Leisure Living

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Martha Arroyo arrived at the facility unannounced to conduct the required annual visit today. Upon arrival, there were two (2) staff members and five (5) residents present. The LPA was greeted by staff who then contacted the Administrator telephonically and informed them of today’s visit. Administrator, Michelle Maurer arrived at approximately 09:55 a.m. Entrance interview conducted. Beginning at 09:56 a.m., the LPA along with staff toured the physical plant areas inside and outside to ensure there are no health and safety hazards, and facility is in compliance with Title 22 Regulations. The following was observed: Kitchen: The LPA inspected the kitchen/food service area at approximately 09:56 a.m. Knives and sharps were observed in a kitchen cabinet locked and inaccessible. Kitchen appliances were in operable condition. The facility has a sufficient supply of perishable and non-perishable food. Refrigerator and food pantry were checked for proper labels and expiration dates. Expiration dates were clearly marked. At 09:58 a.m., the hot water temperature in the kitchen sink was measured and it read 110.7 degrees Fahrenheit. Common Areas: At the time of the visit, furniture in the common areas was observed to be in good condition. The facility maintained a comfortable temperature. Report Continued on LIC 809C... Report Continued from LIC 809... The LPA observed a fire extinguisher to be new with a purchase date of 08/14/2025. Fireplace was observed adequately covered at the time of the visit. Required postings were observed throughout the common space. There is a working telephone on premises. Activities were observed in the common areas. Auditory alarms were observed functioning at the time of the visit. At 10:15 a.m., the smoke detector and carbon monoxide were tested and operational at the time of the visit. LPA observed cameras in common areas. No hazards/obstructions observed inside or out. Restrooms: There are two (2) restrooms for residents’ use. One (1) bathroom is located inside bedroom #1 and second bathroom was observed by the main hallway. Bathrooms were clean and sanitary and in operating condition with non-skid surfaces. The bathrooms were sufficiently stocked with supplies and paper towels. Starting at 10:05 a.m., the hot water temperature was measured in both bathrooms, and they measured within the required range of 105 – 120 degrees Fahrenheit. Personal hygiene items were observed locked and inaccessible to residents at the time of the visit. Bedrooms: There are three (3) bedrooms for resident use and are designated as shared / double occupancy bedrooms. Bedrooms were observed to be furnished appropriately and had sufficient lighting. Additional clean linens and towels were observed in a closet by the hallway. Staff bedroom was observed locked and inaccessible. Garage/Laundry Room: The garage is accessible directly from the main house. Garage was locked at the time of the inspection. Washer and dryer were observed inside the garage. Cleaning supplies and detergents were observed locked and inaccessible at the time of the visit. The LPA observed an adequate amount of emergency food and water. Outdoors: The backyard has a covered patio area with adequate furniture for residents use. Emergency passageway was observed to be clear of any obstructions. There is one (1) side gate with latching mechanisms. No bodies of water noted at the time of the visit. Report Continued on LIC 809C... Report Continued from LIC 809C.. Records: Record review began at approximately 10:25 a.m. Five (5) resident files were reviewed for, but not limited to, the following: signed admission agreements, current medical assessments with TB results, consent for treatment form, and current needs and services plan/IPP. All files were in order. Two (2) personnel files including the current Administrator’s file were reviewed for, but not limited to: personnel records, health assessments with negative TB test results, criminal record clearances, first aid/CPR training, and the appropriate yearly training. All personnel files were complete. The Administrator’s Certificate is valid until 02/02/2028. Infection Control / Emergency Disaster Planning: The LPA reviewed the facility's infection control plan and emergency disaster plan. The facility’s policies and procedures as they pertain to infection control are adequate. The LPA observed the emergency disaster plan to be complete and recently reviewed/updated. Emergency disaster drills conducted quarterly as per regulation; last drill conducted on 03/05/2026.at the time of the visit. Medications: Medications review began at approximately 12:30 p.m. Medications are centrally stored and kept in a locked closet. Medications are properly documented on the centrally stored medication and destruction record. Medications appear to be administered as prescribed at the time of the visit. No citations issued at this time. Exit interview conducted. Report was reviewed and copy provided.the state’s words, verbatim · CDSS document, Mar 20, 2026

