Cherokee Retirement Home

Type of visit: Required - 1 Year

Licensing Program Analysts's (LPA) Melina Oropeza and Kesha Lewis arrived at this facility unannounced to conduct a Required 1 Year Annual Inspection Visit. LPA's were met by administrator. LPA's explained the purpose of the visit to Administrator. There are no residents in care and no staff employed. The building in currently under construction with the expected completion date of June 2026. Currently, LPA's were not able to inspect the facility because the facility is only at studs. LPA's were not able to review any resident or staff records at this time. Exit interview. Copy of the report left with administrator.the state’s words, verbatim · CDSS document, Mar 25, 2026

Allegation investigated: Illegal eviction

On 7-15-2025 at 11:05am, Licensing Program Analyst (LPA) Michael Bilger arrived unannounced to deliver findings for the allegation noted above. LPA met with Licensee/Administrator (S1) Jagtar Singh and explained the purpose of the visit. During this investigation LPA conducted interview with S1 and reviewed admission agreement for resident1 (R1). Additionally, LPA conducted a facility observation as part of this investigation. Allegation: Illegal eviction. Based on interview and observation, it was revealed that a section of a ceiling in the living room area of the facility became damaged resulting in dust particles and other debris in the room. Interview revealed there were two residents living at the facility at the time including R1 who were sent to the hospital by licensee after the damage occurred for safety reasons. {Cont. on 9099C) Substantiated Both residents were transported via ambulance. Further investigation and interview revealed that S1 did not utilize the emergency disaster protocol for temporary placement, and informed conservators to find residents new places to live as there was no intention of accepting residents back, and did not provide a written notice of eviction. Additionally, it was revealed that R1 received a verbal notice of eviction due to renovations in March 2025 without a formal written notice to accompany verbal notice per regulatory requirements. As a result, the preponderance of evidence standard is met, and this allegation is SUBSTANTIATED. Citation is issued under Title 22, Division 6 and noted on LIC 9099D. Civil penalty in the amount of $250 is issued in addition to citation due to repeat violation of Section 87224(a) within a 12-month period. An exit interview was conducted with S1 and a copy of this report was provided. Appeal rights and LIC 811 provided. Record reviews revealed that a prescription for Triamcinolone cream was given on 4-24-2024 to treat an observed rash. Records also reveal that R1 was seen by physician on 6-24-2024 for a check up at which time itchiness and rash were observed and treated. Medication Triamcinolone was increased in strength during this visit. An additional prescription for Triamcinolone was prescribed on 10-25-2024. Record review further indicated R1 was seen by physician on 10-30-2024 for a follow up and noted with Erythema and lesion on multiple parts of body. Medication Temovate was started during this visit. Interviews conducted revealed R1 was given medication as prescribed. LPA reviewed medication prescription orders as part of documentation review. Additional interviews revealed that on later part of March 2025, R1 discharged from facility, and on or about 5-20-2025 was taken to physician by another party and diagnosed with Herpes 1 and 2. Based on interviews and records review in this investigation, there are no additional corroborated statements or evidence to indicate facility did not assist R1 with obtaining medical treatment for observed rashes during R1’s residency. Furthermore, there is no additional evidence to support the diagnosis of Herpes 1 and 2 occurring as a result of facility not assisting with medical treatment as R1 discharged in March 2025 and diagnosed in May 2025 with the condition. As a result, the preponderance of evidence standard is not met, and this allegation is UNSUBSTANTIATED. A finding of unsubstantiated means the allegation may have happened or is valid, but there is not a preponderance of the evidence to prove that the alleged violation occurred. An exit interview was conducted with Licensee/Administrator and a copy of this report was provided. Appeal rights provided.the state’s words, verbatim · CDSS document, Jul 15, 2025 · control 27-AS-20250521091347

From the deficiency page — Deficiency type: Type B · Section cited: CCR 87224(a) · Plan of correction due date: Jul 25, 2025

87224(a) Eviction Procedures. (a).The licensee may evict a resident for one or more of the reasons listed in Section 87224(a)(1) through (5). Thirty (30) days written notice to the resident is required except as otherwise specified in paragraph (5). This requirement was not met as evidenced by: Based on interview and record review, Licensee verbally expressed notice of eviction after property damage; licensee did not provide a written notice of eviction to R1. This posed a potential health, safety, and resident rights risk to residents in care.the state’s words, verbatim · CDSS document, Jul 15, 2025

Plan of correction: Licensee is not currently providing care for residents at this time and planning renovations. Licensee to read regulation 87224 and submit a signed statement of understanding to LPA by POC due date.

