Granny's Place #2

Type of visit: Required - 1 Year

On January 26, 2026, Licensing Program Analyst (LPA) Garlli Tat conducted an unannounced visit to the facility for the purpose of a required annual inspection. LPA explained the purpose for the visit and was greeted and granted entry by staff on duty. During the visit, staff on duty contacted the facility administrator (AD) Kimberly Arnett about the visit. For this visit, there are two staff members on duty, both of which are background cleared and associated. AD later arrived to assist with the inspection. The PUB475 ‘See Something, Say Something’ poster was observed to be located near the front entrance. LPA observed the Administrator's Certificate for Kimberly Arnett expires on July 21, 2026. The facility is a Residential Care facility for the Elderly (RCFE) licensed for six residents, six of which may be non-ambulatory, and a hospice waiver for six. LPA toured the interior and exterior portions of the facility with AD. For this visit, there are a total of five non-ambulatory and one ambulatory residents in care, one of which is on hospice, and none are bedridden. The facility is a single story home. There are a total of six bedrooms, four of which are private resident bedrooms, one is a shared resident bedroom, and one staff bedroom. LPA toured each bedroom with the AD and observed that bedrooms were provided with furniture in good repair, clean linens, adequate storage space, and free of any hazards. There is a linen closet in the hallway. LPA observed the staff room is kept locked and inaccessible to residents in care. Smoke and carbon monoxide detectors as well as auditory exit alarms were tested and operational. There are a total of three bathrooms. Continued on LIC 809-C. Bathrooms were observed to be in good repair, toilets and faucets were operational and showers were equipped with grab bars and non-skid floor mats. Water temperature in the bathrooms were measured to be between 106.8 and 109.5 degrees Fahrenheit. Facility met the minimum two day perishable and seven day non-perishable food supplies. Sharp items and knives were locked in a kitchen drawer inaccessible to residents in care. Fire extinguishers were charged, mounted and located in the kitchen, laundry room, and recreation room. Fire extinguisher was dated and tagged on April 9, 2025. LPA observed the emergency disaster and evacuation plan, which is posted in the hallway. LPA observed the facility conducted their last emergency disaster drill on December 1, 2025. Facility had back-up emergency food and water supplies, located in the garage. LPA observed that the First Aid kit had all the required components. Medications were observed to be locked in a medication room in the hallway, inaccessible to residents in care. Chemicals were observed to be locked underneath the kitchen sink and the garage. LPA observed the door leading to the attached two car garage is kept locked and inaccessible to residents in care. The garage is used for storage. There is a laundry room. Cleaning supplies are kept locked and inaccessible to residents in care. For the exterior portion, LPA observed patio furniture under shading, and the grounds were free of any hazards or obstructions. There is one self-latching gate in the backyard that can be opened in case of an emergency. The gate requires a code to open it. No bodies of water were observed. During this visit, six resident files and two staff files were reviewed. All staff are background cleared and associated with the facility. LPA reviewed residents’ medication and medication records and two resident interviews were conducted. Based on today's observations, there are no deficiencies being cited per Title 22 of the California Code of Regulations. An exit interview was conducted with Kimberly Arnett. This report was reviewed with the administrator and a copy was provided at the end of the visit.the state’s words, verbatim · CDSS document, Jan 26, 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 staff Michelle Nesbitt, Kimberly Arnett and Jozef Springer were notified of the visit via telephone and arrived later to assist with the visit. There are currently six residents in care, one of which is receiving hospice care. LPA observed residents relaxing in their respective bedrooms and 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. The facility has four private bedrooms and one shared room, in addition to a room for use by staff which is confirmed to be locked and inaccessible to residents during the visit. There are two full bathrooms throughout the facility. Bedrooms appeared clean and sanitary. Two beds are equipped with half rails and one with full rails. Physician orders for the postural support reviewed. LPA observed all the resident bedrooms have the required furnishings. Bathrooms appear clean and sanitary. Bathroom are equipped with grab bars and slip mats. Hot water temperature measured at 107F in two separate bathrooms 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 are stored in a secure drawer. Fire extinguishers are charged and mounted, with up-to-date maintenance documented on the attached tags. LPA tested the smoke and carbon monoxide detectors which were found to be operational. The centrally stored medication is located in a secure closet. The attached garage is inaccessible to residents and is used for storage and laundry, with an additional refrigerator/freezer present. Cleaning supplies are stored securely in the garage as well as under the kitchen sink and bathroom sinks which are all verified to be secure. CONTINUED ON FORM LIC809-C CONTINUED FROM FORM LIC809 LPA and facility staff toured the outside of the facility. LPA observed an shaded outdoor seating area with furniture for resident use. The perimeter gate on one side of the property is self-latching and can easily be opened in an evacuation. There are no bodies of water on the premises. There is an adequately fenced water feature in the backyard with no pooled water observed. LPA reviewed six resident records which included all necessary components. LPA reviewed resident medication records and prescription orders for all residents with no discrepancies observed. There are no bedridden residents present on the premises. LPA reviewed three staff records which were found to be complete. Training and CPR/First aid training reviewed and up-to-date. All staff are background cleared and associated to the licensed location accurately. Based on the observations made during today’s visit, no deficiencies are being cited per Title 22 Division 6 of the California Code of Regulations. An exit interview was conducted and a copy of this report was provided to a facility representative.the state’s words, verbatim · CDSS document, Feb 26, 2025

