Canterbury House

Type of visit: Required - 1 Year

On 6/24/26 at 9:00am Licensing Program Analyst (LPA) Kevin Gould arrived at Canterbury House for the purpose of conducting a required 1 year annual inspection. LPA met with Administrator, Yacub Lucas and together conducted a tour of the home. LPA and Administrator evaluated the physical plant to ensure the health and safety of the residents in care. Areas inspected are including but not limited to the kitchen, resident bedrooms; resident bathrooms, living and dining room and outdoor areas. LPA observed the facility to be free of odor. LPA observed evidence of insect activity in the kitchen. LPA observed one sliding closet door with a broken mirror that is in need of replacement. LPA observed that all rooms are equipped with the required furniture. LPA observed several rooms did not have sufficient lighting as bulbs were burnt out or missing. LPA observed two emergency exits obscured or blocked by plants that are required to be cut back or removed. LPA measured the water temperature, temperature measured at 108 degrees F which meets the 105-120 degree Fahrenheit regulation. LPA observed sufficient seven day non-perishable and two day perishable food supplies. LPA did observe expired canned good and some perishable food supplies expired. Fire extinguishers and smoke detectors are current and in compliance with fire safety. LPA notes the facility had the required carbon monoxide detectors. First aid kit was checked and is complete. LPA observed centrally stored medications secure from residents. LPA observed not all resident files to be complete and are missing signatures/names and or dates. Per California Code of Regulations, Title 22 the following deficiencies are cited during today's inspection. An exit interview was conducted, and a copy of this report and appeal rights were left at the facility.the state’s words, verbatim · CDSS document, Jun 24, 2026

The state marks this report as 7 pages; the online copy we transcribed has 4. You can request the full file from the county licensing office.

Type of visit: Case Management - Other

On 6/23/25 Licensing Program Analyst (LPA) Holly Williams conducted a case management to address reporting of a death to the department. LPA met with administrator Yacub Lucas and together discussed the report. LPA conducted an interview with Paula Ngantung to confirm what happened when the incident took place. LPA will follow up if needed. Exit interview conducted and a copy of this report and appeal rights was left at the home.the state’s words, verbatim · CDSS document, Jun 23, 2025

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Holly Williams arrived unannounced to conduct an annual inspection. LPA Williams met Facility Designated Administrator (FDA) Lucas Yacub and a brief interview was conducted. LPA Williams reviewed four resident files (R1-R4) and two staff files (S1-S2). The census is 4 residents and the facility has a hospice waiver for 6. LPA Williams toured the facility with the FDA and inspected common areas, the kitchen, bedrooms, bathrooms, and backyard areas. Furniture and furnishings were sufficient to meet the needs of residents. The facility temperature was 73 degrees Fahrenheit, which is within the required range of 68 and 85 degrees. The facility's water temperature measured 120 degrees Fahrenheit, which is within the required range of 105 and 120 degrees. LPA Williams observed first aid supplies, a fully-charged and up-to-date fire extinguisher, and working carbon monoxide/smoke detectors. LPA Williams observed a minimum 2-day supply of perishable food and a minimum 7-day supply of nonperishable food. While touring the facility LPA observed medication in 3 out of the 4 residents rooms. LPA observed the medication cart unlocked and pre poured medication in the medication cart and pre poured medication in the unlocked drawer in the kitchen. LPA Williams observed unlocked cabinets for the storage of cleaning solutions and knives in the kitchen, unlocked cleaning solutions in the 2 out of 3 bathrooms. In the 2 laundry rooms LPA observed unlocked detergent and rat poisons. LPA Williams interviewed staff member (S1) and 2 resident (R1-R2). The following deficiencies were observed and cited on the following LIC 809-D pursuant to Title 22 Rules and Regulations, Health and Safety Codes. Appeal rights were printed and a copy was given to the facility designated Administrator at this time. Exit Interviewthe state’s words, verbatim · CDSS document, May 9, 2025

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Ruth Wallace conducted an unannounced annual inspection. LPA met with administrator and explained the purpose of the visit. Administrator certificate # is 6051257740 expires on 02/20/2025. LPA inspected the physical plant including but not limited to the common area, kitchen, dining area, client bedrooms, client bathrooms, laundry room and outside courtyards of the facility to ensure compliance with Title 22 regulations. This facility is a single story building licensed to serve six (6) non-ambulatory clients. LPA observed the facility to be free of odor, clean and in good repair. LPA observed bedrooms to be properly furnished with appropriate bedding and lighting. There are no bodies of water present. LPA observed sufficient seven day non-perishable and two day perishable food supplies. Hot water temperature was measured at 113.2 degrees Fahrenheit in resident bathroom sink, which is within the required regulation of 105 to 120 degrees Fahrenheit. Fire extinguishers, smoke and carbon monoxide detectors are in compliance with fire safety. Fire extinguisher last serviced 10/16/2023. Fire Drill last conducted 4/1/2024. LPA checked medication storage and found medication to be locked away and inaccessible to clients. First aid kit was checked and is complete. LPA reviewed three resident files and three staff files, including criminal record clearances. A review of staff records indicates that all facility staff or other individuals who require caregiver background checks are Fingerprint cleared and associated to the facility. LPA verified staff training for staff file reviews. LPA requested the following updated documents for community care licensing to be submitted via email by May 23, 2024: LIC 308 Designation of Administrator, LIC 500 - Personnel Report, Copy of Administrator's Certificate, and Copy of Liability Insurance with expiration date. ruth.wallace@dss.ca.gov Based on today’s visit, Per California Code of Regulations, Title 22 Division 6, Chapter 8, no deficiencies observed or cited today. Exit interview conducted with administrator. A copy of report and LIC 811 (Confidential Names) left at facility.the state’s words, verbatim · CDSS document, May 16, 2024