Aunt Dottie's Place 2

Type of visit: Case Management - Other

Licensing Program Analyst (LPA) Talwinder Bains arrived on 5/20/26 to conduct case management visit. LPA met with Staff and explained the purpose of today's visit. Staff notified, Licensee/Administrator, Selam Kidane regarding LPA's visit and administrator came after short while and assisted LPA with today's visit. The Department received a request from the facility on April 29, 2026 to convert the garage into residents living quarters. The facility obtained permits from the appropriate agency to convert the garage into two separate bedrooms. The fire department conducted an inspection on 5/8/26 and approved rooms 6 and 7 to serve two non-ambulatory residents. During today’s visit, the converted rooms were found to be in compliance with Title 22 Regulations. No citations were issued during this visit. Exit interview was conducted and a copy of the report was provided.the state’s words, verbatim · CDSS document, May 20, 2026

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Talwinder Bains arrived at the facility unannounced on 4/22/26 to conduct a Annual Inspection utilizing the CARE inspection tool. LPA met with staff and explained the purpose of the visit. LPA requested for staff to notify Administrator that LPA is present at the facility to conduct an annual inspection. Administrator, Selam Kinade, arrived after a short while to assist. LPA and administrator toured the interior and exterior of the facility together to ensure health and safety of residents in care. Areas toured include but are not limited to: common areas, resident bedrooms, bathroom, kitchen, laundry room, and backyard. In the areas toured no immediate health, safety, or personal rights violations were observed. The home is clean. Pool in outside area was properly fenced and secured. Facility was conducting fire drills per requirement. Water temperature was within compliance. LPA reviewed 3 residents files and their medications records. Files are complete and organized. Medications review did not indicate any concerns. LPA reviewed 3 staff files. Files are complete. Several topics and resources discussed. No deficiencies are noted for this visit per Title 22 Regulations. Report reviewed and copy was provided.the state’s words, verbatim · CDSS document, Apr 22, 2026

Type of visit: Office

On 11/03/2025 at 4::00 PM, an informal conference was conducted with Sacramento Regional Office via Microsoft Teams. The purpose of this informal conference meeting is to discuss the deficiencies observed from facility visit on 10/21/25 and to address current issues at facility. Present in the meeting were Licensing Program Manager (LPM) Laura Munoz , Licensing Program Analyst (LPA) Talwinder Bains, and licensee/administrator, Selam Kidane. The Administrator was told that this Informal conference is a part of the Administrative Action process, and that further noncompliance may result in an elevation to a formal noncompliance conference, which could lead to a referral to the Department's legal division for possible revocation of license. The informal conference process was explained during this meeting. Issues discussed during the meeting were: - Residents’ Personal Rights - Complete residents and staffs records and readily available for department audit - Staff need to be fingerprint cleared and associated with facility prior employment - Facility’s Operation and Maintenance - Adequate staffing at facility per residents needs - Administrator’s availability and oversight with facility’s operation - Compliance with Fire Clearance as approved in facility file The facility has stated they will do the following to achieve continued and substantial compliance: • Submit a letter of understanding of Title 22 by 11/10/25 • Reach out to Community Care Licensing Division (CCLD) as a resource. Technical Support Program (TSP) was offered and accepted. No deficiencies were cited per Title 22 Regulations . Exit interview conducted. Informal meeting concluded and a copy of report was provided to the facility via email. A copy must be signed and returned to the Department by 11/04/25 by 5PM.the state’s words, verbatim · CDSS document, Nov 3, 2025

Type of visit: Case Management - Other

Licensing Program Analyst (LPA) Talwinder Bains arrived on 10/21/25 to conduct the post licensing inspection. LPA met with Staff, Abraham Tewelderhan and explained the purpose of today's visit. LPA reviewed three (3) residents files and found them to be incomplete. LPA observed that main facility entry door ,backside door, resident's bathroom doors had padlock on it and residents cannot enter or exit without staff's assistance. Staff indicated doors were locked so residents cannot AWOL from the facility. The facility is restricting resident's from entering and exiting the facility which was not allowed per Title 22 Regulations. Civil Penalties are being assessed today in the amount of $500. Deficiencies were observed and cited per Title 22, CCR Regulations as listed on LIC 809-D. Civil penalties shall be assessed if facility does not comply with POC requirements which were issued today. Exit interview conducted. Copy of this report and appeal rights were provided. ( this case management is related to post licensing visit which was conducted on 10/21/25).the state’s words, verbatim · CDSS document, Oct 21, 2025

From the deficiency page — Deficiency type: Type A · Section cited: CCR 87468(a)(1)(6) · Plan of correction due date: Oct 22, 2025

87468.1 -Personal Rights of Residents in All Facilities -(a)Residents in all residential care facilities for the elderly shall have all of the following personal rights:(6) To leave or depart the facility at any time and to not be locked into any room, building, or on facility premises by day or night. This does not prohibit a licensee from establishing house rules, such as locking doors at night to protect residents....this requirement is not as evidenced by; LPA observed that facility has locked front entry door, backside door, resident's bathroom door with padlock which pose a immediate health and safety risks for residents in care.the state’s words, verbatim · CDSS document, Oct 21, 2025

Plan of correction: Administrator shall submit a letter of understanding of this regulation and will train staff as well. Administrator shall ensure that all exits are accessible to residents at all times. All POC documents are due by 10/22/25. Staff removed padlock from front entrance doors while LPA was present. Civil Penalties assess in the amount $500.

