were labeled and checked for expiration dates and were properly documented on the centrally stored medication and destruction record. Resident medications were observed to be prepared in advance in pill organizers. The LPA advised the Staff that they are no longer allowed to prepare medications. Three (3) civil penalties in the total amount of $750 were assessed for repeat violations within a twelve (12) month period (Refer to LIC 421FC). The Licensee was advised that failure to correct and continued violation may result in additional civil penalties. Pursuant to Title 22 CA Code of Regulations, the following deficiencies were cited (Refer to LIC 809-D). Exit interview conducted. A copy of the appeal rights and report were reviewed and provided.the state’s words, verbatim · CDSS document, Sep 3, 2026

From the deficiency page — Deficiency type: Type A · Section cited: CCR 87303(e)(2) · Plan of correction due date: Sep 4, 2026

(2) Faucets used by residents for personal care… shall deliver hot water. Hot water temperature controls shall be maintained to automatically regulate the temperature of hot water used by residents to attain a temperature of not less than 105 degree F (41 degrees C) and not more than 120 degree F (49 degrees C). This requirement was not met as evidenced by: Based on observation, the license did not comply with the above section in hot water temperatures were not withtin the required range which posed an immediate health, safety, and personal rights risk to persons in care.the state’s words, verbatim · CDSS document, Sep 3, 2026

Plan of correction: The Licensee will lower the water temperature and provide CCLD with video proof measuring the hot water.

From the deficiency page — Deficiency type: Type A · Section cited: CCR87309(a) · Plan of correction due date: Sep 4, 2026

(a) Except as specified in subsection (b), the licensee shall ensure that … sharp objects… which could pose a danger to residents are in locked storage and are not left unattended if outside the locked storage. This requirement was not met as evidenced by: Based on observation, the licensee did not comply with the above section in sharp objects were not secured which posed an immediate health, safety, and personal rights risk to persons in care.the state’s words, verbatim · CDSS document, Sep 3, 2026

Plan of correction: The staff secured the scissors during the visit. POC cleared.

From the deficiency page — Deficiency type: Type A · Section cited: HSC 1569.618(c)(4) · Plan of correction due date: Sep 4, 2026

(4) Ensure that the facility is clean, safe, sanitary, and in good repair at all times. This requirement was not met as evidenced by: Based on observation, the licensee did not comply with the above section in the staff room was not secured and staff had personal medications laying around the facility which posed an immediate health and safety risk to persons in care.the state’s words, verbatim · CDSS document, Sep 3, 2026

Plan of correction: The Licensee temporarily removed the hazards and will replace the staff's door lock for an operational one and provide proof to CCLD by POC due date.

From the deficiency page — Deficiency type: Type A · Section cited: CCR87465(h)(2) · Plan of correction due date: Sep 4, 2026

(2) Centrally stored medicines shall be kept in a safe and locked place that is not accessible to person other than employees responsible for the supervision of the centrally stored medication. This requirement was not met as evidenced by: Based on observation, the licensee did not comply with the above section in resident medication pills were stored accessible in a cup which posed an immediate health and safety risk to persons in care.the state’s words, verbatim · CDSS document, Sep 3, 2026

Plan of correction: The Licensee will destroy the unused medications and submit proof to CCLD with a statement of understanding by POC due date.

From the deficiency page — Deficiency type: Type B · Section cited: CCR 87303(a) · Plan of correction due date: Sep 24, 2026

(a) The facility shall be clean, safe, sanitary and in good repair at all times. … This requirement was not met as evidenced by: Based on observation, the licensee did not comply with the above section in the hallway closet doors were in disrepair and the facility was not maintained in a clean state which resulted in pests which posed a potential health and safety risk to persons in care.the state’s words, verbatim · CDSS document, Sep 3, 2026

Plan of correction: The Licensee will repair the closet doors and conduct a deep cleaning of the facility and provide proof to CCLD by POC due date.

From the deficiency page — Deficiency type: Type B · Section cited: CCR87303(c) · Plan of correction due date: Sep 17, 2026

(c) All window screens shall be clean and maintained in good repair. This requirement was not met as evidenced by: Based on observation, the licensee did not comply with the above cited section restroom and bedroom window screens were in disrepair or missing which posed a potential health, safety, and personal rights risk to persons in care.the state’s words, verbatim · CDSS document, Sep 3, 2026

Plan of correction: The Licensee will repair all window screens and provide proof to CCLD by POC due date.

