Arbor View 5

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Joseph Alejandre made an unannounced visit to conduct the required annual inspection. LPA met with Administrators Erin Fisk and Mark Fisk and explained the reason for the visit. Mark Fisk's Administrator Certificate expires on January 26, 2028. Facility is licensed for licensed for 6 non-ambulatory and hospice waiver for three. Facility is a two story home with 5 bedrooms, 4 bathrooms, kitchen, dining room and living room. The second floor has an open loft area and a staff room. The second floor is off limits to residents. There is a gate blocking the staircase. LPA observed the signal system which can be heard from the kitchen and second story is operational. LPA observed the PUB 475 poster posted in the main entry way of the facility. LPA observed the kitchen has a 2 day supply of perishable food and a 7 day supply of non-perishable food on hand. LPA observed the medication is kept locked in a kitchen cabinet. LPA observed the knives are kept locked. The fire extinguisher in the kitchen is fully charged. The garage is kept locked and used for storage. LPA observed a 3 day supply of emergency food and water stored in the garage. LPA inspected the first aid kit. The first aid kit had all the required elements. Smoke detectors/carbon monoxide detectors tested operational. The last emergency drill was conducted on March 8, 2026. LPA observed the resident rooms have the required furnishings and bed linens. LPA observed all 4 bathrooms are clean and operational. Hot water measured 105.0 to 115.4 degrees Fahrenheit. LPA observed extra linens stored in the hall pantry. LPA toured the backyard. No bodies of water observed. There is a cover patio with chairs to sit outside. No obstacles and hazards observed in the backyard. LPA reviewed 6 resident files and medication. LPA observed all 6 resident files had the required documents. No discrepancies observed. LPA reviewed 2 staff files. Both staff members are background cleared and associated to the facility. Both staff members have CPR/First Aid training and the required 20 hours of training. No discrepancies observed in the facility files. No deficiencies are being as a result of this visit. An exit interview was conducted and a copy of the report provided.the state’s words, verbatim · CDSS document, Jun 9, 2026

Type of visit: Required - 1 Year

On September 22, 2025, at 1:15 PM, Licensing Program Analyst (LPA) Edward Kim conducted an unannounced required 1-Year annual visit using the CARE Inspection Tool. Upon arrival at the facility, LPA Kim met with Administrator (ADMIN) Mark Fisk and explained the purpose of the visit. The facility is licensed to operate for six (6) nonambulatory residents and has a hospice waiver for three (3) residents. The facility is a two-story building located in a residential neighborhood. It consists of the following: five (5) resident bedrooms, a loft on the second floor with one (1) Staff Bedroom, four (4) bathrooms, one (1) living area, dining area, kitchen, three outdoor covered patio area, and an attached two car garage. LPA Kim toured inside and outside of the physical plant with ADMIN Fisk. There were no bodies of water or obstructions on the premises. All rooms were inspected. Beds and bedding supplies were in good condition, adequate lighting was provided, storage for each resident’s personal belongings was observed. Bed linens, comforters, and bath towels were adequately stocked at the time of visit. The Resident’s rooms were inspected: Resident Room 1, Resident Room 2, Resident Room 3, Resident Room 4, and Resident Room 5 Bathrooms were found to be within Title 22 regulations and were clean and operational. The water temperature measured between 118.5 degrees F to 120.0 degrees F. A comfortable temperature of 76 degrees F was maintained in the facility. LPA Kim observed the facility to be sanitary and appropriately furnished at the time of visit. Storage areas for personal hygiene, cleaning supplies, toxins, and sharps objects were stored and not accessible to residents. The kitchen was inspected and there is a two-day supply of perishable and seven-day supply of non-perishable food available and maintained properly. Emergency food, emergency water, and emergency supplies were stored in the kitchen pantry. Evaluation Report Continues on LIC 809-C. During the visit, LPA Kim observed the facility's infection control practices, plan of operation, and screening protocols for visitors, staff, and residents. LPA observed the facility has a 30-day supply of Personal Protective Equipment (PPE). All mandated inspection control posters were posted. A working telephone (949) 998-9191 remains available. First Aid kit had all the necessary elements. The facility has one (1) fire extinguisher that was charged, mounted in the kitchen that was serviced on October 1, 2024. Evidence of liability insurance is effective July 20, 2025, to July 20, 2026 The following observations were made: LPA observed a spiral stairway leading up to a loft. The loft had a mattress lying on the floor. There is an enclosed area next to the loft with a door that can be locked from the inside. LPA observed when entering the enclosed area to the left there is a bed with a dresser. When the LPA is entering inside the enclosed area to the right there is another bed with a dresser. As LPA enters towards the back of the enclosed area there is a curtain divider. When LPA enters pass the curtain divider there is a bed to the left. Due to time constraints the following will be addressed on the continuation inspection on a later date: staff interviews, resident interviews, resident records, staff records, smoke detector and carbon monoxide detector inspection, and an audit of medication and medication administration records. An exit interview was conducted, and a copy of this report was provided to Administrator Mark Fisk.the state’s words, verbatim · CDSS document, Sep 22, 2025

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 caregiving staff after explaining the purpose of the visit. Facility administrators Mark and Brigitte Fisk were notified by telephone and arrived later to assist. 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 a loft. Facility has four private rooms, one shared room and one staff dwelling area located in the house's lofted level. All resident bedrooms have the required furnishings. LPA observed all beds have linens and blankets. The backyard has a shaded area and the routes of egress are free of clutter and obstructions. There are currently six residents admitted to the facility with one resident 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. LPA observed the facility has a 2-day supply of perishables and a 7-day supply of non-perishable food as required. Combined smoke and carbon monoxide detectors tested operational. Fire extinguisher present is observed to be fully charged with up-to-date maintenance. 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 six resident files and two staff files as well as conducted multiple staff and resident interviews. Based on the observations made during today’s inspection, no deficiencies are being cited per Title 22 Division 6 of the California Code of Regulations. One Technical Violation Advisory Note was provided to the licensee based on consultation provided during the visit. An exit interview was conducted, and a copy of this report was left at the facility.the state’s words, verbatim · CDSS document, Jun 4, 2024

The state marks this report as 2 pages; the online copy we transcribed has 1. You can request the full file from the county licensing office.