Wellness World

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Type of visit: Required - 1 Year

On 05/02/2025 at 12:45pm, the Department conducted an unannounced annual required visit using the CARE Inspection Tool. The Department met with staff member Elizabeth Gomez (Adminstrator) and purpose of the visit was explained. The facility is licensed to serve residents age 60 and over, of which six (6) may be non-ambulatory, one (1) may be bedridden, and the facility has a hospice waiver for three (3). The facility currently has five (5) residents in care with (1) on hospice & (3) on receiving home health. The facility’s annual fees are current. The facility administrator’s certificate is Elizabeth Gomez #7017473740 valid 10/25/2024 - 10/24/2026. The facility has liability insurance with Certain Underwriters at Lloyd's (policy #ISCAH0100000189-00) with each occurrence at $1,000,000 and general aggregate at $3,000,000 valid from 11/02/2025 - 11/02/2026 The facility is a two-story residential home located in a residential neighborhood. The licensed facility space is located on the first floor and consists of three resident bedrooms, two bathrooms, a living room, dining room, kitchen, laundry area, activity room, garage/storage area with 2 refrigerator, and a backyard with a shaded area. On 05/02/2026, between the hours of 12:47pm - 1:00pm, the Department toured the physical plant and observed no bodies of water or firearms/ammunition on the premises. All resident rooms were checked and found to have beds and bedding in good condition, adequate lighting, and sufficient storage space for personal belongings. Walls and floors were in good repair. Bed linens, comforters, and bath towels were adequately stocked. Bathrooms were found to be within Title 22 regulations. Toilets and water faucets worked properly, the shower was free of mold and mildew, lighting was adequate, and sufficient toiletries were accessible to residents. The water temperature properly measured between 105°F -120°F with temperature testing at 117.1°F in kitchen and 105.8 in Bathroom 1. Report continues on LIC 809-C The Department observed the facility to be clean, orderly, and appropriately furnished. Storage areas for personal hygiene items, cleaning agents, toxins, and sharps were locked and inaccessible to residents. The kitchen was inspected and found to have an adequate supply of perishable and non-perishable food stored properly. Medications were centrally stored and properly locked. The First Aid kit was fully stocked. Fire extinguishers were fully charged and inspected on 11/01/2025. Smoke and carbon monoxide detectors were operable. The facility also has a landline phone avaliable for the resident s On 05/02/2026, between the hours of 1:05pm -2:35pm, the Department conducted a review of five (5) resident records, five (5) staff records, and reviewed the facility disaster plan. The facility disaster plan was current and in compliance with Title 22 at the time of the visit. The Department reviewed five (5) resident Medication Administration Records. During today’s visit, the Department did observe the deficiencies during the annual inspections. Based on observation, interview and records review, the facility did not have the following on file Resident 1 (R1) - TB Test & No LIC 601 & LIC 625 Resident 2 (R2) - No LIC 601, LIC 602, LIC 603, LIC 625, No Hospice Care Plan Resident 3 (R3) - No LIC 602, LIC 613, LIC 625 Resident 4 (R4) - No LIC 625 Resident 5 (R5) - No LIC 603, LIC 625 and No TB Test An exit interview was conducted, and a copy of this Facility Evaluation Report was provided with Appeal Rights to the Administrator Elizabeth Gomezthe state’s words, verbatim · CDSS document, May 2, 2026