Allegation investigated: Facility staff are not following regulatory procedures for increasing rates based on level of care changes

On 6-20-2025 at 1:35pm, Licensing Program Analyst (LPA) Michael Bilger arrived unannounced to deliver findings for the allegation noted above. LPA met with Licensee Jagtar Singh and explained the purpose of the visit. Allegation: Facility staff are not following regulatory procedures for increasing rates based on level of care changes. During this investigation, LPA conducted interviews with three residents in care, two staff members, and two additional witnesses. LPA also reviewed admissions agreement, and a level of increase notice for resident1 (R1). Based on interviews and record reviews it was determined that on 4-21-2025, Licensee furnished to R1’s responsible person via email a notice reflecting a new rate of $4,000.00 starting “ASAP” to meet R1’s care requirements. A review of R1’s admissions agreement states a basic service rate of $1344.00 and a “rate change” clause which states in part: “Written notice must be provided to the resident and the resident's representative, if any, within two business days of providing service at a new level of care that result in a rate increase. {Cont. on 9099C} Substantiated The notice must include a detailed explanation of the additional services provided at the new level of care, and must itemize the charges." A review of the emailed notice states various care needs of R1, however, does not state itemized charges to accompany care needs. As a result, the preponderance of evidence standard is met, and this allegation is SUBSTANTIATED. Citation issued under Title 22, Health and Safety Codes, Chapter 3.2, and noted on LIC 9099D. An exit interview was conducted with Licensee and a copy of this report was provided. Appeal rights provided. LIC 811 provided.the state’s words, verbatim · CDSS document, Jun 20, 2025 · control 27-AS-20250401093031

From the deficiency page — Deficiency type: Type B · Section cited: CCR 1569.657(a) · Plan of correction due date: Jun 30, 2025

1569.657 Rate increase due to change in level of resident care; notice. (a) For any rate increase due to a change in the level of care of the resident, the licensee shall provide the resident and the resident’s representative, if any, written notice of the rate…The notice shall include a detailed explanation of the additional services to be provided at the new level of care and an accompanying itemization of the charges. This requirement was not met as evidenced by: Based on interview and record review, Licensee did not ensure a proper notice for a level of care rate increase to R1 per regulatory requirements. This posed a potential health, safety, and resident rights risk to resident in care.the state’s words, verbatim · CDSS document, Jun 20, 2025

Plan of correction: Licensee will read regulation 1569.657(a) and provide a written declaration of understanding to LPA by POC due date.

Allegation investigated: Illegal Eviction

On 4/2/25 at 10:26am, Licensing Program Analysts (LPAs) Michael Bilger and Noel Wolf Petersen met with Licensee Jagtar Singh to deliver and discuss findings for the allegation noted above. LPA explained the purpose of the visit. During this investigation, LPA conducted interviews with two staff members, four residents in care, and two additional witnesses. LPA also reviewed facility’s admission agreement as part of this investigation. Based on interviews conducted it was determined that Licensee verbally expressed to various residents in care the need to vacate facility due to a planned major renovation project. Admission agreement reviewed indicates reasons to evict which are linear to regulation Section 87224(a)(1-5) Eviction Procedures. Reasons for eviction do not include renovation projects. Additionally, it was determined that Licensee did not provide a formal written notice of eviction to accompany verbal statement. As result, the preponderance of evidence standard is met, and this allegation is SUBSTANTIATED. Citation is issued under Title 22, Division 6 and noted on LIC 9099D. {Cont. on 9099C} Substantiated An exit interview was conducted with Licensee and a copy of this report was provided. Appeal rights provided. Administrator Jagtar Singh departed facility prior ot end of report and gave permission for staff2 (S2) to received paperwork and sign in his absence.the state’s words, verbatim · CDSS document, Apr 2, 2025 · control 27-AS-20250312161929

From the deficiency page — Deficiency type: Type B · Section cited: CCR 87224(a) · Plan of correction due date: Apr 11, 2025

Eviction Procedures. (a).The licensee may evict a resident for one or more of the reasons listed in Section 87224(a)(1) through (5). Thirty (30) days written notice to the resident is required except as otherwise specified in paragraph (5). This requirement was not met as evidenced by: Based on interview and record review, Licensee verbally expressed a notice of eviction and did not provide a written copy to residents or their responsible persons. This posed a potential health, safety, and resident rights risk to residents in care.the state’s words, verbatim · CDSS document, Apr 2, 2025

Plan of correction: Licensee to inform residents in care in writing that previous verbal eviction notice is rescinded. Proof to be sent to LPA by POC due date.

