Gentle Home Care

Type of visit: Case Management - Incident

At approximately 11:40AM, Licensing Program Analyst (LPA) Felias arrived unannounced to conduct a Case Management - Incident visit, and met with Staff Member, Tigist Dinka. Administrator, Martha Ghezzehai, arrived during visit at approximately 1:50PM. The purpose of the visit was to follow up on a self-reported incident report that was submitted to the Santa Rosa Regional Office (SRRO). Incident Report 1: The SRRO received a report on 12/22/2025. Report stated that on 12/19/2025, Resident 1 (R1) left the facility. Per report, the night-time caregiver was providing care to another resident when R1 left the facility. Facility notified San Rafael Police Department (SRPD) and Fire Department. R1 was found down the street from the facility by SRPD. R1 was sent to the hospital for further evaluation as it was observed R1 had a fall. Facility made all appropriate notifications per regulation. Review of R1's medical assessment dated 10/05/2025 does not indicate if they have a diagnosis of dementia and stated they can to leave the facility unassisted. Review of R1's care plan dated 12/07/2025 indicated that R1 had a diagnosis of dementia. Review of R1's medical assessment dated 02/20/2026, states that R1 has a diagnosis of dementia and is unable to leave unassisted. There was no updated care plan to reflect R1's new medical assessment from February 2026. Review of documents showed that facility conducted elopement training on 12/20/2025. LPA discussed with Administrator on ensuring that resident documents are filled out correctly and are updated to reflect their care needs as required. Per Administrator, R1 is scheduled for a new medical assessment at the end of the month. Administrator to submit updated paperwork to Community Care Licensing (CCL) as part of their plan of correction. Deficiencies are cited from the California Code of Regulations (CCRs), and/or the Health and Safety Code. Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment. Exit interview conducted. Copy of report, LIC809D (Deficiency Page), Plan of Corrections, and Appeal Rights, discussed and provided to Administrator. Signature on form confirms receipt of documents.the state’s words, verbatim · CDSS document, Jun 9, 2026

From the deficiency page — Deficiency type: Type B · Section cited: CCR 87705(e)(7) · Plan of correction due date: Jun 19, 2026

87705 Care of Persons with Dementia (e) Licensees that use delayed egress devices... shall meet the following...requirements: (7) Delayed egress devices shall not substitute for trained staff in sufficient numbers to meet the care and supervision needs of all residents...this requirement was not met as evidenced by: based on record review, Licensee did not comply with the section cited above. Resident 1 (R1) eloped from the facility. R1's physician report showed they are unable to leave unassisted. This poses an potential health/safety/personal rights risk to residents in care.the state’s words, verbatim · CDSS document, Jun 9, 2026

Plan of correction: Licensee provided proof of elopement training dated 12/20/2025 during visit. Licensee to update LPA on when R1's medical assessment is scheduled by POC due date of 06/19/2026. Licensee to submit proof of updated documents: LIC602/Physician's Report and LIC625/Care Plan to CCL once received.

Type of visit: Required - 1 Year

On 11/17/2025 at approximately 10:30AM, Licensing Program Analyst (LPA) Ali Deniz arrived unannounced to conduct 1-Year Required visit of this licensed Residential Care Facility for The Elderly (RCFE). LPA was greeted by Administrator, Martha Ghezzehai. Facility has an approved fire clearance and capacity for 6 non-ambulatory residents. Facility has an approved hospice waiver for 3 individuals. Upon arrival, LPA was informed that there were 5 residents in care and 3 staff members on-site. Facility is a 1 story building with 6 Resident bedrooms, 3 bathrooms, staff bedroom, and common spaces. At approximately 11:00AM, LPA reviewed the Facility's Staff Roster and found that all staff on-site were background cleared and associated to the facility per regulation. At approximately 11:35AM, LPA and Administrator toured the building and grounds which was found to be clean and in good repair. LPA observed all walkways and exits to be unobstructed. All notices that are required to be posted have been posted and are in a highly visible area. LPA observed activity supplies for resident use. The amount of fresh and nonperishable foods is within regulation. Facility kitchen, refrigerators and freezers were clean, and food was stored properly. Staff were in the process of cleaning up kitchen at the time of this inspection. Toxins are stored in the garage inaccessible to the residents. Water temperature measured 110.6 degrees F and 114.4 degrees F which is within regulation between 105- and 120-degrees F at faucets accessible to residents. Fire Extinguishers found to be last charged on 02/12/2025 at the time of visit. Carbon Monoxide and smoke detectors were present and in order. There was enough lighting in all common areas, resident rooms, and hallways. Medication is centrally stored and secure in a cabinet next to the dining room. Continued on LIC809-C... Continued from LIC809... At approximately 12:15PM, LPA reviewed 3 resident records and found 3 of 3 residents have care plans, signed admission agreements, and TB results on file. 1 out of 3 residents with dementia did not have annually updated medical assessment report (LIC602), administrator contacted family for updated medical assessment, last medical assessment has completed on 2024 (Technical Advice Given). Medication records are thorough and contained physician's orders for each resident. At approximately 12:45PM, LPA reviewed 4 staff records. 4 of 4 records did contain documentation of completed training records as required. Evidence of current first aid and CPR training were current. LPA was presented with proof of current CPR & 1st Aid certification. Administrator Certificate is for Martha Ghezzehai #7026047740 expires 05/10/2027. LPA reviewed the facility emergency disaster plan. Facility has supplies enough to operate for more than 72 hours in an emergency. Facility conducted and documented a disaster drill on 10/20/2025. Updated copies of the following documents were requested for facility file and are to be submitted to CCL by due date of 11/30/2025: LIC 308 Designation of Facility Responsibilities LIC 500 Personnel Summary LIC 610 Emergency Disaster Plan (If Changed) LIC 9020 Register of Facility Client’s/Resident’s Copy/Proof of Updated Certificate of Liability Insurance No deficiencies were observed in the areas inspected, No citations were issued during today’s visit. Exit interview conducted. Copy of report provided to Administrator. Signature on form confirms receipt of documents.the state’s words, verbatim · CDSS document, Nov 17, 2025

