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LPA Jeung met with assisted living coordinator to deliver an amended Complaint Investigation Report for complaint #14-AS-20250801130031. See LIC9099D

In response to Incident Report of 11/7/25 of a medication administration error, LPA Jeung met with resident care director/RN to obtain additional information. Nursing staff received remedial training, and proof of training is given to LPA today. Facility responded appropriately to medication error to prevent future errors and reported incident to client's physician, responsible party, as well as CCLD. No deficiency cited.

To complete annual inspection of 6/17/25, LPA Jeung reviewed residents' medications recorded on Centrally Stored Medication Records, requested additional information for staff training, and tested hot water temperature in private bathroom of second floor Laurel Wing unit. Medications are observed to be complete, accurate and up to date. Hot water temperature tested at 118 degrees. More specific information on staff training is provided. No deficiencies are observed today.

LPA Jeung reviewed random staff and client files to complete annual inspection of 8/5/24. RCFE administrator certificate for executive director was submitted to CCLD, along with other requested information: • LIC 308 Designation of Administrative Responsibility • Bedridden Plan of Operation • Medication Training requirements for staff • Board Resolution appointing administrator Janie Woo No deficiencies of the RCFE California Code of Regulations, Title 22, Division 6, Chapter 8 are observed. See also Technical Advisory Note.

LPA Audrey Jeung toured facility and grounds of this Continuing Care Retirement Community, consisting of studio, one, two and three bedroom apartments--each with full private bathrooms--on 10 floors. On the 2nd floor, there are 9 studio apartments which comprise the Laurel Wing, where up to 12 residents can receive assisted living services; there are 5 residents in the Laurel Wing with 2 caregivers and an LVN present. Facility provides 3 meals daily to those residents of the Laurel Wing. Dinner meal is provided to other residents, who are mostly independent. Food supplies of perishables for 2 days and non-perishables for 7 days are maintained. Common areas on the ground floor include living room, library, fitness room, sauna room, indoor pool, dining room. On the 11th floor, there is a large and small meeting room. No fire safety hazards are observed. PPE supply is adequate and first-aid kit is inspected and complete. Medications, toxins and sharps are stored appropriately and inaccessible to clients, a comfortable temperature is maintained, and lighting is sufficient for comfort and safety. Centrally Stored Medications Records are maintained. Toilet and bathing facilities are equipped with grab bars and nonskid flooring material. Liquid soap is available at all sinks. Emergency call system is installed in all rooms; when cord is pulled, staff with cell phones are alerted, and a visual and audio alert appears on monitors at Laurel Wing nurses station and reception desk on ground level. An updated Disaster and Mass Casualty Plan is accessible. Criminal record clearances or exemptions for facility staff or other individuals who have client contact have been reviewed. Executive director Janie Woo is an RCFE administrator and is assisted by resident care director/RN Lori Wolfe, who is a certified RCFE administrator (x 5/26). Staff and client records to be reviewed at a later date. The following updated forms/information are requested to be submitted to CCLD BY 8/19/24: • LIC 308 Designation of Administrative Responsibility • Bedridden Plan of Operation • Medication Training requirements for staff LPA is provided with the following information today: • LIC 500 Personnel Reports • LIC 610 Emergency Disaster Plan No deficiencies of the RCFE California Code of Regulations, Title 22, Division 6, Chapter 8 are observed.

LPA Audrey Jeung toured facility and grounds of this Continuing Care Retirement Community, consisting of studio, one, two and three bedroom apartments--each with full private bathrooms--on 10 floors. Most staff are observed wearing face coverings. No accessible bodies of water or fire safety hazards observed. Infection control practices are reviewed: entry procedures, staff training and policies, resident monitoring, containment strategies, environmental preparation and cleaning. PPE supply is adequate and infection control signs are posted. Medications, toxins and sharps are stored appropriately and inaccessible to clients, a comfortable temperature is maintained, and lighting is sufficient for comfort and safety. Toilet and bathing facilities are equipped with grab bars and nonskid flooring material. Liquid soap is available at all sinks. First-aid kit is inspected and complete. An updated Disaster and Mass Casualty Plan is posted. There are 8 residents in the assisted living unit--Laurel Wing--and 2 caregivers plus 2 nurses present. Criminal record clearances or exemptions for facility staff or other individuals who have client contact have been reviewed, including caregivers' health screenings and TB test results. First-aid training for Laurel Wing caregivers is current. Camille Christie is a certified RCFE administrator (x 6/22) that oversees facility operations. The following updated forms/information are requested to be submitted to CCLD BY 7/29/21: • LIC 309 Administrative Organization • LIC 500 Personnel Report No deficiencies of the RCFE California Code of Regulations, Title 22, Division 6, Chapter 8 are observed. See Technical Assistance issued.