Freedom Springs Manor

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) William Vanegas made an unannounced visit to conduct the required annual inspection. LPA was greeted and granted entry by Administrator Mayla Mach after explaining the purpose for the visit. LPA began a tour of the facility LPA observed that Administrator (AD) Mayla March has an active Administrator certificate that expires on November 18, 2026. The facility is a single-story home with six private resident bedrooms, one staff room, five resident bathrooms, two of which are shared, a living room, a dining room, a kitchen, and an attached two car garage. LPA accompanied by the AD conducted a tour of the interior portion of the facility. On today's visit, LPA observed six residents in care, one of which is on hospice, and two caregiving staff present. LPA observed residents lounging in the living room as well as their respective bedrooms. LPA observed the See Something, Say Something poster (PUB 475) mounted on a wall by the entryway of the facility. LPA inspected all six resident bedrooms, and they were observed to be free of any hazards. LPA observed the resident bedrooms had the required furnishings of a bed, a chair, a chest of drawers,a reading lamp, and enough storage space to store personal belongings. All resident beds had clean linens and blankets in good repair; meaning no strains or tares. LPA observed additional linens are stored in a hallway closet. LPA inspected the five resident bathrooms. Resident bathrooms are clean. Bathrooms are equipped with grab bars and slip resistant floor mats. Faucets and toilets were operational. Hot water temperature measured between 114.3 and 120.3 degrees Fahrenheit. LPA observed the staff room is kept locked and inaccessible to residents in care. LPA observed the kitchen has a two day perishable and seven day nonperishable food supply on hand. CONTINUED ON LIC809-C LPA Observed kitchen area to be clean and free of any debris, LPA observed an electric stove, refrigerator, dishwasher. a microwave, a washer, and a dryer in the facility. All were observed to be in good condition and operational. LPA observed all fire extinguishers to be up to date. Smoke detectors and carbon monoxide detectors tested operational. First aid kit was observed to have all required items such as tweezers, scissors, bandages, thermometer, adhesive tape, and a first aid manual. LPA observed exterior of the facility to have a pond that is fully fenced, no hazards or objects were blocking the exit routes. Side doors were observed to be unlocked and self latching. LPA observed backyard to have a shaded sitting area. LPA reviewed two staff files, and six resident files all files (Staff and Resident) had all required documents annual staff training was up to date and documented. LPA reviewed medication administration record, and medications with AD. Per LPA review medications are being administered per physicians orders. Based on observations made during today's inspection no deficiencies will be issued. An exit interview was conducted with AD and a copy of this report was left at the facility additionally one will be mailed to the facility as well.the state’s words, verbatim · CDSS document, Feb 5, 2026

