Kingdom Works

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) N. Galarza arrived at the facility unannounced for the purpose of conducting the Required 1-Year annual evaluation. LPA was greeted and granted entry by caregiver staff Dante Serrano. Administrator Edjeska Macandili arrived later. The following was observed during the inspection: Infection Control: The facility has an Infection Control Plan that is reviewed annually. Operational Requirements: A Dementia and hospice waiver for 6 residents has been approved. A fire clearance for 6 non-ambulatory of which 1 may be bedridden. Facility does not handle resident P & I monies. Liability Insurance in the amount of at least ($1,000,000) per occurrence and ($3,000,000) in total annual aggregate expires 10/29/2026. Physical Plant/Environment Safety: The interior and exterior physical plant was inspected. The facility is a single-story home located in a residential neighborhood. It is licensed for a capacity of six (6) residents. The facility consists of a kitchen, dining room, family room, living room, one (1) live-in staff bedroom, four (4) resident bedrooms, laundry area, and detached garage. Rooms are equipped with required furniture mattress pads, and bedding. Cleaning supplies and toxic substances are inaccessible to residents. The facility has fire extinguisher. Cleaning supplies and toxic substances are inaccessible to residents. Water temperature readings measured within the required 105 - 120 degrees Fahrenheit. The facility maintains emergency food supply and water. Emergency Phone numbers, exit plan and programming schedules were posted. The building contains central air conditioning and heating. First aid kits/Manuals are kept in activity rooms; consisting of thermometer, tweezers, scissors, antiseptic, bandages, gauze. Exit doors are free of any obstruction. The last Emergency Disaster drill was conducted on 8/10/2026. *There are 2 staff living in the garage. The facility sketch and plan of operation do not indicate the garage is permitted as an additional dwelling unit. The side gate door had a lock. citation was issued. Indoor surveillance cameras were observed; a technical advisory was issued. Staffing: A total 6 staff members provide care and supervision to the residents. Personnel Records/Staff Training: Six files were reviewed. Files were reviewed for criminal background clearance, training, health clearance, and 1st Aid/CPR training. Administrator certificate expires 7/28/2027. * Administrator on record is not current. A citation was issued. Resident Records/Incident Reports: A total of six (6)resident files were reviewed. They contained admission agreements, Physician's Reports, Appraisals, TB clearance, Physician's Orders, medical consent. RCFE complaint poster and Personal rights were observed posted. However, the RCFE complaint poster is not the correct size i.e., 20 x 24. A Technical Advisory was issued. Planned Activities: Sufficient space to accommodate both indoor and outdoor activities was observed. The facility does not have a Resident Council. Food Service: Sufficient food supply is stored in the kitchen and pantry areas consisting of: 2-day perishables, 7-day non-perishables, and emergency food supplies. No residents require modified diets. Incident Medical and Dental: Centrally Stored Medication And Destruction Record/ 30-Day supply of medications were reviewed. Medical and dental transportation is provided by family. The facility uses electronic Medication Administration Records (MARs). Disaster Preparedness: Emergency and Disaster Plan LIC 610E was reviewed. Facility has a First Aid Kit and Manual. Residents with Special Health Needs: All residents are enrolled in home health services. Pursuant to Title 22, deficiencies were cited. An exit interview was conducted with . A copy of the report/appeal rights were provided.the state’s words, verbatim · CDSS document, Sep 17, 2026

