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13 | On 07/24/2026, Licensing Program Analyst (LPA) Yi Sam Jian conducted an unannounced visit to the facility to initiate a complaint investigation. Upon arrival, LPA met with resident R4 at the door and R4 allowed the LPA to enter the facility. The LPA observed residents R1 and R2 seated in the living room. Resident R1 escorted the LPA to the bedroom located at the end of the hallway, where the licensee, William Encarnacion was present. The LPA informed the licensee of the purpose of the visit. During the visit, the LPA toured the facility, conducted interviews with staff and residents, and reviewed relevant documentation and records.
Regarding the allegation that residents were left without supervision due to staff neglect, the Department conducted an investigation that included interviews, observations, and the collection and review of relevant records and documentation. Regarding the allegation that staff do not ensure residents medications are kept centrally secured, the Department conducted an investigation that included interviews, observations, and the collection and review of relevant records and documentation. |
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13 | On 07/24/2026, Licensing Program Analyst (LPA) conducted an unannounced visit to the facility to initiate a complaint investigation. LPA met with licensee, William Encarnacion. The LPA informed the licensee of the purpose of the visit. During the visit, the LPA toured the facility, conducted interviews with staff and residents, and reviewed relevant documentation and records.
Regarding the allegation that staff does not ensure kitchen is kept in clean sanitary conditions at all times, the Department conducted an investigation, which included interviews, observations, and review of available information. Based on the information obtained, the allegation was determined to be UNSUBSTANTIATED. There were insufficient corroborating evidence to confirm whether the allegation occurred.
Although the above allegations may have happened or are valid, there is not a preponderance of evidence to prove whether the allegations did or did not occur, therefore the above allegations are UNSUBSTANTIATED. Report is reviewed and a copy of this report is provided to the administrator. |
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Deficiency Type
POC Due Date /
Section Number | DEFICIENCIES | PLAN OF CORRECTIONS(POCs) |
Type A
07/27/2026
Section Cited
CCR
87465(h)(2) | 1
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7 | 87465 Incidental Medical and Dental Care(h)(2) Centrally stored medicines shall be kept in a safe and locked place that is not accessible to persons other than employees responsible for the supervision of the centrally stored medication. Based on information gather | 1
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7 | The facility will develop a written plan to ensure that Centrally stored medicines shall be kept in a safe and locked place that is not accessible to persons other than employees responsible for the supervision of the centrally stored medication. The facility will |
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14 | during investigation, LPA observed medications were accessible to person other than employees responsible for the supervisions of the centrally stored medication, which poses an immediate health, safety or personal rights risk to persons in care. | 8
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14 | submit a copy of the plan to CCL by POC due date. |
Type A
07/27/2026
Section Cited
CCR
87464(f)(1) | 1
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7 | CCR 87464 (f) Basic services...(1) Care and supervision as defined in Section 87101(c)(3) and Health and Safety Code 1569.2(c) "Care and supervision" means the facility assumes responsibility for...the resident’s physical health, mental health, safety | 1
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7 | The facility shall submit a written plan describing how it will ensure staff remain present and provide required care and supervision to residents at all times, including procedures to prevent staff from leaving the facility while responsible for resident supervision. |
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14 | Based on interviews, review of facility documentation, staff left the facility premises while responsible for supervising residents, resulting in residents being left without caregiver supervision. creating an immediate risk to resident health and safety. | 8
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14 | The facility shall submit the written plan to Community Care Licensing by the POC due date. |