The state marks this report as 4 pages; the online copy we transcribed has 3. You can request the full file from the county licensing office.

Type of visit: Case Management - Annual Continuation

At approximately 9:10AM, Licensing Program Analysts (LPAs) Felias and Frank arrived unannounced to continue a Required 1-Year Visit and met with Staff Member, Elsa Banton. Licensee, Martha Ghezzehai, arrived during visit at approximately 11AM. Facility is a Residential Home for the Elderly and provides care and assistance for Older Adults. Facility has a plan of operation for dementia care and programming on file. Facility has an approved fire clearance and capacity for 6 non-ambulatory residents. Facility has an approved hospice waiver for 3 individuals. Upon arrival, LPA was informed that there were 5 residents in care, and 3 staff members on-site. LPAs reviewed the Facility's Staff Roster and found that all staff on-site were background cleared and associated to the facility per regulation. LPAs reviewed staff files, resident files and resident medication. All files were all found to be well organized, thorough and contained the required documentation. Staff files had current First Aid and CPR certification. Medication was observed to be centrally stored and secure. Administrator's Certificates for Martha Ghezzehai (7026047740) was current with an expiration date of 05/10/2025 and Miriam Ghezzehai (7026138740) was pending with their renewal application received date as of 09/26/2023. LPAs also cleared the two deficiencies that were cited during visit conducted on 11/19/2024. Copies of Plan of Corrections Letters provided to Licensee. LPAs requested the following documents to update facility file: Designation of Facility Responsibility (LIC 308) Emergency Disaster Plan (LIC 610E) Updated Personnel Report (LIC 500) Updated Liability Insurance Active and Current Administrator Certificate Documents to be submitted to Community Care Licensing (CCL) by due date of 02/07/2025. No Deficiencies Cited during Visit. Exit interview conducted. Copy of report discussed and provided to Licensee. Signature on form confirms receipt of documents.the state’s words, verbatim · CDSS document, Jan 7, 2025

