Annie's Family Home Care of Calistoga

Type of visit: Required - 1 Year

At approximately 10:00 AM, Licensing Program Analyst (LPA) Julie Florio arrived unannounced to conduct a required 1-year annual inspection and met with Carisma Patterson, Administrator. Facility is a Residential Care Facility for the Elderly (RCFE) with four (4) residents in care. All residents were present during today's inspection. Facility has a hospice waiver for six (6), bedridden waiver for one (1), and is approved for all non-ambulatory residents. At approximately 10:30 AM, LPA initiated a tour of the facility with Administrator and observed the following: Facility is a one story home, was a comfortable temperature, and passageways were free from obstructions. LPA observed the required postings in the facility's entryway. Water temperatures in residents' bathrooms measured within the allowable range of 105 to 120 degrees F per Title 22 regulations. LPA observed a supply of clean linens, and hygiene, incontinent care, and paper products available for residents. Residents' bedrooms were inspected and observed to have all the appropriate furnishings as outlined in regulations. Cabinets containing cleaning supplies and other items that could pose a risk were observed locked. Facility has at least two days of perishable food and one week of non-perishable foods, as well as an emergency water supply. Medications were centrally stored and locked. There is a shaded seating area in the backyard with outdoor space for gardening and activities. LPA observed a locked shed in the backyard which contains holiday decor, care equipment, PPE, tools, chemicals, and a back up generator for emergency preparedness. LPA observed residents watching TV or sitting out in the backyard. Facility has an internet access device designated for resident use. Continued on LIC809C... Continued from LIC809... Facility has internet service available to residents in care and the telephone was tested an operational during inspection. Smoke and carbon monoxide detectors were tested and operational during inspection. Facility's two fire extinguishers were observed fully charged and were last inspected 05/2025. Facility conducts quarterly disaster drills with the last one conducted 03/2026. Facility has an emergency disaster plan which was last updated 06/2025. LPA reviewed three (3) resident records and three (3) staff records and observed the following: three (3) of three (3) resident records reviewed contained the required documents. LPA observed the file for Resident 1 (R1) missing an updated annual physician's report and the file for Resident 3 (R3) missing a consent for emergency medical treatment and an appraisal needs and services plan. Administrator agreed to ensure that all of the required documents are complete and in the resident files in order to bring the facility into compliance with regulations. Three (3) of three (3) staff files reviewed have the required documents including proof of initial and annual training, proof of the required initial and annual medication training, and proof of current CPR and first aid certification. LPA reviewed medications and medication logs which were inspected and observed stored and maintained in compliance with regulation. Facility does not manage P&I cash resources. Updated copies of the following documents are to be submitted to CCL within 30 days of this visit: LIC500 Personnel Report (updated) LIC610 Emergency Disaster Plan (updated) Proof of Liability Insurance (updated) No deficiencies were cited during today's inspection. Exit interview conducted with Administrator whose signature on form confirms receipt of documents.the state’s words, verbatim · CDSS document, Jun 2, 2026

Type of visit: Required - 1 Year

At approximately 10:45 AM, Licensing Program Analyst (LPA) Julie Florio arrived unannounced to conduct a required 1-year annual inspection and was greeted by Susanna Villasenor, Licensee. Carisma Patterson, Administrator was contacted via telephone and arrived at approximately 11:00 AM. Facility is a Residential Care Facility for the Elderly (RCFE) with three (3) residents in care. All residents were present during today's inspection. Facility has a hospice waiver for six (6), bedridden waiver for one (1), and is approved for all non-ambulatory residents. At approximately 11:30 AM, LPA initiated a tour of the facility with Administrator and observed the following: Facility is a one story home, was a comfortable temperature, and passageways were free from obstructions. LPA observed the required postings in the facility's entryway. Water temperatures in residents' bathrooms measured within the allowable range of 105 to 120 degrees F per Title 22 regulations. LPA observed a supply of clean linens, and hygiene, incontinent care, and paper products available for residents. Residents' bedrooms were inspected and observed to have all the appropriate furnishings as outlined in Title 22 regulations. Cabinets containing cleaning supplies and other items that could pose a risk were observed locked. Facility has at least two days of perishable food and one week of non-perishable foods, as well as an emergency water supply. Medications were centrally stored and locked. There is a shaded seating area in the backyard with outdoor space for gardening and activities. LPA inspected two locked sheds in the backyard which contained holiday decor, care equipment, PPE, tools, chemicals, and a back up generator for emergency preparedness. LPA observed residents watching TV or working on puzzles in the common area of the facility. Continued on LIC809C... Continued from LIC809... Facility has an internet access device designated for resident use. Facility has internet service available to residents in care and the telephone was tested an operational during inspection. Smoke and carbon monoxide detectors were tested and operational during inspection. Facility's two fire extinguishers were observed fully charged and were last inspected 05/2025. Facility conducts quarterly disaster drills with the last one conducted 03/2025. Facility has an emergency disaster plan which was last updated 04/2021. LPA reviewed three (3) resident records and three (3) staff records and observed the following: three (3) of three (3) resident records reviewed contained required documents. Administrator agreed to ensure that all of the required documents are complete and in the resident files in order to bring the facility into compliance with regulation. Three (3) of three (3) staff files reviewed have the required documents. However, three (3) of three (3) staff files reviewed were missing proof of the required initial and annual medication training, (see LIC809D). LPA reviewed medications and medication logs which were inspected and observed stored in compliance with regulation. Administrator agrees to ensure facility that centrally stored medication logs are maintained in compliance with regulation. Facility does not manage P&I. Updated copies of the following documents are to be submitted to CCL within 30 days of this visit: LIC500 Personnel Report (updated) LIC610 Emergency Disaster Plan (updated) Control of Property – Deed Copy of Administrator’s Certificate (updated) Proof of Liability Insurance (updated) Observed deficiencies (see LIC809D) were cited from the California Code of Regulations, Title 22, Division 6 of California Regulation. Failure to correct the deficiency and/or repeat deficiencies within a 12 month period may result in civil penalties. Exit interview conducted with Administrator whose signature on form confirms receipt of documents. Appeal rights provided.the state’s words, verbatim · CDSS document, Jun 17, 2025

