Sonoma County Care Home

Type of visit: Required - 1 Year

At approximately 9:00 AM, Licensing Program Analyst (LPA) Robert Frank arrived unannounced to conduct a Required 1 Year Visit. Administrator Luke Ensign arrived at approximately 10:00 AM. Sonoma County Care Home is Licensed as a Residential Care Facility for the Elderly (RCFE). The facility is a large single story ranch house. The facility has an approved fire clearance for fifteen (15) non-ambulatory residents. The facility has a Hospice Waiver for three (3) residents. Upon arrival, LPA was informed that there were twelve (12) residents in care and two (2) staff members on-site. LPA reviewed the Facility's Staff Roster and found that all staff on-site were background cleared and associated to the facility per regulation. At approximately 9:35 AM, LPA toured the facility. All exits were clear and unobstructed. The facility's two (2) fire extinguishers were last serviced and tagged on 4/16/2026. The fire alarm system was inspected and cleared in 1/2026. The facility was sufficiently lighted. LPA inspected eight (8) resident bedrooms and found all to have sufficient lighting and furnishings as required per Title 22 Regulations. There was a sufficient supply of both perishable and nonperishable foods as required by Title 22 Regulations. There was an appropriate supply of cleaning products, linens, hygiene products and paper products available for residents. Toxins were observed unsecured in the shower room, kitchen, bathroom in room #9 and the bathroom between rooms #10 & #11. This deficiency will be cited. The facility has an infection control plan as required. The facility does have emergency food and supplies to meet the "72 hour shelter in place" requirements. Facility smoke detectors and carbon monoxide detectors were observed to be operational. Continued on 809-C... ...Continued from 809 At approximately 11:00 AM, LPA reviewed six (6) resident files. Five (5) of six (6) resident files (for residents R1, R2, R3, R4 and R5) were observed not to have LIC 603 Preplacement Appraisal Forms. One (1) of six (6) residents LIC 602A Physician's Report (for resident R3) was observed to have their ambulatory status marked as Bedridden. The Facility is not currently licensed to accept Bedridden residents. These deficiencies will be cited. LPA unable to complete Annual Inspection. Annual Continuation Visit to be conducted at a later date. Deficiencies are cited from the California Code of Regulations (CCRs), and/or the Health and Safety Code. Failure to correct the cited deficiency, on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment. Exit interview conducted. Copy of report, LIC-809Ds, Plan of Corrections, 811 Confidential Names and Appeal Rights discussed and provided to Administrator Ensign. Signature on form confirms receipt of documents.the state’s words, verbatim · CDSS document, May 20, 2026

The state marks this report as 13 pages; the online copy we transcribed has 5. You can request the full file from the county licensing office.

Type of visit: Post Licensing

At approximately 1:15 PM, Licensing Program Analyst (LPA) Robert Frank arrived unannounced to conduct a Required Post Licensing Visit. Sonoma County Care Home is Licensed as a Residential Care Facility for the Elderly (RCFE). The facility is a single story ranch house. The facility has an approved fire clearance for fifteen (15) non-ambulatory residents. The facility has a Hospice Waiver for three (3) residents. Upon arrival, LPA was informed that there were six (6) residents in care and two (2) staff members on-site. LPA reviewed the Facility's Staff Roster and found that all staff on-site were background cleared and associated to the facility per regulation. LPA toured the facility with Administrator Ensign. All exits were clear and unobstructed. Facility has multiple fire extinguishers, which are brand new and fully charged Facility fire alarm and sprinkler system were certified operational as of 2/21/2025. Food supply was sufficient. The facility was sufficiently lighted. LPA inspected seven (7) resident bedrooms and found all to have sufficient lighting and furnishings as required per Title 22 Regulations. There was a sufficient supply of both perishable and nonperishable foods as required by Title 22 Regulations. There was an appropriate supply of cleaning products, linens, hygiene products and paper products available for residents. Toxins were observed to be stored inaccessible to residents. Facility has an infection control plan as required. The facility has a required emergency disaster plan. The facility will be conducting fire and emergency drills quarterly. The facility does have emergency food and supplies to meet the "72 hour shelter in place" requirements. Hot water temperatures for all sinks in facility were found to be within Title 22 regulations of 105 to 120 degrees Fahrenheit. Continued on 809-C... ...Continued from 809 LPA reviewed three (3) resident files. Three (3) of three (3) resident files were found to be well organized and thorough with all required documentation. LPA reviewed three (3) staff files. All staff files were observed to be well organized with all required documentation including First Aid and CPR certification. LPA spot checked Medication for two (2) residents. LPA observed all medications to be centrally stored and secure. The facility does not handle resident’s monies for personal and incidental items. Jonathan Ensign’s Administrator Certification 6069070740 is current with an expiration date of 5/7/2027. LPA requested the following documents be submitted to Community Care Licensing by 12/7/2025: LIC 500 Personnel Report LIC 308 Designation of Responsibility The facility is in compliance. No deficiencies cited during today's visit. Exit interview conducted. Copy of report discussed and provided to Administrator Ensign. Signature on form confirms receipt of documents.the state’s words, verbatim · CDSS document, Nov 6, 2025

The state marks this report as 6 pages; the online copy we transcribed has 3. You can request the full file from the county licensing office.