From the deficiency page — Deficiency type: Type B · Section cited: CCR 87470(d)(6) · Plan of correction due date: Sep 17, 2026

87470(d)(6) The Emergency Infection Control Plan shall be reviewed and updated as necessary or whenever new infection control measures are recommended… This requirement was not met as evidenced by: Based on record review, the licensee did not comply with the above section in the infection control plan was not reviewed annually which posed a potential health and safety risk to persons in care.the state’s words, verbatim · CDSS document, Sep 3, 2026

Plan of correction: The Licensee will provide CCLD with a signed/reviewed infection control plan and submit a statement of understanding by POC due date.

From the deficiency page — Deficiency type: Type B · Section cited: HSC1569.695(d) · Plan of correction due date: Sep 17, 2026

d) A facility shall review the plan annually and make updates as necessary… The licensee or administrator shall sign and date documentation to indicate that the plan has been reviewed and updated as necessary. This requirement was not met as evidenced by: Based on record review, the licensee did not comply with the section above in the emergency disaster plan was not reviewed annually which posed a pottential health and safety risk to persons in care.the state’s words, verbatim · CDSS document, Sep 3, 2026

Plan of correction: The Licensee will provide CCLD with a signed/reviewed infection control plan and submit a statement of understanding by POC due date.

From the deficiency page — Deficiency type: Type B · Section cited: HSC 1569.625(b)(2) · Plan of correction due date: Sep 17, 2026

(2) In addition to paragraph (1), training requirements shall also include an additional 20 hours annually, eight hours of which shall be dementia care training… four hours of which shall be specific to postural supports, restricted health conditions, and hospice care… This requirement was not met as evidenced by: Based on record review, the licensee did not comply with the above section in staff did not receive the required training topics and hours which posed a potential health, safety, and personal rights risk to persons in care.the state’s words, verbatim · CDSS document, Sep 3, 2026

Plan of correction: The Licensee will provide staff with the remaining training and provide proof to CCLD by POC due date.

From the deficiency page — Deficiency type: Type B · Section cited: HSC1569.69(b) · Plan of correction due date: Sep 17, 2026

(b) Each employee who received training… and who continues to assist with the self-administration of medicines, shall also complete eight hours of in-service training on medication-related issues in each succeeding 12-month period. This requirement was not met as evidenced by: Based on record review, the licensee did not comply with the above section in staff did not receive the hours which posed a potential health, safety, and personal rights risk to persons in care.the state’s words, verbatim · CDSS document, Sep 3, 2026

Plan of correction: The Licensee will provide staff with the required training and provide proof to CCLD by POC due date.

From the deficiency page — Deficiency type: Type B · Section cited: CCR 87506(a) · Plan of correction due date: Sep 17, 2026

(a) The licensee shall ensure that a separate, complete, and current record in maintained for each resident… This requirement was not met as evidenced by Based on record review, the licensee did not comply with the above section in 3 residents did not have a complete Appraisal with signatures which posed a potential health, safety, and personal rights risk to persons in care.the state’s words, verbatim · CDSS document, Sep 3, 2026

Plan of correction: The Licensee will obtain signatures on the residents' Appraisals and provide CCLD proof by POC due date.

From the deficiency page — Deficiency type: Type B · Section cited: CCR00 · Plan of correction due date: Sep 3, 2026

Intentaionally left blankthe state’s words, verbatim · CDSS document, Sep 3, 2026

Plan of correction: Intentaionally left blank

From the deficiency page — Deficiency type: Type B · Section cited: CCR 87608(a)(5)(B) · Plan of correction due date: Sep 17, 2026

(B) Bed rails that extend the entire length of the bed are prohibited except for residents who are currently receiving hospice care and have a hospice care plan that specifies the need for full bed rails. This requirement was not met as evidenced by: Based on observation and record review, the licensee did not comply with the section above in 2 residents had full bed rails and were not on hospice which posed a pottential health and safety risk to persons in care.the state’s words, verbatim · CDSS document, Sep 3, 2026

Plan of correction: The Licensee will remove the resident's full bed rails and provide CCLD proof by POC due date.