Type of visit: Required - 1 Year

On April 23, 2024, Licensing Program Analyst (LPA) Shannan Hansen made an unannounced annual required inspection of this licensed senior care facility. LPA met with Administrator Carisma Patterson. Facility has 3 residents, all on hospice. At approximately 8:45 AM, 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 although Administrator was informed a copy of facility Admissions Agreement is to be posted in public view per Regulation 87507( e)(2) (see LIC9102). The amount of fresh and nonperishable foods is within regulation. Facility kitchen, refrigerators and freezers were clean, and food was stored properly. Toxins are stored in a locked storage cupboard. Water temperature measured 119.4 degrees F and 133.8 degrees F., falling out of regulations between 105 and 120 degrees F in 1 out of 2 faucets accessible to residents (see LIC809-D). Administrator adjusted water heater during visit. There was a supply of cleaners, hygiene products and paper products available for residents. Bathrooms were equipped with necessary grab bars and non-slip floors/mats. Fire extinguishers were last inspected 5/9/2023. Smoke detectors were found to be in working order. Carbon Monoxide detectors were present and also in working order. There was enough lighting in all common areas, resident rooms, and hallways. LPA observed activity supplies, puzzles, and newspapers for resident use. Medication is centrally stored and secure in individually locked cabinets in garage. At approximately 10:00 AM, LPA reviewed 3 of 3 resident records and found 3 of 3 residents have current physician’s reports although 3 of 3 residents did contain required updated Reappraisals/care plans indicating change of conditions (see LIC809-D). 3 of 3 resident records contained current and signed admission agreements. Continue on LIC809-C At approximately 11:20 AM, LPA reviewed 4 of 4 staff records. 4 of 4 records contain documentation of completed training records as required. Evidence of current first aid and CPR training were observed. Medications were centrally stored in locked cabinet in the facility laundry/lounge room. At approximately 1:15pm LPA observed facility has not kept a log of Centrally Stored Medication Record (CSMR) (see LIC809-D) Facility has a generator to supply power during an outage. Facility has supplies enough to operate for more than 72 hours in an emergency. Facility records indicate they conduct quarterly disaster drills with the last disaster drill conducted on 3/10/2023. Administrator informed they changed over to logging in licensee’s laptop after 3/10/2023 and that is not available at this time (see LIC809-D). Carisma Patterson Administrator Certificate 6060960740 expired 10/27/2023 LPA was presented proof of trainings & Certificate submission. LPA reviewed Licensing Information System (LIS) with Licensee who stated that is correct and updated at this time; no need to change any of the information other then facility number to change with mobile. Appeal of Rights Given. The following deficiencies were observed (see LIC 809D) and cited from the California Code of Regulations, Title 22, Division 6 of California Regulation. Failure to correct the deficiency and/or repeat deficiencies within a 12 month period may result in civil penalties. Exit interview conducted and appeal of rights provided LPA Hansen is requesting Licensee to update and submit the following documents to CCL by 5/10/2024: LIC 308 Designation of Responsibility (if changed) LIC 500 Personnel Summary LIC 610 Emergency Disaster Plan (if changed) LIC 9020 Register of Facility /Resident’s Control of Property – Deed Copy of Administrator’s Certificate Proof of Liability Insurancethe state’s words, verbatim · CDSS document, Apr 23, 2024

The state marks this report as 7 pages; the online copy we transcribed has 4. You can request the full file from the county licensing office.