From the deficiency page — Deficiency type: Type B · Section cited: CCR87506(b) · Plan of correction due date: Nov 4, 2025

87506; (b) Each resident's record shall contain at least the following information: This requirement is not met as evidenced by Based on record review, documents were not complete/filled for 2 out of 3 residents files , which poses an potential health, safety or personal rights risk to persons in care.the state’s words, verbatim · CDSS document, Oct 21, 2025

Plan of correction: Administrator shall send a letter of understanding of this regulation and shall ensure that all residents files are complete and all paperwork is filled out. All POC documents are due by 11/04/25.

Type of visit: Post Licensing

Licensing Program Analyst (LPA) Talwinder Bains arrived on 10/21/25 to conduct the post licensing inspection. LPA met with Staff, Abraham Tewelderhan and explained the purpose of today's visit. During today's annual inspection, the Compliance and Regulatory Enforcement Tool was used. LPA reviewed three (3) residents files. LPA requested staff files for audit but they were not available. 2 staff were working at the facility without fingerprint clearance .Deficiencies were observed and cited as listed on 809-D. LPA toured the facility to ensure the health and safety of residents in care. The areas toured included resident rooms, bathrooms, kitchen, and common areas and outside area. The food supply is within compliance, 2 days of perishable and 7 days worth of non-perishable food items. Grab bars were present at the toilet and in the shower. All exits were unobstructed. LPA checked the kitchen area for the ability to prepare and store food. LPA observed the area used for medication to be locked and inaccessible to residents. LPA observed smoke detectors and carbon monoxide detector at the care home are operational. Following issues were observed during today's visit: 2 staff working without fingerprint clearance , no staff's files were available for department audit, incomplete residents files, therefore citations were issued as listed on LIC809-D. LPA requested a copy of the LIC308, LIC 500, LIC610E and current liability insurance to be sent to the Department by 10/31/25. Deficiencies were observed and cited per Title 22, CCR Regulations as listed on LIC 809-D. Civil penalties shall be assessed if facility does not comply with POC requirements which were issued today. Exit interview conducted. Copy of this report and appeal rights were provided.the state’s words, verbatim · CDSS document, Oct 21, 2025

Type of visit: Prelicensing

On 04/03/25, Licensing Program Analyst (LPA) Talwinder Bains met with Administrator, Selam Kidane to conduct a announced Pre- Licensing visit. The facility has a fire clearance for five (5) non-ambulatory and one (1) bedridden residents . Facility has no residents at this time. LPA conducted an inspection of the care home to ensure compliance with Title 22 regulations. LPA inspected 4 bedrooms for residents, 3 bathrooms, common area, family room, kitchen, laundry room ,garage and outdoor area. LPA observed facility to be properly furnished, including appropriate bedding and lighting in the facility . Bathrooms were in sanitary condition and properly maintained. LPA checked the kitchen area for the ability to prepare and store food. LPA observed cleaning products and other toxins to be locked away. LPA observed the area used for medications to be locked and inaccessible to residents. LPA observed smoke detectors and carbon monoxide detectors at the care home to be operational. Fire extinguisher and first aid kit are maintained and ready for emergency use. Water temperature was observed at 110 degrees F. Applicant agrees to notify LPA once first resident is admitted. A working telephone has been set up for residents use. Pre-licensing passed and Component III (RCFE) was waived as applicant is associated with other facilities licensed by the department. Facility has satisfied all requirements in accordance to Title 22, California Code of Regulations. Application is pending and LPA will forward findings to the Centralized Application Bureau (CAB) for final review and approval. CAB will further contact applicant on final status of application. A copy of this report was provided to the facility. Exit interview conducted.the state’s words, verbatim · CDSS document, Apr 3, 2025

Type of visit: Office

Facility Type: RCFE Application Type: Initial Capacity: 6 Census (if any clients in care): 0 COMP II Participants: KIDANE, SELAM - Licensee/Adminsitrator Interview Method: Telephone interview On 03/11/2025, applicant/administrator participated in COMP II. Identification of the applicant and administrator was verified through interview questions based on photo ID and other identifying personal information. During COMP II, applicant and administrator confirmed that they have read and understand community care facility licensing laws included in the Health and Safety Codes and the California Code of Regulations Title 22. Signed LIC 809 with copy of photo ID have been obtained. During COMP II, CAB analyst confirmed Applicant/Administrator’s understanding of following areas: 1. Facility operation: License type, client/resident populations, and program 2. Admission Policies 3. Staffing requirements & Training 4. Restrictive/Prohibited Health Conditions 5. General provisions 6. Emergency Preparedness 7. Complaints & Reporting 8. Pre-licensing readinessthe state’s words, verbatim · CDSS document, Mar 11, 2025