Glorious Home #2

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Ruth Martinez is conducting this unannounced visit for the purpose of completing an annual required inspection. LPA arrived at the facility and was greeted and granted entry by staff. LPA met with Jean-Pierre Delagne, Administrator explained the nature of the visit. There are six (6) residents at the facility and there is two (2) residents receiving hospice services currently. The facility is a one-story house with an attached garage, with four private bedrooms, one shared bedroom and two bathrooms. LPA began the tour of the inside and outside of the facility. LPA observed required department postings throughout the facility. Facility stays within the capacity limitations. There is a minimum of one week of non-perishables foods and two days of perishables foods available. There is additional food storage in a spare refrigerator in the garage. The facility is maintained at a comfortable temperature. LPA inspected that medication is centrally stored in a safe locked storage cabinet located in the kitchen. LPA reviewed medication and observed medication was labeled and stored inaccessible to residents in care. LPA observed the first aid kit located in the kitchen. LPA inspected the facility bathrooms and LPA measured the hot water temperature which measured 117.5 Fahrenheit degrees. All bathrooms observed to have a supply of soap, toilet paper and towels. Bathrooms are equipped with required safety measures such as non-skid mats and grab bars. Lighting is sufficient to ensure safety and comfort. The facility is equipped with sufficient hand hygiene, cleaning, and disinfecting supplies. LPA observed that toxic chemicals, cleaning solutions and disinfectants are stored locked underneath kitchen sink and locked storage cabinet in the laundry unit. Continued LIC809-C The facility has an available clean supply of linens. LPA inspected residents’ bedrooms which has sufficient lighting to ensure safety and comfort. All bedrooms observed to have all required components. Storage space is provided for residents in their bedroom. Smoke detectors/carbon monoxide detectors were tested and found to be operational. LPA toured the outside of the facility and observed outdoor passageways are free of obstructions. LPA observed there are shaded seating areas for residents’ enjoyment in the front yard as well as the backyard of the facility. LPA observed a fire extinguisher charged and mounted in the kitchen. Fire drills are conducted every three months, LPA verified fire drill logs are kept and last drill was conducted April 16, 2026. LPA began review of records. LPA reviewed three resident records. All the required documentation was present and reviewed in the residents’ files. LPA reviewed three employee records. All employees present have a criminal record clearance and are associated to the facility. LPA observed records reviewed have a First Aid certificate. Based on the observations made during today’s visit, no deficiencies were noted today in the areas inspected per Title 22 Division 6 of the California Code of Regulations. This report was reviewed with the Administrator, and a copy of this report was provided to the facility.the state’s words, verbatim · CDSS document, Aug 10, 2026

Type of visit: Required - 1 Year

On this day, Licensing Program Analyst (LPA) Kevin Saborit-Guasch made an unannounced visit to the facility to conduct the required annual inspection. LPA was greeted and granted entry by facility caregiving staff after introducing himself and stating the purpose of the visit. Administrator Jean-Pierre Delagneau was notified of the visit via telephone and arrived later to assist. There are currently four residents in care, two of which are receiving hospice care at this time. LPA observed residents relaxing in their respective bedrooms or in the facility's common living areas. LPA accompanied by facility staff toured the physical plant. The facility is a one-story house with an attached garage, with four private bedrooms, one shared bedroom and two shared bathrooms. Bedrooms appear clean and sanitary. There are three residents requiring the use of half rails for postural supports at the time of the visit. Hospice plans of care reviewed for the relevant residents. All resident bedrooms have the required furnishings. Bathrooms appear clean and sanitary and are equipped with grab bars and slip mats. Hot water temperature measured at 109F and 110F in two separate bathrooms equipped with faucets used for personal grooming. LPA observed the kitchen has a minimum two (2) day perishable and seven (7) day non-perishable food supply. Sharp items, cleaning supplies and the medication central storage are verified to be secured. Medication belonging to a staff member is however observed to have been left on the dresser in one of the bedrooms. Type B citation issued. CONTINUED ON FORM LIC809-C CONTINUED FROM LIC809 Fire extinguisher present is charged with up-to-date maintenance tag. Smoke detectors were found to be operational. Carbon monoxide detector found to have an inoperant battery that was replaced during the visit. Type A citation issued and cleared. The garage is secured and used for the storage of supplies and food. Laundry room and cleaning supplies are secured. Emergency food and water supplies verified to be present. LPA and facility staff toured the outside of the facility. LPA observed a shaded outdoor seating area with furniture for resident use. The identified route of egress is free of clutter and obstructions. There are no bodies of water on the premises. Gardening equipment observed not to be secured. Type B citation issued. Egress alarms are in use on exit doors, however facility does not utilize locked perimeters or delayed egress. LPA reviewed four resident records which included all necessary components. LPA reviewed resident medication records and prescription orders for all residents with no discrepancies observed. One resident is observed to have been assessed as bedridden upon admission but is currently able to reposition and attends meals and activities in the common living areas. Type B citation issued as the change in condition has not been documented at this time. Consultation provided on updated requirements for medical assessments and copy of the updated physician report LIC602a provided. Resident interviews were conducted or attempted during the visit along with staff interviews. LPA reviewed staff records for three staff members present during the visit. CPR training, initial and annual training reviewed for 2024 and 2025. Disaster drills are conducted quarterly and documented. Staff members are verified to be background cleared and associated to the licensed location. Administrator certificate is pending, consultation provided. The governing body appears to be inactive per Secretary of State records, consultation provided. Based on the observation conducted during the present visit, one type A deficiency and 5 type B deficiencies are being cited. An exit interview was conducted and a copy of this report was provided.the state’s words, verbatim · CDSS document, Jul 2, 2025

The state marks this report as 11 pages; the online copy we transcribed has 7. You can request the full file from the county licensing office.

Type of visit: Required - 1 Year

On this day, Licensing Program Analyst (LPA) Kevin Saborit-Guasch made an unannounced visit to the facility for the purpose of conducting the Required Annual Inspection. LPA was greeted and granted entry by facility administrator Jean-Pierre Delagneau after stating the reason of the visit. During the inspection, LPA and facility staff conducted a tour of the physical plant and observed the following: The facility is a one story home with two private and two shared bedrooms and one staff room in addition to the facility's common living areas and two shared bathrooms. All resident bedrooms have the required furnishings. LPA observed all beds have linens and blankets. Postural supports observed in one room with corresponding physician orders verified to be on file. There are currently four residents admitted to the facility with one receiving hospice care. Residents are observed to be clean and appear well taken care of. Bathrooms faucets and toilets were operational. Water temperature was verified to be within acceptable range. LPA observed emergency disaster plan with means of exiting and emergency phone numbers listed and posted. Current form LIC610E provided during the visit. Fire drills are conducted quarterly. LPA observed the facility has a 2-day supply of perishables and a 7-day supply of non-perishable food. Smoke and carbon monoxide detectors tested operational. Fire extinguisher present are observed to be fully charged. Medication, sharp items and cleaning supplies were confirmed to be inaccessible throughout the physical plant. The medication central storage was also observed to be secure and reviewed for accuracy during the visit. LPA reviewed four resident files and three staff files. Two medical assessments for residents with an indication of dementia were found to be outdated and will need an update. Based on the observations made during today’s inspection, one type B deficiencies and three advisory notes are being issued per Title 22 Division 6 of the California Code of Regulations. An exit interview was conducted, and a copy of this report along with appeal rights was left at the facility.the state’s words, verbatim · CDSS document, Aug 12, 2024

The state marks this report as 5 pages; the online copy we transcribed has 2. You can request the full file from the county licensing office.