Amaikah Home Care

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Angelica Boyles conducted an unannounced Required Annual Inspection. The facility file was reviewed prior to the visit. LPA was welcomed by, identified herself to, and discussed the purpose of the visit with Administrator Jeremy Bagaoisan. According to the facility’s license, the facility has a maximum capacity of 6 residents of which 6 may be non-ambuatory and 1 may be bedridden in room #6. There is a hospice waiver for 5. LPA, accompanied by Administrator, toured the interior and exterior of the facility, and inspected each room. The facility was clean, sanitary, and in good repair. Pathways were free of obstruction and slip hazards. Resident bedrooms contained the required furnishings. Doors, windows and screens, toilets, and showers were in working order. Extra linens and hygiene supplies were present. The facility had sufficient space and equipment to facilitate dining, laundry, visitation, meetings, and resident activities. There was at least 2 days of perishable food, and at least 7 days non-perishable food present, all safely stored. Cooking/dining equipment and utensils were present. There were no sharp objects, toxic chemicals/poisons, or fireplaces accessible to residents. Medications were labeled, as required, and stored in locked areas. (CONTINUED ON LIC 809C) (CONTINUED FROM LIC 809) No pools or bodies of water were observed on the premises. Per Administrator, no firearms or ammunition are kept at the facility. Smoke alarms, carbon monoxide detectors, emergency lighting, and facility telephone were all working. First aid kit(s) were complete and readily accessible. Required licensing postings were observed in visible areas of the facility. LPA reviewed multiple staff and resident records/files. The reviewed files contained required documents. Confidential records were stored in locked areas. No deficiencies were observed or cited on today's visit. An exit interview was conducted with Administrator Jeremy Bagaoisan, to whom a copy of this report and the Licensee/Appeal Rights (LIC9058 03/22) were provided at the conclusion of the visit.the state’s words, verbatim · CDSS document, Jul 9, 2026

Type of visit: Prelicensing

Licensing Program Analyst (LPA) David Roman conducted an announced Pre-Licensing visit to observe the facility’s physical plant for compliance with Title 22, Division 6 of the California Code of Regulations and Health & Safety Code. LPA D. Roman identified himself to and explained the purpose of the visit to Administrators, Jeremy Bagaoisan, and Reyner Grangos. The facility fire clearance was granted on 01/28/2025 and reflects that the facility was approved for five (5) non-ambulatory residents and 1 bedridden resident totaling 6 residents. Fire extinguishers were serviced on 02/17/2025, smoke alarm/monoxide alarms were tested at 02:00 PM. During today’s visit, LPA D. Roman, accompanied by Jeremy Bagaoisan and Reyner Grangos, toured the interior and exterior of the facility and inspected each room. The facility was sanitary and in good repair. The facility consist of 1 story home with 6 bedrooms, 3 bathrooms, living room, dining room, and kitchen area, laundry/dryer are in garage. Bedrooms contained the required furnishings (closet and night stand). Water temperature was in compliance measured at 120 degrees. The facility has enough linens, hygiene supplies and dining supplies for client use. The facility has locked areas for storage of medication and confidential client and staff records. Facility has a storage unit on the grounds that is kept for medical equipment which is locked. No bodies of water observed on the premises. There were no toxic chemicals/poisons, fireplaces, or open-faced heaters accessible to clients. According to Administrators reported no firearms or ammunition are or will be stored at the facility. Emergency lighting, and facility telephone were all operational. First aid kits were present and readily available. Required licensing postings were observed in visible areas of the facility. (Cont. on LIC-809) The items reviewed were complaint with Title 22, Division 6 of California Code of Regulations and Health & Safety Code. The facility passed the pre-licensing inspection. LPA D. Roman also provided the Component III Training during today’s visit. The supervisor was advised that the facility’s application is pending management final review and approval. An exit interview was conducted with the applicant, to whom a copy of this report and the Licensee/Appeal Rights were providedthe state’s words, verbatim · CDSS document, Sep 9, 2025

Type of visit: Office

Component II completion: Successful Facility Type: RCFE Application Type: CHOW Capacity: 6 Census (if any clients in care): 6 COMP II Participants: Jeremy Bagaoisan (CEO/Administrator) Interview Method: Telephone interview On June 23, 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, Jun 23, 2025