Type of visit: Case Management - Other

On 4/2/2025 at 11:33am, Licensing Program Analysts (LPAs) Michael Bilger and Noel Wolf Petersen met with Licensee/Administrator Jagtar Singh to conduct a case management visit. LPA explained the purpose of the visit. During this case management, LPA conducted interviews with two staff members, four residents in care, and two additional witnesses. Additionally, LPA reviewed facility’s eviction procedures within the admission agreement. Based on interviews and record reviews, it was determined that Licensee/Administrator verbally expressed to various residents in care and various residents’ responsible parties an eviction notice due to a planned renovation project for facility. It was further determined that Licensee/Administrator did not ensure a formal written notice of eviction to accompany this verbal notice. Additionally, it was determined that LPA requested on 3-24-25 from Administrator a roster of information regarding resident whereabouts upon any discharge. Roster has not been sent per records review. Administrator Jagtar Singh departed facility prior to end of report and gave permission for staff1 (S1) to sign received paperwork and sign in his absence. As a result of this case management, citations are issued under Title 22, Division 6 and noted on LIC 809D. An exit interview was conducted with Licensee and a copy of this report was provided. Appeal rights provided.the state’s words, verbatim · CDSS document, Apr 2, 2025

From the deficiency page — Deficiency type: Type B · Section cited: CCR 87405(d)(2) · Plan of correction due date: Apr 11, 2025

Administrator Qualifications and Duties. (d) The administrator shall have the qualifications specified in Sections 87405(d)(1) through (7). If the licensee is also the administrator, all requirements for an administrator shall apply. (2) Knowledge of and ability to conform to the applicable laws, rules and regulations. This requirement was not met as evidenced by: Based on interviews and record reviews, Licensee/Administrator did not adhere to eviction regulations as specified in section 87224 Eviction Procedures. This posed a potential health and safety risk to residents in care.the state’s words, verbatim · CDSS document, Apr 2, 2025

Plan of correction: Licensee and Administrator will read regulation 87224 and submit a signed declaration of understanding to LPA by POC due date.

From the deficiency page — Deficiency type: Type B · Section cited: CCR87755(b) · Plan of correction due date: Apr 11, 2025

Inspection Authority of Licensing Agency (b) The licensee shall ensure that provisions are made...for the examination of all records relating to the operation of the facility. This requirement was not met as evidenced by: Based on record review, Administrator did not ensure requested information regarding resident whereabouts in a timely manner. This posed a potential health and safety risk to residents in care.the state’s words, verbatim · CDSS document, Apr 2, 2025

Plan of correction: Licensee will read reguation 87755 and provide a written declaration of understanding to LPA by POC due date.

Type of visit: Required - 1 Year

On 3-19-2025 at 10:08am, Licensing Program Analyst (LPA) Michael Bilger arrived at this facility unannounced to conduct an annual inspection visit. LPA met with the administrator Jagtar Singh and explained the purpose of the visit. LPA inspected the physical plant including but not limited to the kitchen, dining room, resident bedrooms; resident bathrooms, laundry room, living area, common TV area, and outside of the facility to ensure compliance with Title 22 regulations. Facility is a residential care facility for the elderly (RCFE) with a current census of 8. Facility has 6 bedrooms and 3 bathrooms for resident use. A separate cottage on the property is not in service at this time. Facility has a dining area off the kitchen and a formal living room. LPA also conducted the inspection using the CARE tool. The facility has an approved infection control plan in place. Water temperature reads 105*F to 120*F in the bathroom and room temperature reads 76*F. LPA observed the facility to have adequate food supply. Resident rooms were sanitary and had the required furniture and furnishings. The facility common areas were clean and furnished. Smoke and carbon detectors were in good repair. Fire extinguisher was checked 6-7-24. Facility has an emergency food and water kit. All toxins and other dangerous items including sharp objects were locked and inaccessible to residents in care. Medication storage area was observed to be locked and inaccessible to residents in care. Medications were reviewed and contained accompanying regulatory required Physician’s orders. First aid kit was observed to have adequate supplies and accessible to staff. During this inspection 5 resident files and 3 staffing files were reviewed for regulatory compliance. All files contained required contents including staff training requirements. All staff noted on LIC 500 contained criminal background clearances. LPA completed 3 resident interviews and 2 staff interviews. Resident files reviewed contained all required contents including updated admission agreements, medical assessments, and updated appraisal forms as required. {Cont. on 809C} Facility’s liability insurance is up to date. Facility does not contain any bodies of water. LPA observed personal rights and complaint information posted. Facility has appropriate internet access available for resident use. LPA observed facility’s sufficient equipment and supplies to meet activity program needs of residents in care. LPA reviewed facility’s disaster plan to ensure regulatory compliance. Facility conducts quarterly fire drills. LPA requested an updated copy of LIC 308 and LIC 500. Per California Code of Regulations, Title 22, no deficiencies were observed during this visit. Administrator departed facility for other pre-arranged commitments and gave permission for caregiver (S1) to sign in his absence. Exit interview was held and a report was given to S1.the state’s words, verbatim · CDSS document, Mar 19, 2025

