At Home Senior Care I

Type of visit: Required - 1 Year

On February 23, 2026, Licensing Program Analyst (LPA) Komal Curley conducted an unannounced annual inspection. LPA met with Administrator, Debbie Sazon and explained the purpose of the visit. LPA toured the facility inside and outside including all of resident rooms, common areas & kitchen. The indoor and outdoor passageway was free of obstruction. No accessible bodies of water of fire safety hazards observed. This is a single story facility. There are six resident bedrooms, all of which are private rooms. Resident bedrooms were observed to be clean with all required furniture. Two full bathrooms and one half bathroom were observed to be clean, odor-free and in good repair. LPA observed one staff room and one office room. Dining room was observed free from tripping hazards. A comfortable temperature is maintained and lighting is sufficient for comfort. LPA observed two day perishables and seven day non-perishables. Extra food supply was observed to be present. Medications, sharps, and chemicals were observed locked an inaccessible to clients in care. Carbon monoxide monitors are working properly. All fire extinguishers have been checked and current as of February 2026. Emergency drills are logged and done every three month. LPA reviewed 5 resident records and 5 staff records. Client records are updated, complete and signed. Staff records are complete, with training logs that have met the basic requirement. Medication review was done, and all medications are accounted for, and centrally stored medication records are updated. No citations are issued during the visit. Report is reviewed with Administrator and a copy is provided.the state’s words, verbatim · CDSS document, Feb 23, 2026

Type of visit: Required - 1 Year

On February 18, 2025, at 08:50 AM, the Licensing Program Analyst (LPA) Kiran Jain arrived unannounced at the facility to conduct a Required 1-Year Annual inspection. The LPA met with the Administrator, Debbie Sazon, and disclosed the purpose of the inspection. The Administrator informed the LPA that the facility had (5) residents in care and (2) staff members present at the time. At 9:13 AM, the LPA initiated a walk-through of the facility, accompanied by the Administrator. LPA inspected the kitchen and found it clean, with no food preparation and cooking in progress at the time. The appliances were checked and observed to be in working order. The LPA inspected a locked cabinet containing knives and sharp objects. The refrigerator and pantry cabinets were inspected, and sufficient supplies of fresh perishable food for (2) days and nonperishable staples for (7) days were observed. No expired food or stored medications were noted. LPA inspected the dining area adjacent to the kitchen and found it clean. The dining table and chairs were observed to accommodate the residents, and all the furniture was in good repair. LPA inspected the fire extinguisher mounted on the wall in the hallway next to kitchen and found it fully charged, with the last service tag dated 02/17/2025. The Administrator tested the smoke and carbon monoxide detector located in the kitchen area in the LPA's presence, and it was found to be functional. Additional smoke and carbon monoxide detectors were observed in all bedrooms and common areas of the facility during the visit. LPA inspected the living room and observed it clean, with all furniture in good repair. There were sofa sets, chairs, recliners, a bench, and a television in the living room. (3) residents were observed sitting and watching TV. Continued on LIC809-C There were (6) bedrooms and (3) bathrooms designated for residents' use. All (6) resident rooms were single occupancy. (2) bathrooms were common and (1) bathroom was private. LPA inspected all (6) resident rooms and found them clean, well-lit, and equipped with the required furniture. All exit doors were connected to centrally monitored system for notification. LPA inspected (3) full bathrooms and found them clean, sanitary, and in good working condition. The bathrooms contained soap, grab bars, paper towels, a trash can, a shower chair, and non-slip mats. At 9:41 AM, the hot water temperature at the sink faucet was measured 97.5°F in bathroom #1, 118.8°F in bathroom #2, and 128.3°F in bathroom #3. LPA inspected the (1) storage closet in the hallway and observed them contained clean linens, blankets, and towels for residents’ use. LPA inspected the garage and found it clean. Garage access door was locked and inaccessible to residents in care. A washer, a dryer, a refrigerator, a freezer containing additional food supplies, wheelchairs, detergents, disinfectants, cleaning supplies, and storage racks shelves with non-perishable food items, incontinence supplies, and paper products were observed. LPA toured the porch area and found ramps and passageways in good condition, clear of obstructions, with no blocking or tripping hazards. The porch had a table, chairs, and shaded areas for resident use. No bodies of water were noted. LPA reviewed (5) staff personnel records and (5) resident records. The LPA observed that 5 of 5 residents had an Admission Agreement, Physician's Report, Appraisal Needs and Services Plan, and CSDMR. LPA observed that 5 of 5 staff members had LIC 508 Criminal Record Statements and LIC 503 Health Screening and confirmed that 5 of 5 staff members were associated with the facility. At 10:42 AM, LPA observed a locked centrally stored medication cabinet inside the kitchen. Medications were organized in separate bins for each resident. Centrally Stored Medication Records were reviewed and found to be complete. 5 of 5 resident’s prescription medication labels were altered with the handwritten dates on them. LPA inspected the first aid kit and found it fully stocked. Emergency Drill Logs were reviewed, and it was observed that Emergency Disaster Drills were conducted quarterly, with the most recent drill completed on 02/17/2025. Continued on LIC809-C The following updated forms are requested to be submitted to CCLD by 02/25/2025: LIC 500: Personnel Report LIC 308: Designation of Facility Responsibility Certificate of Liability Insurance Administrator Certificate(s) The deficiencies are being cited based on LPA observations, records reviewed, and interviews conducted in accordance with the California Code of Regulations, Title 22, see LIC809D. An exit interview was conducted with the Administrator. A copy of this report was left with the Administrator, Debbie Sazon, whose signature on this form confirms receipt of the report.the state’s words, verbatim · CDSS document, Feb 18, 2025

The state marks this report as 6 pages; the online copy we transcribed has 4. You can request the full file from the county licensing office.

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Mita Partoza conducted an unannounced annual inspection at the facility. LPA met with administrator (ADM) Debbie Sazon and two staff. Current census 6 residents and 4 out 6 have neurocognitive disorder. During visit, LPA toured the facility to include the living room, dining room, kitchen, 7 bedrooms, including staff room and 6 resident's bedrooms. 3 bathrooms, garage, and backyard. The bathroom hot water temperature was measured at 113.4 degrees Fahrenheit to 120.2 degrees Fahrenheit. The kitchen water temperature is within range of 125 degree Fahrenheit. The room temperature in the facility ranges from 68 degree Fahrenheit to 75 degree Fahrenheit. LPA observed 2 days of perishable and 7 days non-perishable food supply as required by regulation. Toiletries such as toilet paper, paper towels, toothpaste are inspected and found to be in ample supply. Toxic materials such as laundry detergent, disinfectant are inaccessible to residents that are in a locked cabinet. Hallways have night lights and have ample lighting. LPA toured the facility and observed emergency exits and walkways are clear of obstruction and lawn is well maintained. continued on page 2 (LIC 809C) continued from page 1 of LIC 809 LPA tested the carbon monoxide and the smoke alarm and found them to be in good working condition. LPA randomly reviewed 3 resident's record (R1 to R3) R1 and R3 needs and appraisal plan is missing and R2 needs to be updated. LPA reviewed R1 to R3's centrally stored medication and destruction record (CSDMR) and found no discrepancy LPA randomly reviewed 3 staff record and observed that training are up to date, including the emergency disaster plan.. Deficiencies were cited per California Code of Regulations, Title 22 during today's visit. This report was reviewed with administrator Debbie Sazon. Page 2 of 2 End of reportthe state’s words, verbatim · CDSS document, Feb 13, 2024

The state marks this report as 7 pages; the online copy we transcribed has 3. You can request the full file from the county licensing office.