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Quoc Huynh arrived at the facility unannounced to conduct a required annual visit at 9:36AM. The LPA was greeted by Staff, informed them of the reason for the visit, and Staff proceeded to notify the Licensee and Administrator. Licensee Jeffrey Alvarez and Administrator Madeleine Ayllon arrived at 10:56AM. Entrance interview conducted. Beginning at 9:53AM, the LPA and Staff toured the physical plant areas inside and outside to ensure there were no health and safety hazards, and the facility is in compliance with Title 22 Regulations. The following was observed: KITCHEN: Knives were stored inaccessible in a locked drawer near the sink with cleaning supplies stored inaccessible and locked under the sink. The LPA observed the lower drawers to the right of the stove was not on its tracks/hinges and contained an unsecured hammer and butcher knife. The Staff secured the knife and hammer immediately. Kitchen appliances were clean and in operable condition. The facility had a supply of perishable food and did not have a sufficient supply of non-perishables. The Licensee purchased non-perishables during the visit. Non-perishables consisted of five (5) canned tunas located in the cabinet pantry. Interview with Staff and the Licensee revealed the facility did not have emergency food. Food in the refrigerator and freezer were observed to be properly stored and labeled. The LPA observed the lower fridge drawer containing produce was also in disrepair and was sitting on the bottom of the fridge, not on the hinges. Report Continued on LIC 809-C COMMON AREAS: At the time of the visit, the facility had two (2) living rooms, a dining room, and a den with furniture observed to be in good condition. Dining room cabinets contained unsecured medications which the Staff stated were old and belonged to prior residents. The Staff discarded of the medications. Required postings were in the entryway hallway and the dining room. The LPA observed water damage on the ceiling, above the dining table. The two (2) ceiling planks were lifting, had water stains, and cracks. The LPA observed emergency water stored near the second living room. The hallway closet contained extra linens, and the closet doors were in disrepair as they were leaning and not aligned with the closet tracks. The Staff stated it has been broken for 2 months. The facility maintained a comfortable temperature throughout the visit. BEDROOMS/RESTROOMS: There were six (6) total bedrooms: one (1) staff room, one (1) guest room, and four (4) private resident rooms. Bedroom #5 had a direct exit to the outside and was approved for one (1) bedridden resident. The guest room was occupied by a family member of the Licensee who was fingerprint cleared but was not associated with the facility. Bedrooms were furnished appropriately with clean linens, appropriate furnishings and sufficient lighting. Bedroom #4 had window blinds that were in disrepair with seven (7) panels broken off. There were four (4) total restrooms in the facility: two (2) staff restrooms, one (1) private resident restroom, and one (1) shared resident restroom in the hallway. Restrooms were clean and sanitary and in operating condition with grab bars and non-slip surfaces. All restrooms were sufficiently stocked with soap, paper products, and displayed hand washing signs. The shared resident restroom contained a closet with extra linens and towels. One (1) staff restroom had accessible cleaning supplies, laundry detergent, and insect aerosol sprays. Hot water was tested and measured between 97 degrees F and 138.2 degrees F, which was not in the required range of 105 degrees F and 120 degrees F. The Licensee stated they would lower the water temperature. OUTDOOR AREA: The surrounding grounds had one (1) shaded patio area equipped with furniture in good condition for residents and visitors to use. There were two (2) manual driveway gates, and two (2) self-latching gates used for emergencies. No bodies of water noted, and exits were free of obstructions. Report Continued on LIC 9099-C The rear had laundry machines that were observed to be operational with a nearby garage. The garage contained general storage and had a broken door handle that was inoperable. The LPA and Staff pushed the garage door open to gain access. RECORDS: Record review began at 11:07AM. Resident records were reviewed for, but not limited to care plans, physician's report, admissions agreement, and consent forms. Resident #1 (R1) did not have a TB test result on file. The Administrator contacted their Physician who stated a skin test was not done and would check for X-Ray results. At this time the facility could not provide the LPA the TB results. Four (4) out of four (4) residents’ Pre-Placement Appraisal and Appraisal/Needs and Services Plans were completed but did not have the residents’, or their representative’s, signatures. The Administrator stated they review all documents with the families over the phone, however, did not obtain signatures. Personnel records were reviewed for, but not limited to health assessments, criminal record clearances, first aid/CPR training, and the appropriate training. All records were in order. The LPA discussed the documentation of staff training to include the training hours, per regulation. The Administrator understood. INFECTION CONTROL/EMERGENCY DISASTER PLAN: During today's visit, LPA reviewed the facility's infection control plan and emergency disaster plan. Both documents were observed to be complete and updated annually as required. Emergency disaster drills are conducted quarterly, with the last documented drill on 07/15/2025. Smoke and carbon monoxide detectors were tested at 11:06AM and were operational at the time of the visit. Two (2) fire extinguishers were observed throughout the facility and were last serviced on 08/05/2025. Report Continued on LIC 9099-C MEDICATIONS: Medication review began at 12:17PM. Medications were centrally stored and kept inaccessible in the hallway cabinet located between the staff room and staff restroom. Medications were observed for two (2) residents. Medications were labeled and checked for expiration dates. Medications were not properly documented on the centrally stored medications and destruction record. R1 had Acetaminophen 650MG filled on 12/26/2024 that was not documented. Resident #2 (R2) had two (2) Quetiapine Fumarate 25MG filled on 08/01/2025 and 08/25/2025, and two (2) MAPAP 500MG filled on 07/11/2025 and 08/04/2025 that were not documented. The Administrator stated that Staff must not have documented the medications because it was not yet in use. Additionally, R1 did not have a PRN (as needed) Authorization Letter. R2 had an outdated PRN Authorization Letter that did not reflect the current PRN medications they were taking. The Administrator stated they would contact Hospice to obtain the letters. Pursuant to Title 22 CA Code of Regulations and/or Health and Safety Code, the following deficiencies were cited (Refer to LIC 809-D). Exit interview conducted. A copy of the appeal rights and report were reviewed and provided.the state’s words, verbatim · CDSS document, Sep 3, 2025