Type of visit: Required - 1 Year

Licensing Program Analysts (LPA) Erica Mosley arrived at the facility unannounced to conduct a required annual visit and entered the facility at 9:35 a.m. Upon arrival, LPA Mosley was greeted by house manager, Leah Dela Cruz who called the Administrator to inform them of the visit. Parvin Hashemi, Licensee Representative arrived shortly after. The LPA met with Licensee Representative Parvin Hashemi and explained the reason for the visit. The LPA along with Licensee Representative toured the physical plant areas inside and outside to ensure there are no health and safety hazards and facility is in compliance with Title 22 Regulations. INTERVIEWS: From 9:37 a.m. - 9:55 a.m. One (1) staff and three (3) resident interviews were conducted during the inspection. Staff interview revealed that staff are knowledgeable in Resident rights, different forms of abuse, and reporting procedures. Resident interviews revealed that no concerns were noted or voiced at the time of the visit. COMMON AREAS: At the time of the visit, furniture in the common areas were observed to be in good condition. The facility maintained a comfortable temperature. At 10:10 a.m., smoke detector(s) and carbon monoxide detectors were tested and operational at the time of the visit. The fire extinguisher was observed and fully charged on 09/01/2024. The LPA observed required postings throughout the common space. The last emergency disaster drill took place on 03/07/2025 and conducted monthly. Activities were observed in the common areas. Hygiene items were observed locked and inaccessible in a hallway closet. The facility has a working telephone on the premises. Auditory alarms on all doors were functional at the time of the visit. Entry/exits were free of obstruction. BEDROOMS: The facility is a single-story residential home with four (4) bedrooms of which three (3) are for resident use and one (1) for staff use. Resident bedrooms are shared, double occupancy bedrooms. The LPA observed resident bedrooms, which were furnished appropriately with clean linens, appropriate furnishings, and sufficient lighting. Staff room remains locked at all time. Report Continued on LIC 809C... Report Continued from LIC 809... RESTROOMS: There are two (2) resident restrooms. The first restroom is located inside bedroom #1, and the second restroom is located by the main hallway. Restrooms were clean and sanitary and in operating condition with grab bars and slip resistant surfaces. The restrooms were sufficiently stocked with hand liquid soap and paper towels; towels and washcloths are not shared. The hot water temperature was measured in both restrooms; the first restroom measured 105.1 degrees Fahrenheit at 9:56 a.m.; and the second restroom measured 113.5 degrees Fahrenheit at 9:58 a.m. GARAGE: The garage was observed locked and inaccessible to residents at the time of the visit. The washer and dryer were observed inside the garage. Cleaning supplies and detergents were observed locked and inaccessible at the time of the visit. The facility has a sufficient amount of emergency food and water which was observed to be in good condition. The LPA observed a sufficient supply of Personal Protection Equipment (PPE). KITCHEN: The LPA inspected the kitchen/food service area at 10:02 a.m. Kitchen appliances appeared clean and were in operable condition at the time of the visit. The facility has a sufficient supply of two (2) day perishable and seven (7) day non-perishable food. Food labels were inspected and checked for dates and expiration. Dates and food labels had expiration date clearly marked. The knives and sharps were observed in a locked cabinet inaccessible. BACKYARD: The backyard has an area equipped with outdoor furniture including a table and chairs for resident use with a portable outdoor umbrella for shade. Emergency exits and passageways were observed free of obstruction. There was one (1) gate that self-latches. No bodies of water were noted at the time of the visit. RECORDS: Records review began at 10:10 a.m.; five (5) resident records were reviewed for, but not limited to: appraisals, medical records, admissions agreement, consent forms. All records were in order. Five (5) personnel records were reviewed for, but not limited to: personnel records, health assessments, criminal record clearances, first aid/CPR training, and the appropriate training. All files were in order. Report Continued on LIC 809C... Report Continued from LIC 809... Infection Control / Emergency disaster planning: During today’s visit LPA Mosley reviewed the facility’s infection control practices and the facilities emergency disaster plan. The facilities policies and procedures as it pertains to infection control are adequate. MEDICATIONS: Medications review began at approximately 12:15 p.m. Medications are centrally stored and locked in the hallway closet adjacent to the garage entrance; Medications for five (5) residents were reviewed. Medications are labeled and checked for expiration dates. All medications including PRNs were labeled, stored, and locked inaccessible to residents in care. PRNs have physicians order on file. Medications reviewed were found to be self-administered as prescribed and documented on the centrally stored medication and destruction records. No errors observed. Documents obtained during the visit include: LIC 500 facility roster, LIC 9020A Resident roster, and current Liability Insurance. No citations issued. Exit interview conducted. A copy of the report was provided.the state’s words, verbatim · CDSS document, Mar 12, 2025

