Gem's Senior Living I

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Imaculada Vasquez arrived unannounced to conduct an annual inspection. Upon arrival LPA was greeted by facility staff and granted entry. LPA began inspection with introduction and visit purpose. Resident record review began- Two (2) records were reviewed. LPA reviewed for admission agreement, medical assessment and TB test results, consent forms, identification and emergency information, appraisal needs and service plans, centrally stored medication/destruction records, safeguard for personal property/valuables, and personal rights notification. This facility has met documentation requirements. Employee records review began- Two (2) records were reviewed. LPA reviewed employee record for first aid certification, fingerprint clearance, personnel/job application, health screening and TB test results, criminal record statement, employee rights, training verification, and current administrator certification. CPR and first aid requirements have been met. The facility employs enough staff to maintain cleanliness and meet the needs of the clients in care. Administrator certification expires on 03/29/2028. Physical Plant and Safety of Environment/Operational Requirements- LPA toured the facility inside and outside. The home is maintained at a comfortable temperature for the clients. Lighting is sufficient for safety and comfort. Water temperature measured 108.9 degrees F. Laundry facilities and a locked cabinet is present for storing laundry soap and other chemicals in the garage. All outdoor and indoor passageways are free of obstruction. A locked area is provided for medications and sharp objects. LPA verified there is a telephone working at this location. (Continued from LIC809, Page 2) (Continued from LIC809, Page 1) Food Service- Food supply meets the of one week supply of nonperishable and 2-day supply of perishables food on hand. Food prep areas are clean and organized. Emergency food and water was observed. LPA made observation throughout the inspection process to assess if the facility remains in conformity with the State Fire Marshall regulations. The facility has not exceeded its capacity limitation, and the structure remains unchanged according to the approved floor plan. Smoke detectors and carbon monoxide detectors were tested and found to be operational. Two (2) fire extinguishers are tested annually and were last done so on 06/12/2026. The facility is conducting emergency disaster drills. The last disaster drill was conducted on 03/16/2026. There were no bodies of water observed. Based on the information received during this visit today, there are zero (0) deficiencies being cited per Title 22, Division 6 of The California Code of Regulations. Two (2) technical advisories have been given. This report, two (2) technical advisories were reviewed and given to Caregiver Sri Gutta at the time of the exit interview.the state’s words, verbatim · CDSS document, Sep 28, 2026

The state marks this report as 5 pages; the online copy we transcribed has 3. You can request the full file from the county licensing office.

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Yolanda Delgado arrived unannounced to conduct an annual inspection. Upon arrival LPA was greeted by facility staff and granted entry. LPA began inspection with introduction, visit purpose and provided the facility caregiver with LPA identification and business card. Resident record review began- Four (4) records were reviewed. LPA reviewed for admission agreement, medical assessment and TB test results, consent forms, identification and emergency information, appraisal needs and service plans, centrally stored medication/destruction records, safeguard for personal property/valuables, and personal rights notification. This facility is not meeting documentation requirements. Employee records review began- Two (2) records were reviewed. LPA reviewed employee record for first aid certification, fingerprint clearance, personnel/job application, health screening and TB test results, criminal record statement, employee rights, training verification, and current administrator certification. CPR and requirements have been met. The facility employs enough staff to maintain cleanliness and meet the needs of the clients in care. Administrator certification is not present. Physical Plant and Safety of Environment/Operational Requirements- LPA toured the facility inside and outside. The home is maintained at a comfortable temperature for the clients. Lighting is sufficient for safety and comfort. Water temperature measured 109.0 degrees F. Laundry facilities and a locked cabinet is present for storing laundry soap and other chemicals in the garage. All outdoor and indoor passageways are free of obstruction. A locked area is provided for medications and sharp objects. LPA verified there is a telephone working at this location. Two (2) exterior window screens need to be repaired. (Continued from LIC809, Page 2) (Continued from LIC809, Page 1) Food Service- Food supply meets the of one week supply of nonperishable and 2-day supply of perishables food on hand. A menu is posted, foods are dated to assure safety. Food prep areas are clean and organized. No emergency food and water was observed. LPA made observation throughout the inspection process to assess if the facility remains in conformity with the State Fire Marshall regulations. The facility has not exceeded its capacity limitation, and the structure remains unchanged according to the approved floor plan. Smoke detectors and carbon monoxide detectors were tested and found to be operational. Fire extinguishers are tested or replaced annually and were last done so on 06/2025. The facility is conducting emergency disaster drills. The last disaster drill was conducted on 06/11/2025. There were no bodies of water observed. Based on the information received during this visit today, the following eleven (11) deficiencies is being cited per Title 22, Division 6 of The California Code of Regulations. This report was reviewed with Sri Gutta, LIC809D, Appeal Rights at the time of the exit interview and copies will be emailed to the facility and confirmation of receipt will be requested.the state’s words, verbatim · CDSS document, Jun 30, 2025

Type of visit: Required - 1 Year

On June 05, 2024, Licensing Program Analyst (LPA), Venus Mixson arrived at the facility unannounced to conduct the Required Annual Inspection and met with Gerlita Higa, the Licensee. The facility file review was conducted in the Regional Office and additional forms were reviewed and requested on site. The facility is licensed for six Elderly Adults (740), and is operating at four currently. LPA Mixson toured the facility along with the Licensee and inspected the facility inside and outside, and there was no debris or obstructions to the indoor or outdoor passageways at the time of this visit. The facility is a single-story home located at 28701 Portsmouth Drive, Sun City, CA. 92586. Physical Plant: The facility phone number is(951) 672-1470. The LPA observed the residents’ bedrooms. Each bedroom was equipped with required furniture as per Title 22. LPA Mixson inspected facility bathrooms, and the hot water temperature tested within regulations. The bathrooms were clean, appliances were operating appropriately currently at the time of this visit, and exit signs were observed. The facility is equipped with operating smoke detectors, carbon monoxide alarms, and fire extinguishers. LPA Mixson observed required postings such as "If you See Something, Say Something" the "Personal Rights" and the Ombudsman postings. The cleaning supplies and sharp items were locked and inaccessible to the residents in care at the time of this visit. A designated storage space for the residents and staff files was observed, and it was locked and inaccessible to residents in care currently at the time of this visit. The overall facility is clean, the furniture is in good condition. The facility cooling system and other appliances were operable currently at the time of this visit. There were safety lights for night. Medications: The medications were locked and inaccessible to residents in care. There are a sufficient supply of medication for each resident currently. Food Service: Non-perishable and perishable food supply is sufficient per regulations, and there are a variety of food types available for residents. Dishes and utensils were in sufficient supply and stored properly, and sharps are locked. Care & Supervision: Facility has sufficient staff, two staff on site at the time of this visit, and the staff were engaging the residents with morning meal and medications. Records Review: LPA Mixson reviewed six resident files, along with two staff files, conducted staff interviews, and resident interviews. Previous Community Care Licensing forms were reviewed. There were no Title 22, Division 6 Regulation violations observed or cited during today’s visit. An exit interview was conducted, and a copy of this report was given to the Licensee, Gerlita Higathe state’s words, verbatim · CDSS document, Jun 5, 2024