Type of visit: Case Management - Annual Continuation

Licensing Program Analyst (LPA) Erik Zaragoza conducted an unannounced annual continuation visit using the full Care Compliance and Regulatory Enforcement (CARE) Tools. LPA met with Amor Donato, direct support staff for the facility, and explained the purpose of the visit. Administrator Edjeska Mian Macandili was notified of the visit by phone call. There are currently six (6) residents currently living in the facility. The following 12 (CARE) tool domains were observed and reviewed: Infection Control, Physical Plant/Environment Safety, Operational Requirements, Staffing, Personnel Records/Staff Training, Resident Rights/Information, Resident Records/Incident Reports, Food Service, Planned Activities, Incident Medical and Dental, Disaster Preparedness, and Residents with Special Health Needs. Infection Control: · Infection control plan is on file. Physical Plant/Environment Safety: · The facility is a single-story home located in a residential neighborhood. The facility consists of a kitchen, a dining room, a living room, two (2) staff bedrooms, an attached garage the contains miscellaneous supplies, a back yard that contains a shaded area, four (4) resident bedrooms, three (3) bathrooms of which Restroom #1 had a hot water temperature reading of 107.4 degrees Fahrenheit, and Restroom #2 which had a hot water temperature reading of 111.2 Degrees Fahrenheit, and Restroom #3 had a hot water temperature reading 110.3 degrees Fahrenheit. The facility was observed to be in good repair. · The interior and exterior physical plant was inspected. Exit doors are free of any obstruction. The facility has a fully charged fire extinguisher kept in the facility. Operational Requirements: · The Program Design was reviewed. · Fire clearance was approved by LA County Fire Department for a capacity of six (6) non-ambulatory residents, one (1) of whom may be bedridden, and a hospice waiver approved for all six (6) residents. · Care and supervision to meet the clients’ needs was observed. Staffing: · Four (4) full-time staff members provide care and supervision to the clients. Personnel Records/Staff Training: · Four (4) staff files were reviewed for criminal background clearance and training. · All Four (4) staff records reviewed have a health screening with a Tuberculosis clearance, and five (5) staff have First Aid/CPR trainings that are active. · The administrator’s certificate expires on 7/28/2027. Resident Rights/Information: · Physician orders were reviewed for six (6) resident files. · Medications were also reviewed for six (6) residents. Resident Records/Incident Reports: · Six (6) resident files were reviewed containing admission agreements, Physician's Report, medical/functional assessments, Needs and Services Plans, TB clearance, Appraisal/Needs and Services Plan, personal rights, medical consent, and medication records were reviewed. Food Service: · The kitchen was inspected and has sufficient supply of 2-day perishable & 7-day non-perishable food. Kitchen, food preparation area, and storage areas were observed to be clean and sanitary. Incident Medical and Dental: · All residents have an Appraisal/Needs and Services Plan on file. · Staff training was on file. Disaster Preparedness: · Emergency and Disaster Plan (LIC610E) was posted in the facility. · The last emergency and disaster drill was conducted on 7/1/2025. Planned Activities: · Sufficient Space is provided to accommodate both indoor and outdoor activities. · Sufficient equipment and supplies are provided to meet the requirements of the activity program. Residents with Special Health Care Needs · There is an adequate number of staff to support each resident’s physical, social, emotional, safety and health care needs as identified in his/her appraisal. Per California Code of Regulations, Title 22, and California Health and Safety Code, no deficiencies were observed. Exit interview held and a copy of the report was provided.the state’s words, verbatim · CDSS document, Oct 13, 2025

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Erik Zaragoza conducted an unannounced Required 1-year visit using the full Care Compliance and Regulatory Enforcement (CARE) Tools. LPA met with Amor Donato, direct support staff for the facility, and explained the purpose of the visit. Administrator Edjeska Mian Macandili was notified of the visit by phone call. There are currently six (6) residents currently living in the facility. The following 12 (CARE) tool domains were observed and reviewed: Infection Control, Physical Plant/Environment Safety, Operational Requirements, Staffing, Personnel Records/Staff Training, Resident Rights/Information, Resident Records/Incident Reports, Food Service, Planned Activities, Incident Medical and Dental, Disaster Preparedness, and Residents with Special Health Needs. Infection Control: · Infection control plan is on file. Physical Plant/Environment Safety: · The facility is a single-story home located in a residential neighborhood. The facility consists of a kitchen, a dining room, a living room, two (2) staff bedrooms, an attached garage the contains miscellaneous supplies, a back yard that contains a shaded area, four (4) resident bedrooms, three (3) bathrooms of which Restroom #1 had a hot water temperature reading of 107.4 degrees Fahrenheit, and Restroom #2 which had a hot water temperature reading of 111.2 Degrees Fahrenheit, and Restroom #3 had a hot water temperature reading 110.3 degrees Fahrenheit. The facility was observed to be in good repair. · The interior and exterior physical plant was inspected. Exit doors are free of any obstruction. The facility has a fully charged fire extinguisher kept in the facility. Resident Rights/Information: · Physician orders were reviewed for six (6) resident files. · Medications were also reviewed for six (6) residents. Food Service: · The kitchen was inspected and has sufficient supply of 2-day perishable & 7-day non-perishable food. Kitchen, food preparation area, and storage areas were observed to be clean and sanitary. Due to time constraints, the annual inspection will need to be completed at a later date. Exit interview was held and a copy of the report will be emailed to the administrator.the state’s words, verbatim · CDSS document, Oct 7, 2025