Allegation investigated: Facility is in disrepair Administrator is not present

On 12-11-24 at 10:15am, Licensing Program Analyst (LPA) Michael Bilger arrived unannounced to deliver and discuss the complaint allegations noted above. LPA met with Administrator Jagtar Singh and explained the purpose of the visit. During this investigation, LPA conducted interviews with three clients in care and two staff members. LPA also conducted facility observations on 11-7-24 and 12-11-24. LPA also reviewed facility file documentation including current staff schedule. Allegation: Facility is in disrepair. LPA conducted interviews and observations as noted above. Based on interviews and observation, it was determined that various items necessary for general operation of the facility are functioning properly including but not limited to: Heating and air units, kitchen items, smoke detectors, and faucet units. Additionally, it was revealed that facility, though aging, has made past necessary repairs and continues on-going assessments for any future repairs as necessary. {Cont. on 9099C} Unsubstantiated Interviews and observations further determined that central heat and air covers the original portion of the house while an additional portion of the house, added thereafter is equipped with wall units and portable heating and air units all determined to be functioning properly at this time. As a result, there is not a preponderance of evidence to conclude facility is in disrepair currently, therefore this allegation is UNSUBSTANTIATED. Allegation: Administrator is not present. LPA conducted interviews, observations, and record reviews as noted above. Based on interviews, it was determined that Administrator is observed to be on-site at least 20 hours per week and address resident concerns upon requests. An observation conducted by LPA determined Administrator presence and availability to resident needs. A review of staffing schedule revealed regular Administrator hours and availability between 9am to 5pm Monday thru Friday and additional hours as needed Saturday and Sunday 11am to 4pm. As a result, there is not a preponderance of evidence to conclude that Administrator is not present and available for facility and resident needs. As a result, this allegation is UNSUBSTANTIATED. A finding of unsubstantiated means the allegation may have happened or is valid, but there is not a preponderance of the evidence to prove that the alleged violation occurred. An exit interview was conducted with Administrator and a copy of this report was provided to Administrator. Appeal rights provided.the state’s words, verbatim · CDSS document, Dec 11, 2024 · control 27-AS-20241106095508

Type of visit: Case Management - Incident

On 11/7/2024 at 10:24am, Licensing Program Analyst (LPA) Michael Bilger arrived unannounced to conduct a case management visit regarding a resident to resident altercation. LPA met with Administrator Jagtar Singh and explained the purpose of the visit. LPA also reviewed incident report dated 10-27-24 and conducted a brief interview with Administrator and staff2 (S2). LPA also reviewed physician's reports and needs and services plans for resident1 (R1) and R2. Based on interview and record reviews, on 10-27-24, staff1 (S1) heard screaming within the facility and observed R1 pinching and clawing at R2's face. S1 intervened in an attempt to separate both residents and maintained close proximity to prevent further escalation. Another resident (R3) contacted 911 during the event. While waiting for 911 personnel to arrive R1 engaged in self injury type behavior which consisted of banging her head and face on a table. S1 maintained intervention in attempt to prevent any injury. 911 personnel arrived and took both R1 and R2 to the hospital. R1 and R2 have since returned to the facility with no injuries. The altercation, according to incident report originated over an argument regarding a certain personal item belonging to R1. Administrator has made an appointment for R1 to be evaluated by Psychiatrist. The incident was also reported to licensing department and Ombudsman within regulatory time frames. No citations issued today as a result of this case management. An exit interview was conducted with Celia Nunez as Administrator left premises for a pre-arranged appointment.the state’s words, verbatim · CDSS document, Nov 7, 2024

