Carter Place

On 7/17/25, Licensing Program Analyst (LPA) Greg Clark arrived unannounced to conduct 1-Year Annual Required inspection. LPA met with Administrator, Tomas Salinas and explained the purpose of the visit. LPA toured facility including but not limited to bedrooms, bathrooms, kitchen, common area and backyard. All outdoor and indoor passageways are kept free of obstruction. There are no bodies of water observed. A comfortable temperature is maintained at 70 degrees Fahrenheit. LPA observed lighting in all rooms are adequate for the comfort and safety of the residents. The hot water temperature in the kitchen sink was measured at 108.1 degrees Fahrenheit. Residents’ bathrooms are equipped with grab bars and non-skid mats. There is a minimum of one week supply of non-perishable and 2 day of perishable foods. Centrally stored medication and sharps were locked and inaccessible to residents. Fire extinguisher, smoke detectors and carbon monoxide detectors were in operating condition during visit. Emergency Disaster Plan was last reviewed on 7/17/25. First aid kit was observed to be complete. Emergency disaster drill was last conducted on 6/12/25. LPA reviewed 4 residents records and 4 staff records; all were complete. LPA also reviewed a sample of resident’s medications. No deficiencies cited during visit. Exit interview conducted and a copy of this report provided.

On 07/19/24 around 08:30 AM, Licensing Program Analyst (LPA) L. Holmes arrived unannounced to conduct a required annual inspection. LPA was greeted by one staff upon entry and explained the purpose of the visit. Tomas Salinas, Administrator (ADM) arrived shortly after. ADM currently holds a standard certificate (#6023774740 ). The facility’s fire clearance was approved for six (6) non-ambulatory residents; one (1) may be bedridden and hospice waiver for three (3). Upon entry, LPA observed two residents eating breakfast and the other watching television. LPA and ADM toured the facility including, but not limited to common areas, bathrooms, bedrooms, kitchen, storage area, and backyard. LPA observed mask, cough etiquette, social distancing and hand washing signs posted throughout. There was a sufficient supply of 2-day perishables and 7-day supply of non-perishable foods. All hand washing stations were equipped with soap, paper towels and garbage cans. There is a surplus of PPE stored in the downstairs area and centrally located inside the facility that is accessible to all care staff. Hot water temperature in the shared residents' bathroom was measured at 107.1 degrees Fahrenheit (F) and the facility's temperature was very comfortable at 73 degrees (F). Fire extinguisher was observed full and last serviced 07/10/24. Smoke/Carbon Monoxide detectors were observed operational and first aid kit complete. Continued on LIC809C... 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 ..continued from LIC809. Emergency Disaster Plan is current. Safety drills were last conducted 06/2024 and are rotational between AM and PM schedules monthly. LPA reviewed three (3) staff records, two (2) were complete, and five (5) completed resident records. ADM to complete personnel file; standard certificate is still pending. The following forms are to be updated and submitted to CCLD 07/26/24: -LIC500 Personnel Report -LIC308 Designation of Administrative Responsibility (Reviewed) -LIC610E Emergency Disaster Plan (Reviewed) -An updated copy of Administrator Certificate (Status) Exit interview conducted and a copy of this report provided to ADM.

On 07/27/23 around 09:15 AM, Licensing Program Analyst (LPA) L. Holmes arrived unannounced to conduct a required annual inspection. LPA was greeted by one staff upon entry and explained the purpose of the visit. Tomas Salinas, Administrator (ADM) arrived about 10 minutes later. ADM currently holds a standard certificate (#6023774740 ). The facility’s fire clearance was approved for six (6) non-ambulatory residents; one (1) may be bedridden. Upon entry, LPA observed two residents, one eating breakfast and the other watching television. LPA and ADM toured the facility including, but not limited to common areas, bathrooms, bedrooms, kitchen, storage area, and backyard. LPA observed mask, cough etiquette, social distancing and hand washing signs posted throughout. The facility has an updated Infection Control Plan (ICP) and routine safety drills are conducted. There was a sufficient supply of 2-day perishables and 7-day supply of non-perishable foods. All hand washing stations were equipped with soap, paper towels and garbage cans. There is a surplus of PPE stored in the downstairs area and centrally located inside the facility that is accessible to all care staff. Hot water temperature in the shared residents' bathroom was measured at 106.5 degrees Fahrenheit (F) and the facility's temperature was 77 degrees (F). Fire extinguisher was observed full and purchased 07/19/23. Smoke/Carbon Monoxide detectors were observed operational and first aid kit complete. continued on LIC809C... 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 ...continued from LIC809. Fire extinguisher was purchased 07/19/23. Emergency Disaster Plan is updated. Safety drills were last conducted 03/2023 and are rotational between AM and PM schedules monthly. LPA reviewed three (3) staff records, two (2) were complete, and five (5) completed resident records. ADM to complete his personnel file. The following forms are to be updated and submitted to CCLD 08/10/23: -LIC500 Personnel Report -LIC308 Designation of Administrative Responsibility (Reviewed) -LIC610E Emergency Disaster Plan (Reviewed) -An updated copy of Administrator Certificate(s) Exit interview conducted and a copy of this report provided to ADM.

On 06/20/2022 at 03:35 PM, Licensing Program Analyst (LPA) L. Holmes arrived unannounced to conduct an Infection Control Inspection. LPA was greeted by one staff upon entry and explained the purpose of the visit. LPA was informed that the Administrator, Tomas Salinas is out of town. Facility has a COVID-19 mitigation plan on file and routine safety drills are conducted. LPA observed a screening station at the entry that contained a thermometer, hand sanitizer, COVID-19 signage, and a sign-in log. LPA toured the facility including, but not limited to common areas, bathrooms, bedrooms, kitchen, storage area and backyard. LPA observed mask, cough etiquette, social distancing and hand washing signs posted throughout. Caregiver to post 20 seconds to hand washing signs and add covered garbage cans to shared bathrooms. LPA reviewed staff and residents' files; all vaccinated. There was a sufficient supply of 2-day perishables and 7-day supply of non-perishable foods. All hand washing stations were equipped with soap, paper towels and garbage cans. There is a surplus of PPE stored in the downstairs area and centrally located inside the facility that is accessible to all care staff. Hot water temperature in the shared residents' bathroom was measured at 107.2 degrees Fahrenheit (F) and the facility's temperature was 82 degrees (F). Fire extinguisher was observed full along with two newly purchased ones. Smoke/Carbon Monoxide detectors were observed operational and first aid kit complete. The following forms are to be updated and submitted to CCLD: -LIC500 Personnel Report -LIC308 Designation of Administrative Responsibility (Reviewed) -LIC610E Emergency Disaster Plan (Reviewed) -An updated copy of Administrator Certificate(s) Exit interview conducted and a copy of this report provided to Caregiver, Robert Milloy.