Attentive Senior Care

Type of visit: Required - 1 Year

On 04/17/26, Licensing Program Analyst (LPA) M. Yang arrived unannounced to conduct an Annual Inspection. LPA introduced self, stated the purpose of the visit, and met with staff Tiffany Owen. Licensee Paulette Holland was called and arrived shortly during visit. LPA toured facility with Licensee. All five residents were present during the inspection in the living room. The facility was observed to be at a comfortable temperature, clean, in good repair, and no passageway obstructions or fire hazards were observed inside. Video cameras with audio observed in the living room and kitchen. All residents’ files were reviewed.Fire extinguisher was observed with a service date of: 12/09/25. An adequate supply of perishable and non-perishable food was observed. Freezer temperature was maintained at -2 degree F and refrigerator temperature maintained at 37 degrees F. Knives observed locked in kitchen drawer. First Aid supplies lock medication cabinet. Residents' bedrooms were toured and observed to be adequately furnished with bed, dresser, and adequate lighting. All bathrooms are observed with securely fastened grab bars and non-skid mats. Hot water temperature was tested at 110.8 in bathroom 1 and 110.6 degrees F in bathroom 2. Outside of facility toured and observed free of obstruction. Outdoor seatings observed available for the residents. Medications were checked and observed locked medication cabinet in the dining area. MARS and Centrally Stored Medication Records was reviewed. Carbon monoxide and smoke detectors were tested and observed to be operational. A sample of staff files were reviewed. Technical Support Program (TSP) assistance was offered. Licensee will make a decision and reach out the department regarding acceptance. A deficiency is being cited on the attached Lic 809D in accordance to California Code of Regulations, Title 22, Division 6 see attached 809D. Exit Interview conducted. The following documents are requested and submitted to Fresno CCL by: 04/23/26. The following updated forms were requested: Lic 308, Lic 500, Lic 610E, current Administrator Certificate, and current liability insurance. A copy of this report was provided to Licensee, whose signature on this form confirms receipt of this report.the state’s words, verbatim · CDSS document, Apr 17, 2026

The state marks this report as 6 pages; the online copy we transcribed has 4. You can request the full file from the county licensing office.

Type of visit: Required - 1 Year

On 3/6/25 Licensing Program Analyst (LPA) J. Leffall arrived unannounced to conduct an Annual Inspection. LPA introduced self, stated the purpose of the visit, and was greet by Staff (S1) Magdalucia Velazquez, LPA was granted entry. 4 residents were present during inspection. Administrator (A1) Paulette Holland arrived shortly after LPA’s arrival. LPA toured facility with S1. The facility was observed to be at a comfortable temperature, clean, in good repair, and no passageway obstructions or fire hazards were observed inside. An adequate supply of perishable and non-perishable food was observed. Samples of resident’s medications were checked and observed locked in kitchen cabinet. Clients’ MARS was reviewed. Samples of medications were reviewed. Fire extinguisher reviewed with a service date of: 12/6/24. Fire drill completed on 1/31/25. Clients' bedrooms were toured and reviewed. Cleaning chemicals were observed stored and locked in cabinet. Residents bedrooms observed to be adequately furnished with bed, dresser, and adequate lighting. All bathrooms are toured and observed to be operational. Hot water temperature was tested at a range of 113.5 to 115.5 degrees in 2 bathrooms. Outside of facility toured. Outside observed free of debris. Side gate was self-closing and self-latching. Outside was observed with adequate outdoor seatings available for clients. Freezer temperature observed at -2 degrees F and refrigerator temperature maintained at 37 degrees F. Smoke detectors and carbon monoxide were tested and observed to be operational. All clients’ files and staff’s files reviewed to have all the required documents. No deficiencies issued during this inspection. Exit Interview conducted. LPA is requesting the following documents be submitted to the Fresno CCL office by 3/20/25: Current copy of Administrator Certificate, Designation of Facility Responsibility (LIC308), Administrator Organization (LIC 309), Affidavit regarding Client/Resident Cash Resources (LIC 400), Liability Insurance-RCFE, Emergency and Disaster Plan (LIC 610E), Personnel Report (LIC500), Register of Facility Clients/Residents for (LIC9020A) A copy of this report and form 9102 was provided to A1, whose signature on this form confirms receipt of this report.the state’s words, verbatim · CDSS document, Mar 6, 2025

Type of visit: Required - 1 Year

On 03/13/2024, Licensing Program Analyst (LPA) Walton arrived unannounced to conduct an annual inspection. LPA introduced self, stated the purpose of the visit and requested to meet with the Administrator. Licensee Paulette Holland arrived shotly after LPA. LPA met with Licensee. LPA conducted a tour inside and outside of facility. Facility observed to be clean, odor free and at a comfortable temperature. Common areas were furnished well with adequate seating and lighting available. Resident rooms appeared clean and had required furnishings. Resident bathrooms were properly equipped with securely fastened grab bars in toilet and tub/shower areas, non-skid mats were observed. Hot water measured at 112.6 degrees F in the shared bedroom and 113.2 degrees F in the hallway bathroom.. Kitchen toured, appeared clean, observed a 7-day supply of non-perishable and 2-day supply of perishable food. Exterior tour conducted, all exits open and free of obstructions. Fire extinguisher serviced on 12/08/2023. Smoke detectors and carbon monoxide detector observed operational during today’s inspection. Last fire drill conducted on 01/31/2024. LPA reviewed staff and client records. Upon review of resident records, LPA found that R2 and R5 did not have an updated physician's report. LPA reviewed medication records and found that the facility administered medication outside the parameters of the prescription instructions for R2. LPA reviewed staff records and found that staff records did not have updated training. CONTINUED TO LIC809-C Deficiencies are being issued in accordance to California Code of Regulations, Title 22, Division 6 on the attached 809D. LPA is requesting the following documents be submitted to the Fresno CCL office by 03/27/2024: Current copy of Administrator Certificate, Designation of Facility Responsibility (LIC308), Administrator Organization (LIC 309), Affidavit regarding Client/Resident Cash Resources (LIC 400), Liability Insurance, Emergency and Disaster Plan (LIC 610E) Personnel Report (LIC500), Register of Facility Clients/Residents for (LIC9020A), Surety Bond. Exit interview conducted and a plan of correction was reviewed and developed. A copy of this report and appeal rights were discussed and provided to Licensee, Paullette Holland, whose signature on this form confirms receipt with this document.the state’s words, verbatim · CDSS document, Mar 13, 2024

The state marks this report as 5 pages; the online copy we transcribed has 4. You can request the full file from the county licensing office.