Type of visit: Prelicensing

At approximately 8:40 AM, Licensing Program Analyst (LPA) Robert Frank arrived for a scheduled visit to conduct a pre-licensing inspection and was greeted by Licensee/Applicant/Administrator, Jonathan Luke Ensign. This pre-licensing inspection is being conducted for an initial licensing of a Residential Care Facility for the Elderly (RCFE). Fire Clearance has been approved for fifteen (15) non-ambulatory residents. All bedrooms are approved for non-ambulatory use. Applicant was not approved for bedridden residents by the local fire department. Facility has a dementia care plan. At approximately 9:10 AM, LPA initiated a tour of the facility and observed the following: Facility is a one story home, was a comfortable temperature, and passageways were free from obstructions. Water temperature in residents' bathrooms measured within the allowable range of 105 to 120 degrees F per Title 22 regulations. Applicant had non-slip mats and grab bars in place. LPA observed a supply of clean linens, hygiene products, and paper products available for residents. Residents' bedrooms have all the appropriate furnishings as outlined in Title 22 regulations. LPA observed dishes and cooking supplies for resident use with sharps and other hazardous items kept secured in various designated drawers and cabinets as well as under the kitchen sink. Cabinets in communal areas of the facility containing cleaning supplies and other items that could pose a risk were observed locked. Applicant agrees to keep magnets and keys to these locked areas in facility safe secured and inaccessible to residents in care. Licensee agrees to maintain at least two days of perishable foods and and one week of non-perishable foods and an emergency water supply. The required posters were observed hanging in the facility Dining area and licensee/applicant has purchased a long-term care ombudsman poster which will be hung on the wall prior to resident occupancy. Continued on 809-C... Applicant was advised to post a copy of their admissions agreement and emergency disaster plan in common area of the facility. The facility currently has the Applicant associated to facility in Guardian and will hire an additional staff members once license is approved. Applicant has been informed of association and staff transfer process. Applicant will provide an ipad/computer for residents to use. Facility currently has a cell phone as the facility phone. Applicant is going to add a land line prior to resident occupancy Facility has a designated locked cabinet for centrally stored medications. LPA observed a first aid kit and other emergency supplies. LPA recommended that Applicant add additional, age appropriate activities for elderly residents. Facility has multiple fire extinguishers, which are brand new and fully charged. Smoke and Carbon Monoxide detectors were tested and operational during inspection. Facility fire alarm and sprinkler system were certified operational as of 2/21/2025. The backyard features a shaded patio area for resident use. Windows, screens, and blinds were all observed in good repair. Applicant will submit proof of liability insurance once facility has been licensed . LPA observed a facility sketch which accurately reflects the floor plan. Prior to admitting residents, applicant will: remove construction items from driveway; provide locked cabinet for resident and staff records; purchase night lights for hallways; provide curtains and or window shades for bedrooms and add a gate to step down area next to ramp near kitchen. LPA and Licensee discussed the following items: ·Hospice Waiver - Applicant to apply for a waiver if it's decided they want hospice care in the facility. Requirements for a Hospice Waiver and a Hospice instruction along with copies of 87632 Hospice Care Waiver & 87633 Hospice Care of Terminally Ill Residents regulation were provided to Licensee applicant. Guardian background clearances and associations Updated Dementia regulations Component III orientation was conducted at facility with Jonathan Ensign. Continued on 809-C2... ...Continued from 809-C Jonathan Ensign’s Administrator Certification 6069070740 is current with an expiration date of 5/7/2027. No Deficiencies or Advisories given during visit. Pre-Licensing completed. Facility is ready to be Licensed as a Residential Facility for the Elderly (RCFE). LPA will submit Pre-Licensing Application Report to the Application Unit Analyst in Sacramento. Application Unit Analyst will notify Applicant of Status. Exit interview conducted. Copy of report discussed and provided to Applicant/Administrator Ensign. Signature on form confirms receipt of document.the state’s words, verbatim · CDSS document, Jun 13, 2025