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Erik Zaragoza conducted an unannounced Required 1-year visit using the full Care Compliance and Regulatory Enforcement (CARE) Tools. LPA met with Jesusa Soriano, Cook/Caregiver for the facility, and explained the purpose of the visit. Administrator Nicki Drew arrived shortly thereafter. There are five (5) residents residing within the home. The following 12 (CARE) tool domains were observed and reviewed: Infection Control, Physical Plant/Environment Safety, Operational Requirements, Staffing, Personnel Records/Staff Training, Resident Rights/Information, Resident Records/Incident Reports, Food Service, Planned Activities, Incident Medical and Dental, Disaster Preparedness, and Residents with Special Health Needs. Infection Control: · Infection control practices were observed. · Infection control plan is on file. Physical Plant/Environment Safety: · The facility is a single-story home located in a residential neighborhood. It is licensed for a capacity of six (6) residents, six (6) of which may be non-ambulatory, one (1) of which may be bedridden, and a hospice waiver approved for six (6) residents. The facility consists of a kitchen, a dining room, two (2) living rooms, one (1) staff bedroom, five (5) resident bedrooms, two (2) bathrooms of which restroom #1 had a hot water temperature of 110.6 Degrees Fahrenheit and restroom #2 had a hot water temperature of 105.2 Degrees Fahrenheit, along with a backyard that contains a shaded area and a detached garage. The facility was observed to be in good repair. · The interior and exterior physical plant was inspected. Exit doors are free of any obstruction. The facility has two (2) fully charged fire extinguishers in the facility. · Water temperature readings for one of the bathrooms in the home fell within the required range of 105 - 120 degrees Fahrenheit. Operational Requirements: · The Program Design was reviewed. · Fire clearance was approved by LA County Fire Department for a capacity of six (6) residents, six (6) of which may be non-ambulatory, one (1) of which may be bedridden, and a hospice waiver approved for six (6) residents. · Care and supervision to meet the clients’ needs was observed. Staffing: · Five (5) full-time staff members provide care and supervision to the clients. Personnel Records/Staff Training: · Five (5) staff files were reviewed for criminal background clearance and training. · All staff records reviewed have health a health screening with a Tuberculosis clearance, and all staff have First Aid/CPR trainings that are active. · The administrator’s certificate expires on 4/27/2025. Resident Rights/Information: · Physician orders were reviewed for five (5) resident files. · Medications were also reviewed for five (5) residents. Resident Records/Incident Reports: · Five (5) resident files were reviewed containing admission agreements, Physician's Report, medical/functional assessments, Needs and Services Plans, TB clearance, Appraisal/Needs and Services Plan, personal rights, medical consent, and medication records were reviewed. Food Service: · The kitchen was inspected and has sufficient supply of 2-day perishable & 7-day non-perishable food. Kitchen, food preparation area, and storage areas were observed to be clean and sanitary. Incident Medical and Dental: · All residents have an Appraisal/Needs and Services Plan on file. · Staff training was on file. Disaster Preparedness: · Emergency and Disaster Plan was publicly posted within the facility. · The last emergency and disaster drill was conducted three (3) months ago. Planned Activities: · Sufficient Space is provided to accommodate both indoor and outdoor activities. · Sufficient equipment and supplies are provided to meet the requirements of the activity program. Residents with Special Health Care Needs: · There are no residents currently receiving hospice services, home health services, or have a dementia diagnosis. · There is an adequate number of staff to support each resident’s physical, social, emotional, safety and health care needs as identified in his/her appraisal. Per California Code of Regulations, Title 22, and California Health and Safety Code, no deficiencies were observed during the visit. Exit interview held and a copy of the report was provided.the state’s words, verbatim · CDSS document, Oct 10, 2024