Integral Residence Care

Type of visit: Required - 1 Year

At approximately 9:40 AM, Licensing Program Analyst (LPA) Magdaleno arrived unannounced to conduct a required 1-year annual inspection and was greeted by staff. Administrator Jean Rice arrived at approximately 10:00 AM. Facility is a Residential Care Facility for the Elderly (RCFE) with six (6) residents in care. Facility has a Dementia Care Plan, a Hospice waiver for two (2), with two (2) Hospice residents currently in care, and is approved for all non-ambulatory residents. At approximately 10:10 AM, LPA initiated a tour of the facility with Administrator and observed the following: Facility is a one (1) story home, was a comfortable temperature, and passageways were free from obstructions. Fire extinguishers were last inspected 12/25. Smoke and Carbon Monoxide detectors were tested and operation during inspection. Water temperature measured 105.2 degrees F, which is within the allowable range of 105 to 120 degrees F per Title 22 regulations. LPA observed a supply of clean linens, hygiene, incontinent care, and paper products available for residents. Residents' bedrooms were inspected and all the appropriate furnishings as outlined in Title 22 regulations are available. Cabinets containing cleaning supplies and other items that could pose a risk were locked. LPA observed at least a two (2) day supply of perishable and seven (7) day supply of non-perishable food, as well as an emergency water supply. Food was found to be stored in a safe manner with open items covered. There is a shaded seating area in the backyard with outdoor space for activities. LPA observed one (1) locked sheds in the backyard which is used as an additional staff room. Facility has an internet access device and internet available to residents in care, and the phone was observed operational during today's inspection. Continued LIC809C... Continued from LIC809... Facility conducts disaster drills every two (2) months, and the most recent drill was conducted 11/25. LPA observed emergency disaster plan which was last updated 9/25. LPA observed a supply of PPE, emergency supplies, a first aid kit, and flashlights. At approximately 10:30 AM LPA conducted review of three (3) staff records. All required documentation present. At approximately 10:50 AM LPA conducted a review of three (3) resident records. All required documentation present. At approximately 11:10 AM LPA and Administrator conducted a spot check of medication and medication records. Medication is centrally stored and locked. Jean Rice Administrator Certificate 7006023740 expires 10/1/2026. Updated copies of the following documents were gathered during this visit: LIC308 - Designation of Responsibility LIC500 - Personnel Report LIC610E - Emergency Disaster Plan No deficiencies cited. Exit interview conducted with Administrator, whose signature on form confirms receipt.the state’s words, verbatim · CDSS document, Dec 22, 2025

Type of visit: Post Licensing

At approximately 9:50 AM, Licensing Program Analyst (LPA) Elias Magdaleno arrived unannounced to conduct a post-licensing visit and was greeted by Caregiver. Jean Rice, Administrator arrived shortly after. Facility is a Residential Care Facility for the Elderly (RCFE) with six (6) residents in care. Facility has a Dementia Care Plan, a Hospice waiver for two (2), with one (1) Hospice residents currently in care, and is approved for all non-ambulatory residents. At approximately 10:15 AM LPA and Administrator toured the building and grounds which were found to be clean and in good repair. LPA observed all walkways and exits to be unobstructed. All notices that are required to be posted have been posted and are in a highly visible area. LPA observed at least a two (2) day supply of perishable and seven (7) day supply of non-perishable food, as well as an emergency water supply. Food was found to be stored in a safe manner with open items covered. Cabinets containing cleaning supplies and other items that could pose a risk were locked. Water temperature measured 108.5 degrees F, which is within title 22 regulations of 105 and 120 degrees F at faucets accessible to residents. Fire extinguishers were last inspected 6/24. There was enough lighting in all common areas, resident rooms, and hallways. Facility has an internet access device designated for resident use and internet service available. Facility telephone was tested and operational during inspection. There is a shaded seating area in the backyard with outdoor space for activities. LPA observed one (1) locked shed in backyard which is used as a staff room. LPA observed a supply of PPE, emergency supplies, a first aid kit, and flashlights. Emergency disaster plan last updated 7/2024. Continued 809C... At approximately 11:00 AM LPA conducted a review of two (2) resident records. All required documentation present. At approximately 11:20 AM LPA conducted review of two (2) staff records. All required documentation present. Medication is centrally stored and locked. Jean Rice Administrator Certificate 7006023740 expires 10/1/2026. All fees are current as of this time. Updated copies of the following documents were collected this visit: LIC308 - Designation of Responsibility Admission Agreement LIC500 - Personnel Report LIC610D - Emergency Disaster Plan Updated copies of the following documents shall be submitted to CCL within 30 days of this visit: Control of Property Job Descriptions/Personnel Policies Theft and Loss policy Transportation Policy No deficiencies cited. Exit interview conducted with Administrator, whose signature on form confirms receipt.the state’s words, verbatim · CDSS document, May 6, 2025

Type of visit: Prelicensing

Licensing Program Analyst (LPA) Araceli Canela arrived unannounced to conduct a Pre-Licensing Inspection regarding a change of ownership application & met with Applicant/Administrator, Nino Flores & Administrator, Jean Rice. The home has an approved fire clearance by the Vallejo Fire department on 10/15, 2024 for six (6) non-ambulatory residents, of which one may be bedridden. Home has an approved Hospice waiver for 2 of the residents. This home is a one story residence with three resident bedrooms, 2 bathroom, living room, dining room, kitchen area and the garage. There is an approved staff bedroom in the home and the fire department approved an additional staff bedroom in the outside. LPA will request update and changes to the facility outside sketch to reflect staff bedroom approval that was noted on a follow up visit/fire inspection on 10/28/2024. Resident rooms have the required furnishings in resident bedrooms. Bathroom showers have non-skid shower floors/mats and grab bars. Water temperature in bathrooms is within regulation of 105 & 120 degrees F. Home has sufficient items used for cooking and eating. Cleaning supplies and sharps are locked in kitchen cabinets. Personnel records, resident records and medications are stored in locked cabinet. Auditory alarms on doors were operational. Carbon monoxide and smoke alarms are operational. Fire extinguisher is charged and service 6/17/2024. LPA reviewed staff & resident files and found complete and organized. Required postings were observed. Administrator certificate for Jean Rice #7006023740 exp 10/1/2026. Applicant explained they have the liability insurance ready to be issued by INSUREMYRCFE. Applicant to submit copy of Liability Insurance to Centralized Applications Bureau Analyst or LPA Canela. Applicant has satisfied all requirements in accordance with Title 22, California Code of Regulation. Component III was conducted today, with Applicant, Nino Flores and Administrator, Jean Rice. Pre-Licensing is complete. No citations issued.the state’s words, verbatim · CDSS document, Feb 24, 2025

Type of visit: Office

Facility Type: RCFE Application Type: CHOW Capacity: 6 Census (if any clients in care): 6 COMP II Participants: Nino D Flores; Jean Rice - Licensee; Administrator Interview Method: Telephone interview On 01/30/2025, 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, Jan 30, 2025