Type of visit: Required - 1 Year

On 5/1/25, at 9:00am, Licensing Program Analyst (LPA) Perry Scott conducted an unannounced annual required visit using the new CARE Inspection Tool. LPA was met by Eden Cabebe, staff, and the purpose of the visit was explained. The facility is licensed to serve residents aged 60 and over, of which six (6) may be non-ambulatory, one (1) may be bedridden, and hospice waiver for 3. Currently, the facility has (5) residents. The facilities’ annual fees are current. The facility is a two-story residential home located in a residential neighborhood. The facility is located on the first floor, and consists of (3) resident bedrooms, (2) bathrooms, living room, dining room, kitchen, activity room, garage/ storage and backyard with patio cover and tables and chairs. LPA conducted a records review of (5) resident records, (5) staff records, and reviewed the facility disaster plan. All resident & staff records were complete. The facility disaster plan was current and in compliance with Title 22 at the time of visit. LPA reviewed (5) resident Medication Administration Records and did not observe any discrepancies at the time of visit. At 9:30am, LPA toured the physical plant. There are no bodies of water or firearm/ammunition on the premises. All resident rooms were checked. Beds and bedding were in good condition, adequate lighting provided, adequate storage for resident personal belongings was observed. Walls and floors were in good repair. Bed linens, comforters, and bath towels were adequately stocked at the time of visit. Bathrooms were found to be within Title 22 regulations. Report Continued On LIC809-C Toilets and water faucets worked properly. The shower was free of mold/mildew, there is adequate lighting, and sufficient toiletries accessible to clients. The water temperature measured 119.7F. A comfortable temperature is maintained in the facility. LPA observed the facility to be clean and appropriately furnished at the time of visit. Storage areas for personal hygiene, cleaning agents, toxins, and sharps were inaccessible to residents. The kitchen was inspected and there is enough perishable and non-perishable food available, which is stored properly. Medications were centrally stored and properly locked, first aid kit was checked and fully stocked. The fire extinguishers were fully charged. Smoke/ Carbon Monoxide detectors were operable. The facilities administrator’s certificate was current and expires on 10/24/2026. During the visit, LPA observed the facility infection control practices. LPA observed screening protocols for visitors, staff, and residents. LPA observed that sanitizing stations were in common areas and restrooms. LPA observed that the facility had the required postings, posted throughout the facility. LPA advised the staff to continuously monitor the Centers for Disease Control (CDC) website and Community Care Licensing (www.cdss.ca.gov) for Provider Informational Notices (PIN) and for any updates relating to COVID-19 guidance and other related issues. During today’s visit there were no deficiencies observed. An exit interview was conducted, and a copy of this Facility Evaluation Report was provided to Eden Cabebe, staff.the state’s words, verbatim · CDSS document, May 1, 2025

Type of visit: Required - 1 Year

On 4/11/24, Licensing Program Analyst (LPA) Perry Scott conducted an unannounced annual required visit using the new CARE Inspection Tool. LPA was met by Elizabeth Gomez, Administrator, and the purpose of the visit was explained. The facility is licensed to serve residents aged 60 and over, of which six (6) may be non-ambulatory, one (1) may be bedridden, and hospice waiver for 3. Currently, the facility has (6) residents that include: (2) non-ambulatory, and (4) ambulatory resident. The facilities’ annual fees are current as well as the liability insurance. The facility is a two-story residential home located in a residential neighborhood. The facility is located on the first floor, and consists of (3) resident bedrooms, (2) bathrooms, living room, dining room, kitchen, activity room, garage/ storage and backyard with patio cover and tables and chairs. LPA conducted a records review of (6) client records, (4) staff records, and reviewed the facility disaster plan. All client & staff records were complete. The facility disaster plan was current and in compliance with Title 22 at the time of visit. LPA reviewed (6) Client Medication Administration Records and did not observe any discrepancies at the time of visit. At 10:00am, LPA toured the physical plant. There are no bodies of water or firearm/ammunition on the premises. All resident rooms were checked. Beds and bedding were in good condition, adequate lighting provided, adequate storage for client personal belongings was observed. Walls and floors were in good repair. Bed linens, comforters, and bath towels were adequately stocked at the time of visit. Bathrooms were found to be within Title 22 regulations. Toilets and water faucets worked properly. The shower was free of mold/mildew, there is adequate lighting, and sufficient toiletries accessible to clients. The water temperature measured 118.9F. A comfortable temperature is maintained in the facility. Report continued on LIC809-C LPA observed the facility to be clean and appropriately furnished at the time of visit. Storage areas for personal hygiene, cleaning agents, toxins, and sharps were inaccessible to clients. The kitchen was inspected and there is enough perishable and non-perishable food available, which is stored properly. Medications were centrally stored and properly locked, first aid kit was checked and fully stocked. The fire extinguishers were charged and last inspected on 11/30/2023. Smoke/ Carbon Monoxide detectors were operable. The last fire/emergency drill was conducted on 04/20/2023. During the visit, LPA observed the facility infection control practices. LPA observed screening protocols for visitors, staff, and residents. LPA observed that sanitizing stations were in common areas and restrooms. LPA observed that the facility had the required postings, posted throughout the facility. LPA further observed the facility to have a 90-day supply of Personal Protective Equipment (PPE). LPA advised the administrator to continuously monitor the Centers for Disease Control (CDC) website and Community Care Licensing (www.cdss.ca.gov) for Provider Informational Notices (PIN) and for any updates relating to COVID-19 guidance and other related issues. According to the California Code of Regulations (Title 22, Division 6, Chapter 8), LPA did not observe any deficiencies, therefore no citations were issued at this time. Exit interview held. A copy of the report was provided to Elizabeth Gomez, Administrator.the state’s words, verbatim · CDSS document, Apr 11, 2024