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Brandon Lopez made an unannounced visit to conduct the required annual inspection. LPA was greeted and granted entry by caregiving staff after explaining the purpose for the visit. Administrator (AD) Mayla Mach was notified via telephone but could not arrive to assist due to being away on a vacation. LPA observed that Administrator Mayla Mach submitted a Administrator renewal application to the Administrator Certification Bureau (ACB) on November 18, 2024. The facility is a Residential Care Facility for the Elderly (RCFE) licensed for six non-ambulatory and has a hospice waiver for three. The facility is a single-story home with six private resident bedrooms, one staff room, five resident bathrooms, two of which are shared, a living room, a dining room, a kitchen, and an attached two car garage. LPA accompanied by the caregiving staff conducted a tour of the interior portion of the facility. On today's visit, LPA observed five residents in care, four of which are on hospice, and two caregiving staff present. LPA observed residents relaxing in the living room as well as their respective bedrooms. LPA observed the See Something, Say Something poster (PUB 475) mounted on a wall by the entryway of the facility. LPA inspected all six resident bedrooms, and they were observed to be free of any hazards. LPA observed the resident bedrooms had the required furnishings of a bed, a chair, a chest of drawers, and a lamp. All resident beds had clean linens and blankets. LPA observed additional linens are stored in a hallway closet. LPA inspected the five resident bathrooms. Resident bathrooms are clean. Bathrooms are equipped with grab bars and non-skid floor mats. Faucets and toilets were operational. Hot water temperature measured between 118.5 and 119.1 degrees Fahrenheit. LPA observed the staff room is kept locked and inaccessible to residents in care. LPA observed the kitchen has a two day perishable and seven day nonperishable food supply on hand. LPA observed kitchen appliances to be clean and operational. The electric stove top is operational. CONTINUED ON LIC809-C LPA observed kitchen knives are stored in a locked kitchen cabinet. LPA observed chemicals and toxins are stored in a locked kitchen cabinet under the sink. A fire extinguisher is located in the kitchen, and it was observed the be charged and purchased on January 24, 2025. LPA tested the wired smoke detectors/carbon monoxide detectors which tested operational. LPA observed the facility conducted their last emergency disaster drill on December 9, 2024. The centrally stored medication is kept in a locked closet in the resident hallway. LPA observed a First Aid kit is stored in the locked closet and it was observed to have all the required components. The door leading to the attached two car garage is kept locked and inaccessible to resident in care. LPA observed the garage is used for storage and laundry. LPA observed the facility has a three day emergency food and water supply stored in the garage. LPA and caregiver staff conducted a tour of the exterior portion of the facility. LPA observed the exterior portion to be clear of obstructions and hazards. LPA observed a shaded outdoor seating area with furniture for resident use. The perimeter gate on the north side and southside of the facility are self-latching and can be opened in an evacuation. There is a large pond located in the backyard. LPA observed the large pond to be adequately fenced and locked for resident safety. LPA reviewed all five resident files. LPA observed that the Reappraisals for Resident #1 (R1), Resident #2 (R2), Resident #3 (R3), Resident #4 (R4), and Resident #5 (R5) were outdated. LPA reviewed five residents’ medication and medication records. LPA observed that Resident #2 (R2) had a routine medication container that was empty ar time of visit. LPA observed that R2 did not receive the routine medication on 2/11/25 and 2/12/25 as a result. LPA reviewed three staff files. LPA observed that Staff #1 (S1) and Staff #3 (S3) did not receive the required annual training for the year of 2024. All staff are background cleared and associated to the facility. Based on today's observations, deficiencies being cited per Title 22 of the California Code of Regulations. LPA spoke with Administrator Mayla Mach via telephone who authorized caregiving staff to sign the report. An exit interview was conducted with an authorized facility representative. A copy of the report and Appeal Rights were provided.the state’s words, verbatim · CDSS document, Feb 12, 2025

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Celine De Perio conducted an unannounced visit for the Required 1 Year Inspection. LPA explained the purpose of today’s visit, and was greeted and granted entry by facility administrator (AD) Myla Mach. For today’s visit, LPA observed a total of 6 residents in care and 3 staff members on duty, LPA observed the Administrator's Certificate for facility administrator (AD) Myla Mach which expires on 11/18/2024. The PUB475 "See Something Say Something" poster was observed in the living room. LPA De Perio toured the interior and exterior portions of the facility with AD Mach. The facility is a single level structure and is licensed for 6 non-ambulatory residents, of which 3 may be on hospice and 0 bedridden. For this visit, there are a total of 6 residents in care, of which 3 are on hospice. There are a total of 7 bedrooms, of which are 6 private resident rooms, and 1 private room for staff. LPA De Perio toured each bedroom in the facility and observed that bedrooms were provided with furniture in good repair, clean linens, adequate storage space, and kept free of tripping hazards. Smoke and carbon monoxide detector and auditory exit alarms were tested and operational. There are a total of 5 restrooms, of which were observed to be in good repair, toilets were operational, and grab bars and non-skid floor mats were provided. Water temperature in restrooms were measured to be at 112.1 degrees Fahrenheit. Facility met the minimum two-day perishable and seven-day non-perishable food supplies. Sharp items and knives were locked and inaccessible to residents in care. Fire extinguisher was charged, mounted and located in the kitchen. LPA De Perio observed the emergency disaster and evacuation plan, which is posted in the hallway. Facility had back-up emergency food and water supply, located in the garage. LPA De Perio observed that First Aid Kit had all the required components. LPA De Perio observed that medications and toxins were locked and inaccessible to residents in care. For the exterior portion, LPA De Perio observed patio furniture under shading, and the grounds were free of any hazards. There are 2 gates in the backyard, which both were self-closing and self-latching. LPA De Perio observed that the facility has a body of water in the backyard, and is made inaccessible to residents in care through a locked gate. For today's visit no deficiencies were issued per Title 22 Division 6 of the California Code of Regulations. No citations were issued. An exit interview was conducted with AD Mach. A copy of this report was provided and explained.the state’s words, verbatim · CDSS document, Feb 27, 2024