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Martha Arroyo arrived at the facility unannounced for a required one-year annual inspection today at 11:00 a.m. The last annual conducted at this facility was on 02/16/2023. When the LPA arrived, there were four (4) staff and five (5) residents present. The LPA was greeted at the door by House Manager, Leah Dela Cruz and the reason for the visit was explained. The Administrator, Michelle Maurer arrived during the inspection. Entrance interview conducted. At 11:07 a.m., the LPA along with the House Manager toured the physical plant areas inside and outside to ensure there are no health and safety hazards and facility is in compliance with Title 22 Regulations. KITCHEN: The LPA inspected the kitchen/food service area at 11:17 a.m. Kitchen appliances appeared clean and were in operable condition at the time of the visit. The facility has a sufficient supply of perishable and non-perishable food. Food labels were inspected and checked for dates and expiration dates and food labels had expiration date clearly marked. The knives and sharps were observed in a locked cabinet inaccessible. COMMON AREAS: At the time of the visit, the living room and dining room furniture was observed to be in good condition. The facility maintained a comfortable temperature. At 11:26 a.m., the smoke detector(s) and carbon monoxide detector were tested and operational at the time of the visit. The fire extinguisher was observed to be in compliance with a purchase date of 09/21/2023. The LPA observed a closet in the hallway with extra towels and linens. Continued on LIC 809C... Continued from LIC 809... Hygiene items were observed locked and inaccessible in a hallway closet. The LPA observed required postings throughout the common space. There is a working telephone on premises. Working auditory alarms were observed in all doors at the time of the visit. GARAGE: The garage was observed locked and inaccessible to clients at the time of the visit. The washer and dryer were observed inside the garage. Cleaning supplies and detergents were observed locked and inaccessible at the time of the visit. The facility has a sufficient amount of emergency food and water which was observed to be in good condition. The LPA observed a sufficient supply of Personal Protection Equipment (PPE). BACKYARD: The backyard has a covered outdoor area equipped with furniture for resident use. Emergency exits and passageways were observed free of obstruction. There was one (1) gate that self-latches. No bodies of water were noted at the time of the visit. BEDROOMS: There are three (3) resident bedrooms which are double occupancy. The LPA observed the resident bedrooms to be furnished appropriately with linens, appropriate furnishings, and sufficient lighting. RESTROOMS: There are two (2) resident restrooms. The first restroom is located inside bedroom #1, and the second bathroom is located by the main hallway. Restrooms were clean and sanitary and in operating condition with grab bars and non-skid surfaces. The bathrooms were sufficiently stocked with hand liquid soap and paper towels; towels and washcloths are not shared. The hot water temperature was measured in both bathrooms; the first bathroom measured 110.4 degrees Fahrenheit at 11:10 a.m.; and the second bathroom measured 111.0 degrees Fahrenheit at 11:12 a.m. RECORDS: Records review began at 11:33 a.m.; five (5) resident records were reviewed for, but not limited to: appraisals, medical records, admissions agreement, consent forms. All records were in order. Continued on LIC 809C... Continued from LIC 809C... Five (5) personnel records were reviewed for, but not limited to: personnel records, health assessments, criminal record clearances, first aid/CPR training, and the appropriate training. All files were complete. The last emergency disaster drill took place on 02/15/2024. MEDICATIONS: Medications review began at approximately 2:00 p.m.; medications are centrally stored in a locked closet in the hallway. All medications including PRNs were labeled, stored, and locked inaccessible to residents in care. PRNs have physicians order on file. Medications are properly documented on the centrally stored medications and destruction record. No citations issued. Exit interview conducted. A copy of the report was provided.the state’s words, verbatim · CDSS document, Mar 14, 2024