Forbs Care Home

Type of visit: Prelicensing

Licensing Program Analyst (LPA) Sabrina Calzada conducted a scheduled Pre-Licensing Inspection on August 27, 2026 at 1:00 pm. LPA met with Aida Ssempaka, Administrator and Peter Ssempaka, Administrator Designee. The reason for the inspection is due to a pending new license (RCFE) at the location. There are no residents in care currently. The facility has an approved fire clearance for (6) non-ambulatory residents, (1) of whom may be bedridden. LPA, the Administrator, and Administrator Designee, toured the interior/exterior of the facility, including the common areas, (2) shared resident bedrooms, (2) private resident bedrooms, (1) resident bathroom, staff area, laundry and garage. LPA observed the facility to be clean, in good repair and to have sufficient furniture/lighting throughout. Each resident room is furnished with the required furnishings, and the bathrooms have the necessary grab bars and skid-resistant flooring. Paper towel/soap dispensers will be installed in the resident bathroom. There is 7+ day non-perishable food on hand and dishes, flatware and glasses and cooking pans. Sharps are locked in the kitchen and medications/toxins are secured in separate cabinets near the bathrooms. Additional toxins are locked under the kitchen sink. New smoke/monoxide alarms were installed and tested/working. The fire extinguisher was last serviced April 10, 2026. Hot water measured 130*F in the kitchen- the hot water temperature was lowered on the water heater. A sign may be posted. There is a complete First Aid kit and sufficient linens/towels/blankets. Inside temperature measured 70*F. Required postings are visible in the common area. There is one unlocked exit gate and a patio set with a table/chairs/umbrella will be purchased by 8/31/26. Resident room number stickers will be applied to the doors. Resident staff binders are organized with tab dividers and contain the required paperwork. The Administrator has a valid RCFE Admin Certificate (exp 12/13/26). Comp III was completed during today's inspection. Pre-Licensing is complete and this facility has no deficiencies. LPA to notify the analyst in the applications bureau. Exit interview. Copy of report printed.the state’s words, verbatim · CDSS document, Aug 27, 2026

Type of visit: Office

Component II completion: Successful Facility Type: RCFE Application Type: Initial Capacity: 6 Census (if any clients in care): 0 COMP II Participants: Aida Ssempaka (Managing Member/Administrator) Interview Method: Virtual interview via Microsoft Teams On July 28, 2026, 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, Jul 28, 2026