Joystar Assisted Living

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Javier Prieto made an unannounced visit to the facility. The purpose of the visit was to conduct a required comprehensive annual inspection LPA met with Jiaqi Li, Administrator, and was granted entry to the facility. At the time of the visit there was three (3) staff present, and two (2) resident present. The facility is a four (4) bedroom, two (2), bathroom home, with a kitchen/dining area, living room, and attached garage. The facility is a Residential Care Facility for Elderly (RCFE) Licensed capacity is (5) current census (2). LPA was accompanied by Facility Administrator, to conduct a general overall inspection, which included, but was not limited to, the following: Physical Plant: The facility is operating in the capacity approved by Community Care Licensing (CCL). There are no obstructions to indoor and outdoor passageways. The facility is maintained at a comfortable temperature. LPA inspected resident bedrooms; they are equipped with required furniture such as: mattresses, nightstands, storage space, and sufficient lighting; bathrooms were clean, and appliances were operating appropriately. LPA observed sufficient furniture and lighting throughout the facility. LPA measured and observed the water temperatures in the bathrooms to be at 113.1 degrees F The facility is equipped with operating smoke detectors and carbon monoxide alarms. Posters such as personal rights, the CCL complaint poster, and the disaster plan were posted in a common area. Cleaning supplies, toxins, sharps, and other dangerous items were kept inaccessible to residents in care. There was a designated storage space for resident/staff files. Overall, the facility is clean, in good repair, and operating in safe conditions for residents in care. Food Service: Non-perishable and perishable food supply is sufficient for number of residents in care. Care & Supervision: Facility has sufficient care staff for coverage 24 hours a day, 7 days a week. All staff members working in the facility have criminal record clearance through the department. Record Review: LPA reviewed two (2) resident file for admission agreement, updated physician report, and needs and services plans. LPA also reviewed one (1) staff files for First Aid/CPR certification, criminal record clearance, training, and health screenings. Medications were audited at random and appeared to be dispensed appropriately by staff members. Based on the observations made during today’s visit, no deficiencies were cited per Title 22, Division 6, of the California Code of Regulations. An exit interview was conducted, and this report (LIC809) was discussed and provided to Jiaqi Li, Administrator.the state’s words, verbatim · CDSS document, Nov 20, 2025

Type of visit: Prelicensing

On 10/24/2024 at 1:35 PM, Licensing Program Analyst (LPA) Eldin Serrano conducted an announced visit to the facility for purpose of Prelicensing evaluation. LPA met with Applicant Jiaqi Li. An initial application to operate a Residential Care for the Elderly facility (RCFE) was submitted to the Central Applications Bureau (CAB) on 06/22/2024 for a total capacity of five (5) of which five (5) can be nonambulatory. Fire clearance was granted on 09/25/2024 for five (5) non-ambulatory residents. LPA Serrano observed the following: Structure: Facility was a one (1) story house with four (4) resident bedrooms, two (2) bathrooms, living room, dining area/kitchen and laundry. There was an attached two (2) car garage in the left side of the house. Heating/Cooling System: Central heating and air conditioning system installed with one (1) central panel located in the hallway to control entire house. Bedrooms: Each resident bedrooms accommodate any nonambulatory residents. All resident bedrooms were adequately furnished with bed, chair, closet, appropriate linens, adequate lighting, nightstands, a lamp and an operable smoke/carbon monoxide alarm. Bathrooms: The two (2) resident/staff bathrooms have a working toilet, wash basin, grab bars, non-slip mat and shower with an adequate supply of toilet paper and soap. LPA Serrano tested the water temperatures in the residents' bathrooms. ***CONTINUED ON LIC 809-C*** ***CONTINUED FROM LIC 809*** LPA Serrano verified water temperature was measured at 113.3 degrees Fahrenheit. Kitchen/Laundry: An adequate supply of dishes, glasses, utensils, pots, and pans were observed. Knives/sharp instruments were secured in a locked closet by the kitchen. There was adequate room for food storage. LPA Serrano observed the stove to be operational. Refrigerator/freezer were in working condition. There is sufficient storage for perishable food. There was adequate seating for meals for all clients. Laundry room with washer and dryer was in the laundry room. Laundry detergents and cleaning supplies were observed in a locked cabinet. Garage door is locked away from residents. Living Room: There was a living/family room with adequate seating for all clients and a working TV. Linens and Hygiene Supplies: An adequate supply of linens was stored in a cabinet in the hallway of the residence. Yards/Outside: Patio furniture for outdoor seating observed. Self-latching handle gate on left side of the house that leads into the backyard. All outdoor pathways were free of obstructions. Emergency Phone Numbers, and Exit Plan: Facility sketch was observed posted near the main entrance. There was Let-Us-No poster. Dementia Care Plan: LPA Serrano observed and reviewed the Dementia Care Plan during the visit. General items: One (1) fire extinguisher was charged and located in the kitchen. Five (5) combined smoke detectors and carbon monoxide detectors were tested and were observed to be in working order. Resident records and staff records will be stored in a locked cabinet in the kitchen. First Aid kit with required components, First Aid Book and locked area for medication storage was observed. LPA observed a facility phone and was operational as ***CONTINUED ON LIC 809-C*** ***CONTINUED FROM LIC 809*** evidenced by LPAs dialing the number. The phone number designated for the facility is (909) 870-6352. There is enough Emergency water supply and the required 72-hour emergency food supply for residents and staffs available at the facility. Component III was completed on this day as well. Additionally, LPA Serrano observed facility having Visitor Sign In/Sign Out Sheet and Client Sign In/Sign Out Sheet, upon entering facility. The facility was evaluated in accordance with the California Code of Regulations (CCR), Title 22, Division 6, Chapters 1 and 6 to ensure the health and safety of clients in care. Facility appears to be ready for licensure. An exit interview was conducted, and a copy of this report, LIC809 was discussed and provided to Applicant Jiaqi Li.the state’s words, verbatim · CDSS document, Oct 24, 2024

Type of visit: Office

Facility Type: RCFE Application Type: INITIAL Capacity: 5 Census (if any clients in care): 0 COMP II Participants: Jiaqi Li, administrator Interview Method: Telephone interview On 10-3-2024, 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, Oct 3, 2024