Type of visit: Required - 1 Year

At approximately 1:10PM, Licensing Program Analyst (LPA) Felias arrived unannounced to conduct a Required 1-Year Visit and met with Staff Member, Tigist Dinka. Administrator, Miriam Ghezzehai, was available by telephone. Facility is a Residential Home for the Elderly and provides care and assistance for Older Adults. Facility has a plan of operation for dementia care and programming on file. Facility has an approved fire clearance and capacity for 6 non-ambulatory residents. Facility has an approved hospice waiver for 3 individuals. Upon arrival, LPA was informed that there were 6 residents in care, and 2 staff members on-site. At approximately 1:20PM, LPA reviewed the Facility's Staff Roster and found that all staff on-site were background cleared and associated to the facility per regulation. At approximately 1:25PM, LPA conducted a walk-though of the facility. LPA observed the following: The facility was found to be clean and at a comfortable temperature with all exits free from obstruction. Facility had emergency lighting. Facility is a 1 story building with 6 Resident bedrooms, 4 bathrooms, a staff break room and common spaces. Facility has an Infection Control plan on file. There was a sufficient supply of both perishable and nonperishable foods as required by Title 22 Regulations. There was an appropriate supply of cleaning products, linens, hygiene products and paper products available for Residents. Mattress pads were in place or available for Resident use. During walkthrough, LPA observed the following to be unlocked and accessible to residents in care: clorox jug outside in the backyard, scissors in the cabinet of a resident bathroom, and multiple cleaning supplies underneath the kitchen sink (deficiency cited, LIC809D, regulation 87705(f)). LPA observed that the lock for the kitchen sink cabinet was broken. Staff Member immediately place all toxins in the garage. LPA also observed that all sinks accessible to residents were out of compliance with Title 22 Regulations, measuring at 131.1F, 134.4F, 123.0F, 121.8F, 120.9F, and 121.1F (deficiency cited, LIC809D, regulation 87303(e)(2)). Facility's fire extinguishers were last inspected February 2023. Facility's last fire drill was conducted October 2024. LPA unable to complete the Annual Inspection. Annual Continuation Visit to be conducted at a later date. Continued on LIC809C Continued from LIC809 Deficiencies are cited from the California Code of Regulations (CCRs), and/or the Health and Safety Code. Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment. Exit interview conducted. Copy of report, LIC809D (Deficiency Page), Plan of Corrections, and Appeal Rights discussed and provided to Staff Member. Signature on form confirms receipt of documents.the state’s words, verbatim · CDSS document, Nov 19, 2024

Type of visit: Required - 1 Year

At approximately 9:25AM, Licensing Program Analyst (LPA) Felias arrived unannounced to conduct a Required 1-Year Visit and met with Staff Member, Tigist Dinka. Administrator, Martha Ghezzehai, arrived during visit at approximately 10:00AM. Facility is a Residential Home for the Elderly and provides care and assistance for Older Adults. Facility has a plan of operation for dementia care and programming on file. Facility has an approved fire clearance and capacity for 6 non-ambulatory residents. Facility has an approved hospice waiver for 3 individuals. Upon arrival, LPA was informed that there were 4 residents in care, and 2 staff members on-site. At approximately 9:40AM, LPA reviewed the Facility's Staff Roster and found that all staff on-site were background cleared and associated to the facility per regulation. At approximately 9:45AM, LPA conducted a walk-though of the facility. LPA observed the following: The facility was found to be clean and at a comfortable temperature with all exits free from obstruction. Facility had emergency lighting. Facility is a 1 story building with 6 Resident bedrooms, 4 bathrooms, a staff break room and common spaces. Facility has an Infection Control plan on file. There was a sufficient supply of both perishable and nonperishable foods as required by Title 22 Regulations. There was an appropriate supply of cleaning products, linens, hygiene products and paper products available for Residents. Toxins and other hazardous items were observed to be stored inaccessible to residents in care. Mattress pads were in place or available for Resident use. Hot water temperatures for all sinks in facility were within Title 22 regulations of 105 to 120 degrees Fahrenheit. At approximately 10:30AM, LPA reviewed 5 staff files, 4 resident files and resident medications. 4 of 5 staff files reviewed were found to be well organized, thorough and contained the required documentation. LPA observed that 1 of 5 staff files did not have a Health Screening form (see Technical Advisory, LIC9102, Regulation 87411(f)). Staff files had current First Aid and CPR certification. LPA observed that all resident files were found to be well organized, thorough and contained the required documentation. Resident medications were found to be centrally stored and secure. LPA conducted interviews. Facility's fire extinguishers were found to be last inspected February 2023. Facility smoke detectors and carbon monoxide detectors were tested and operational. Facility's last fire drill was conducted October 2023. Continued on LIC809C Continued from LIC809 Review of Administrator Certificates for Martha Ghezzehai (6060357740) and for Miriam Ghezzehai (6060459740) show that their re-certifications are pending with the Department of Social Services. LPA is requesting the following documents to update facility file: Updated Lease Designation of Facility Responsibility (LIC 308) Emergency Disaster Plan (LIC 610D) Updated Personnel Report (LIC 500) Register of Clients/Residents (LIC 9020) Updated Liability Insurance Active and Current Administrator Certificates when available Facility Documents to be submitted to Community Care Licensing (CCL) by due date of Thursday, 12/28/2023. No Deficiencies Cited during visit. Exit interview conducted. Copy of report and LIC9102 (Technical Advisory/Violation) discussed and provided to Administrator. Signature on form confirms receipt of documents.the state’s words, verbatim · CDSS document, Nov 28, 2023

The state marks this report as 3 pages; the online copy we transcribed has 2. You can request the full file from the county licensing office.