The state marks this report as 12 pages; the online copy we transcribed has 9. You can request the full file from the county licensing office.

Allegation investigated: Staff did not provide responsible party with a copy of resident's admissions agreement Staff did not provide responsible party with a copy of resident's facility file

Licensing Program Analyst (LPA) Emily Peraldi conducted an unannounced subsequent complaint visit to this facility to deliver findings. At 1:40 p.m., the LPA met with the Licensee and explained the reason for the visit. During the initial visit conducted on 07/20/2023 between 10:15 a.m. and 12:30 p.m., LPA Peraldi conducted an interview with the Licensee, conducted a physical plant tour and requested copies of pertinent documents during the time of the visit. Continued on LIC 9099-C. Substantiated Regarding the allegations: 1.) Staff did not provide responsible party with a copy of resident's admissions agreement. 2.) Staff did not provide responsible party with a copy of resident's facility file. On 07/11/2023, the Department received a complaint alleging the Licensee failed to provide copies of R1’s documents including admission agreement to R1’s responsible party. Interview with the Licensee confirmed that R1’s responsible person requested R1’s file, however the Licensee attempted to reach out to R1’s responsible person but couldn’t contact them. The Licensee explained that R1’s responsible person moved, and the Licensee no longer has the correct mailing address to send the documents. The Licensee stated that he will attempt further to contact R1’s responsible party to send R1’s file and admission agreement. Based on record review and interviews, the preponderance of evidence standard has been met, therefore the above allegations are deemed Substantiated. Per the California Code of Regulations, Title 22, Division 6, Chapter 8, the following deficiency were observed and cited during the visit (See 9099-D). Exit interview conducted. A copy of the report and appeal rights were provided. Regarding the allegation: 3.) Staff did not properly refund responsible party after resident's death. On 07/11/2023, the Department received a complaint alleging an incorrect amount of refund after Resident #1’s (R1’s) death was issued to R1's responsible party. Per record review, R1 died on 01/04/2023 and prior to R1’s death, R1’s responsible party paid $3,500 for the time period of 12/07/2022 to 01/07/2023. Per interview with the Licensee, the Licensee stated that he refunded R1’s responsible party for $1,700. The refunded amount is for 01/04/2023 to 01/07/2023 which is less than $1700 given. The information obtained during the investigation did not include evidence sufficient to corroborate the allegation. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur, therefore the allegation is deemed Unsubstantiated at this time. Exit interview conducted. A copy of the report was provided.the state’s words, verbatim · CDSS document, Nov 6, 2024 · control 29-AS-20230711101116

From the deficiency page — Deficiency type: Type B · Section cited: CCR 87506(c)(1) · Plan of correction due date: Nov 15, 2024

87506 Resident Records: (c) All information and records obtained from...(1)The licensee shall be responsible for storing active and inactive records ...This requirement has not been met as evidenced by: Based on interview and records review, the licensee did not comply with the section cited above as R1’s records were not provided to R1’s Responsible Party and/or designated representative which poses a potential health and safety risk to residents in care.the state’s words, verbatim · CDSS document, Nov 6, 2024

Plan of correction: Licensee stated that requested documents to R1’s responsible party will be provided. The Licensee stated that he will send LPA via email proof that documents were provided.

