Heritage Royale

On 01/07/2026, Licensing Program Analyst (LPA) Jaime Vado conducted an unannounced pre-licensing inspection visit. LPA met with administrator Katie Eiseman and explained the purpose of today's visit. Pre licensing inspection conducted. Report is reviewed with Katie and a copy is provided.

On 08/23/2025, Licensing Program Analyst (LPA) Jaime Vado conducted an unannounced annual inspection visit. LPA met with administrator Katie Eiseman and explained the purpose of today's visit. This is a single level facility approved all residents to be non-amblatory and three hospice residents. There is one resident on hospice at this time. The physical plant was toured inside and outside of the facility to ensure the safety of the residents. LPA observed the facility kitchen which is clean and observed appliances are in good repair. Knives are stored and locked in the kitchen in a drawer between the stove and refrigerator. Medications are observed to be locked in a lockable storage area in the office of the facility. Perishable and non-perishable food items are observed as in place. There are additional refrigerators and freezers in the garage area which also carry additional food supplies. First aid kit is observed as complete with required items located in the office area of the facility. LPA observed that there are multiple fire extinguishers in place inspected 08/19/2025, smoke detectors, carbon monoxide detectors are observed in place through out the facility, and central heating system. PPE and additional food supplies are observed as in place. Laundry area is also observed as fully operational. Emergency exit routes are observed inside and outside to be free and clear of obstructions. Last emergency/disaster drill was conducted on 06/23/2025. Water temperature was measured at 110F in two common resident bathrooms and a private bathroom in a vacant resident room. Continued on next page... 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 Page 2 LPA observed rooms numerous resident rooms and all appeared clean, free of odors, and contained all the required furniture per regulatory recommendations. Three resident bedrooms contain a full bathroom. Resident linen supplies are observed as in place. Cleaning supplies are also observed as locked inaccessible to residents in care. There is a live in staff area for sleeping also located in the office. Facility does not handle resident monies. Three resident files and two staff files are reviewed as current. Medications are inspected and observed to be current and in order. The following updated forms are requested to be submitted to CCLD by 08/30/2025 : • LIC308 Designation of responsible staff person • LIC500 Staff Schedule No citations issued during today's visit. Report is reviewed with Katie and a copy is provided.

On 07/18/2024, Licensing Program Analyst (LPA) Jaime Vado conducted an unannounced annual inspection visit. LPA met with caregiver Lojie Fernando upon arrival and explained the purpose of today's visit. Around 2pm the administrator Katie Eiseman arrived and met with LPA. LPA was allowed entry into the facility. This is a single level facility approved all residents to be non-amblatory and three hospice residents. The physical plant was toured inside and outside of the facility to ensure the safety of the residents. LPA observed the facility kitchen which is clean and observed appliances are in good repair. Knives are stored and locked in the kitchen in a drawer between the stove and refrigerator. Medications are observed to be locked in a lockable storage area in the office of the facility. Perishable and non-perishable food items are observed as in place. There are additional refrigerators and freezers in the garage area which also carry additional food supplies. First aid kit is observed as complete with required items located in the office area of the facility. LPA observed that there are multiple fire extinguishers in place inspected 08/15/2024, smoke detectors, carbon monoxide detectors are observed in place through out the facility, and central heating system. PPE and additional food supplies are observed as in place. Laundry area is also observed as fully operational. Emergency exit routes are observed inside and outside to be free and clear of obstructions. Last emergency/disaster drill was conducted on 06/24/2025. Water temperature was measured at 110F in two common resident bathrooms and a private bathroom in a vacant resident room. Continued on next page... 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 Page 2 LPA observed rooms numerous resident rooms and all appeared clean, free of odors, and contained all the required furniture per regulatory recommendations. Three resident bedrooms contain a full bathroom. Resident linen supplies are observed as in place. Cleaning supplies are also observed as locked inaccessible to residents in care. There is a live in staff area for sleeping also located in the office. Facility does not handle resident monies. Four of four resident files are reviewed as current. Medications are inspected and observed to be current and in order. The following updated forms are requested to be submitted to CCLD by 08/28/2024 : • Copy of updated Administrator Certificates • Copy of facility's liability insurance • LIC308 Designation of responsible staff person • LIC610E Emergency Disaster Plan • LIC500 Staff Schedule • Copy of control of property No citations issued during today's visit. Report is reviewed with Katie and a copy is provided.

As per initial annual inspection on 1/19/24, LPA Jeung provided amended Facility Evaluation Report . Due to technical difficulties on 1/19/24, first page of Facility Evaluation Report was inaccurate. Amended page 1 of Facility Evaluation Report is provided, along with additional 3 pages of Advisory Notes. There are no changes or amendments to subsequent pages of Report of 1/19/24.