Type of visit: Prelicensing

Licensing Program Analyst (LPA) Dwayne Mason Jr. made an announced inspection to the facility for purpose of conducting a pre-licensing inspection for a change of ownership. LPA arrived at the facility and was greeted and granted entry by Compliance Manager (CM) Michelle Nesbitt. LPA discussed with CM that, while at Granny's Place #2, they would be reviewing documentation for Granny's Place #1, #3 and #4 to make the best use of time. An application to operate a Residential Care Facility (RCFE) for (6) capacity, (0) ambulatory, (6) non-ambulatory, and (0) bedridden clients was received by Community Care Licensing (CCL) on 7/18/2023. Structure: The facility is a one-story home with five client resident bedrooms, three bathrooms, living room, kitchen, dining room, sun room, staff room, laundry room, backyard and attached two car garage. There is one exit gates in the back yard. The backyard has a seating area. Client Bedrooms: All resident bedrooms had the necessary furnishings. LPA observed all resident beds had linens and blankets. LPA observed all windows were screened. Bathrooms: The bathrooms have working plumbing. Hot water measured at 117.5 degrees Fahrenheit, 116.9 degrees Fahrenheit and 116.5 degrees Fahrenheit in resident bathrooms. Toxins: LPA observed chemicals, cleaning solutions, laundry toxins and disinfectants are inaccessible to client and will be stored under the kitchen sink and in the garage. Medications, First-Aid Kit & Files: Medication and first aid kit will be stored in locked cabinets in the laundry area. There is also a first aid kit hanging on the wall in the kitchen. Records are digitized and were accessible to LPA during inspection. Fire Extinguisher: LPA observed the fire extinguishers to be fully charged as indicated by the arrow pointing in the green zone. Extinguishers were serviced on 10/4/2023 Fire clearance: Was approved by a fire inspector of Orange County Fire Authority on 8/15/2023. Component III: Information provided about how to operate the facility within compliance and reporting requirements. Activity Materials: The facility has a facility calendar with various outings for residents. Facility also has exercise equipment, music and other electronics, plenty of space to lounge and relax and more. Linens: A supply of extra linen is stored in the hallway closet. Emergency Phone Numbers, Exit Plan and Menu: Posted and available for review. Food Service: There is 2-day supply of perishable food and a 7-day supply of non-perishable food on hand. Smoke Detectors: Smoke detectors and carbon monoxide detectors were tested and observed to be operational. Appliances: Gas stove, oven, refrigerator, dish washer, microwave, washer, and dryer are operational. The designated AD was notified that the final application approval will be issued by the Centralized Applications Bureau in Sacramento. Exit interview was conducted and a copy of this report was provided to designated ADthe state’s words, verbatim · CDSS document, Jan 11, 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.