Type of visit: Required - 1 Year

Licensing Program Analysts (LPA) Erica Mosley arrived at the facility unannounced to conduct a required annual visit and entered the facility at 10:00 a.m. Upon arrival, LPA Mosley was greeted by staff and called the administrator to inform them of the visit. The administrator was not available and designated staff / caregiver Merle Pacada to lead the tour and sign the report. The LPA 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. Documents obtained: LIC 500, LIC 9020A, Liability Insurance. KITCHEN: The LPA inspected the kitchen/food service area at 10:15 a.m. Knives and sharps were observed in a locked cabinet. Kitchen appliances were in operable condition. The facility has a sufficient supply of perishable and non-perishable food. Refrigerator and food pantry were checked for proper labels and expiration dates. The kitchen faucet was measured for hot water temperature, and it measured 119.7 degrees Fahrenheit at 10:18 a.m. Cleaning solutions, toxins, chemicals, and hazardous items were inaccessible and locked away inside a kitchen cabinet under the sink. At 10:39 a.m., the LPA observed five (5) cockroaches inside two kitchen cabinets posing a health and safety concern. COMMON AREAS: At the time of the visit, furniture in the common areas was observed to be in good condition. The facility maintained a comfortable temperature. At 2:35 p.m., smoke detector(s) and carbon monoxide detector were tested and operational at the time of the visit. The fire extinguishers were observed and fully charged on 8/14/2024. The LPAs observed required postings throughout the common space. The last emergency disaster drill took place on 08/04/2024. Activities were observed in the common areas. Report Continued on LIC 809C... Report Continued from LIC 809... BEDROOMS: The facility is a single-story residential home with seven (7) bedrooms, five (5) for resident use and two (2) for staff use. The facility has four (4) bathrooms, two (2) for resident use and two (2) for staff use. The LPA observed resident bedrooms, which were furnished appropriately with clean linens, appropriate furnishings, and sufficient lighting. Inside temperature was maintained at a comfortable level. It was observed that a bedridden resident was not in the correct room cleared for bedridden. This was addressed and informed that it is an immediate health and safety risk resulting in civil penalty. RESTROOMS: Restrooms are relatively clean and sanitary and in operating condition with grab bars and non-skid mats. Between 10:55 a.m. and 11:30 a.m., hot water measured between 118.9 and 119.9- degree Fahrenheit. The sinks had sufficient liquid soap, and paper towels. OUTDOOR SPACE: At 12:00 p.m., the LPA observed the back of the facility and front patio area which is partially covered / shaded with trees for the outdoor area for resident use. Staff was made aware that area needs to be cleaned for resident use and proper covering is required. There is a gate on the sides of the house designated for an emergency exit that needs repair. This was addressed and informed that it is an immediate health and safety risk resulting in civil penalty. One of the self-latching gates is not operating properly and does not open smoothly or close at the time of this visit. Staff and administrator was made aware that the gate needs to be fixed immediately. There are no bodies of water on the premises noted at the time of the visit. The garage is not accessible to residents. Laundry units are located outside at the back of the facility. RECORDS: Records were reviewed from approximately 1:00 p.m.- 2:00 p.m. personnel records began at approximately 1:00p.m Resident Records were reviewed at approximately 1:45 p.m.Four (4) resident files were reviewed for, but not limited to, the following: signed admission agreements, current medical assessments with TB results, LIC627(c) Consent for Treatment form, and current needs and services plan. Report Continued from LIC 809C... Report Continued from LIC 809C... Three (3) personnel files including the Administrator’s file were reviewed for, but not limited to: personnel records, health assessments, criminal record clearances, first aid/CPR training, and the appropriate training. All records were in order. INTERVIEWS: Two (2) staff interviews were conducted. Four (4) resident interviews were attempted. Two (2) interviews were conducted. MEDICATIONS: Medications review began at approximately 4:30 p.m. The medications are locked in a cabinet near kitchen between staff room and staff bathroom. Medications for four (4) out of four (4) residents were reviewed. Medications reviewed were found to be self administered as prescribed and documented on the centrally stored medication and destruction records. Medications were pre-sorted for two days in advance. Staff was made aware that medication cannot be pre-sorted and made aware of the potential health and safety risk. The following deficiencies were observed (See LIC 809-D.) and cited from the California Code of Regulations, Title 22 and California Health and Safety Code. The Licensee was made aware that failure to correct the deficiencies may result in civil penalties. Exit interview conducted. A copy of the report and appeal rights were provided.the state’s words, verbatim · CDSS document, Sep 5, 2024