Allegation investigated: Staff did not keep the facility free from mold

On 9-10-24 at 10:27am, Licensing Program Analyst (LPA) Michael Bilger arrived unannounced to open and investigate the complaint allegation noted above. LPA met with lead caregiver Cecilia Nunez and explained the purpose of the visit. Administrator Jagtar Singh was made aware of LPA visit and purpose via phone and gave permission for lead caregiver to sign in his absence. During this investigation, LPA conducted facility tour including resident bedrooms, bathrooms, common areas, kitchen and outside of facility. LPA also conducted interviews with two staff members and one resident in care. Additionally, LPA reviewed resources related to mold. Interviews and observations revealed no current musky or other odors commonly associated with mold. Observations did not reveal substances appearing to fit description of mold including any wet, slimy, or greenish substances or spots. As a result, there is not a preponderance of evidence to conclude this facility currently contains mold. As a result this allegation is UNSUBSTANTIATED. {Cont. on 9099C} Unsubstantiated A finding of unsubstantiated means the allegation may have happened or is valid, but there is not a preponderance of the evidence to prove that the alleged violation occurred. An exit interview was conducted with lead caregiver and a copy of this report was provided. Appeal rights provided.the state’s words, verbatim · CDSS document, Sep 10, 2024 · control 27-AS-20240909175501

Allegation investigated: Staff did not prevent resident from eloping Licensee did not provide responsible party with a refund

On 8-16-24 at 10:27am, Licensing Program Analyst (LPA) Michael Bilger arrived unannounced to open and investigate the complaint allegations noted above. LPA met with Cecilia Nunez (S1) and explained the purpose of the visit. LPA spoke with Administrator Jagtar Singh via phone and explained the purpose of the visit. During this investigation, LPA conducted interviews with Administrator, staff1 (S1) and additional witness. LPA also reviewed facility file documentation including resident appraisal, physician's report, and admission agreement for resident1 (R1). Allegation: Staff did not prevent resident from eloping. LPA conducted interviews and record reviews as noted above. Based on interviews and record reviews, it was determined that R1 admitted to facility on 8-7-24 after admission agreement signed on same day. R1 arrived via non-emergency transport and entered the facility. Shortly thereafter, R1 exited facility but remained on grounds and seated self outside near facility entrance. Interviews further revealed that R1 was supervised by staff throughout the evening on 8-7-24 providing food and blankets. {Cont. on 9099C} Unfounded On this same evening, Administrator determined R1 required further evaluation due to increased confusion and notified emergency personnel who arrived and transported R1 to hospital. A review of R1's physician's report does not indicate a history of wandering or elopement behavior. Based on interviews and record reviews, it was determined that R1 did not elope from facility, therefore, the preponderance of evidence standard is not met and this allegation is UNFOUNDED. Allegation: Licensee did not provide responsible party with a refund. LPA conducted interviews and record reviews as stated above. Based on admission agreement, R1's responsible party signed the agreement on 8-7-24 coinciding with the date of R1's admission date. Based on interviews, R1 was sent to the hospital on 8-7-24 shortly after admission for a re-evaluation due to behaviors. Licensee and staff provided supervisory services and meals to R1 during his stay. A review of R1's physician's report does not indicate a history of wandering or elopement behavior. Interviews further revealed that although Licensee is willing to accept R1 back pending stabilization, hospital staff and R1's responsible party have opted for placement elsewhere at this time. Interviews and record reviews revealed R1 did not furnish a 30-day notice to move at this time. As a result, there is not a preponderance of evidence to conclude Licensee is entitled to issue a refund to R1, therefore, this allegation is UNFOUNDED. An exit interview was conducted with S1 and a copy of this report was provided to R1.the state’s words, verbatim · CDSS document, Aug 16, 2024 · control 27-AS-20240814161949

Type of visit: Post Licensing

On 6-7-2024 at 10:00am, Licensing Program Analyst (LPA) Michael Bilger arrived at this facility unannounced to conduct a post licensing inspection visit. LPA met with the Lead Caregiver Cecilia Nunez and explained the purpose of the visit. Administrator Jagtar Singh was notified by phone and made aware of the purpose of the visit. LPA inspected the physical plant including but not limited to the kitchen, dining room, resident bedrooms; resident bathrooms, laundry room, living area, common TV area, and outside of the facility to ensure compliance with Title 22 regulations. Facility is a residential care facility for the elderly (RCFE) with a current census of 10. Facility has 6 bedrooms and 3 bathrooms for resident use. 1 extra bedroom and 1 extra bathroom is for staff use. Facility also has a separate cottage with 3 bedrooms and 1 bathroom for resident use. Facility has a dining area off the kitchen and a formal living room. LPA also conducted the inspection using the CARE tool. Facility currently provides care for 5 ambulatory residents, 5 non ambulatory residents, 0 hospice, and 0 bedridden. The facility has an approved infection control plan in place. Water temperature reads 105*F to 120*F in the bathroom and room temperature reads 77*F. LPA observed the facility to have adequate food supply. Resident rooms were sanitary and had the required furniture and furnishings. The facility common areas were clean and furnished. Smoke and carbon detectors were in good repair. Fire extinguishers are current and fully charged. Facility has an emergency food and water kit. All toxins and other dangerous items including sharp objects were locked and inaccessible to residents in care. Medication storage area was observed to be locked and inaccessible to residents in care. First aid kit was observed to have adequate supplies and accessible to staff. During this inspection 5 resident files and 4 staffing files were reviewed for regulatory compliance. One of six resident files did not contain a physician's report since admission in April 2024. Five of six resident files did not contain updated reappraisals and evidence of compliance with Section 87463(c). {Cont. 809C} All staff noted on LIC 500 contained criminal background clearances. Facility’'s liability insurance is current and up to date. Facility does not contain any bodies of water. LPA observed personal rights and complaint information posted. Facility has appropriate internet access available for resident use. Facility conducts monthly fire drills. LPA requested an updated copy of LIC 308 and LIC 500 by 6-14-24. Per California Code of Regulations, Title 22, deficiencies were observed during this visit and noted on LIC 809D. Exit interview was held and a report was given to Cecilia Nunez. Appeal rights provided. LIC 811 provided for reference use.the state’s words, verbatim · CDSS document, Jun 7, 2024

Type of visit: Prelicensing

Licensing Program Analyst (LPA) Michael Bilger, conducted a Pre-licensing visit on 3/20/2024 with current facility Administrator and applicant Jagtar Singh. LPA arrived at facility at 1:55pm. Licensee accompanied LPA on facility tour. Facility is currently licensed and seeking a change of ownership as a Residential Care Facility for the Elderly (RCFE). Fire Marshall was also present during today's visit and accompanied LPA. As of today, current census is 11 residents of which 0 are Hospice, 9 are ambulatory, 2 are non ambulatory, and 0 are bedridden. The facility is a 15 bed, 4 bathroom house with a living room, dining area off the kitchen, and laundry room. There is a separate cottage on the property with 3 bedrooms and 1 bath room. Residents have access to all areas of facility except basement area which is secured and locked. Five of five staff were observed with criminal record clearance and associated to facility. LPA observed complaint poster and resident rights posted. LPA toured the facility. Residents were observed in the living rooms and bedrooms. All rooms contained required furniture and furnishings. LPA measured the hot water to be within regulatory range of 105 *F and 120 *F. LPA observed kitchen knives and other sharp objects and toxins to be locked and secured. Observed kitchen was in good condition with properly stored perishable and non perishable foods. LPA observed 2 days of perishable and 7 days of non-perishable food items. Separate cottage area was toured. Currently 4 residents reside in separate cottage. All areas of facility including separate cottage were observed to be clean and sanitary with no foul odors noted. Fire Marshall on-site updated fire clearance and facility sketch to state 8 ambulatory residents and 7 non-ambulatory residents allowed. Linen closet, located in the hallway, was observed to contain a sufficient supply of towels and linens able to meet the needs of the residents at this time.A tour of the exterior grounds was conducted. A review of the facility perimeter fence, side gates, and walkways were observed to be maintained in compliance at this time with adequate lighting and rails installed. LPA observed medications locked and properly stored. LPA observed no obstruction of emergency exits. Exit signs in place as appropriate. Fire extinguisher in place in hallway and fully charged. No deficiencies observed during today's visit. A copy of this report was provided to Jagtar Singh.the state’s words, verbatim · CDSS document, Mar 20, 2024

Type of visit: Office

Facility Type: Residential Care Facility for the Elderly Application Type: Change of Ownership Capacity: 15 Census (if any clients in care): 11 COMP II Participants: Jagtar Singh Interview Method: Telephone interview On January 25, 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 the understanding of the California Code Title 22 Regulations. 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. Restricted/Prohibited Health Conditions 5. General provisions 6. Emergency Preparedness 7. Complaints & Reporting 8. Pre-licensing readinessthe state’s words, verbatim · CDSS document, Jan 25, 2024