Hershey Senior Care

Type of visit: Post Licensing

Licensing Program Analyst (LPA) Cuadra arrive unannounced for the purpose of conducting Post-Licensing inspection visit and met with Administrator/Licensee Pjoebe Mungai. The facility has a dementia care plan and hospice waiver for two residents. There is one resident receiving hospice services. Required postings observed. The facility received a fire clearance approval on 12/18/2025 by the Santa Rosa Fire Department for total capacity of six (6) residents which five (5) may be non-ambulatory residents in single occupancy rooms #1, #3, #4, #5 and #6; Room #2 is single occupancy and cleared as a bedridden room. LPA/Administrator toured the facility inside and outside. Facility is a one story building, with a total of six bedrooms, two full bathrooms, small bathroom, office/launch room, laundry area located in the garage, kitchen, dining room, living room as common areas an outside sitting and garden area available for residents' use. The facility was inspected and found to be clean and in good repair at the time of the inspection with all exits free from obstruction. Fire Extinguishers were charged and serviced as of December 2025. All auditory alarms, Smoke detectors and carbon monoxide detectors were tested and found to be operational at the time of the inspection. Hot water temperature measured at 105.2 degrees in resident's bathrooms which is not within regulation. Resident records, personnel records, medication and toxins were locked and inaccessible to resident's in care. Facility has first aid kit which was found to be appropriate during the Post-Licensing inspection. There is outdoor space for activities. Continued on LIC809C... Continued from LIC809... All resident’s bedrooms have lighting & appropriate furnishings, and resident’s beds were outfitted with mattress pads as required by Title 22 Regulations. The Licensee stated that they have not conducted a fire drill as of today yet because there are no staff (technical advisory). LPA observed a 2 day supply of perishable and 7 day supply of non-perishable food. Refrigerated food was found to be stored in a safe manner being labeled and dated. File review initiated at 9:30am. One staff file and two resident's file was reviewed. Resident has medical assessment and care plan on file. Staff have required CPR/1st aid certificate and initial training 40 hours complete. During Pre-licensing, Licensee agreed that they need to include the use of surveillance cameras in common areas outside to their admission agreement to make residents and their responsible parties aware of their use without audio. However, after conducting file review LPA/Licensee observed that it wasn't included into current lease agreements on file. Licensee agreed to update lease agreements (technical violation issued). Administrator certificate for administrator Phoebe Mungai #7030487740 expires on 2/9/2027. Contact information reviewed. Medication and medication records reviewed. The Licensee agreed to submit updated copies of the following documents by 06/18/2026: LIC500- Personnel Report, LIC308- Designation of Responsibility and liability insurance. No deficiencies were cited during this Post-Licensing inspection. Exit interview was conducted with Licensee, and a copy of this report was given.the state’s words, verbatim · CDSS document, Jun 4, 2026

The state marks this report as 5 pages; the online copy we transcribed has 3. You can request the full file from the county licensing office.

Type of visit: Prelicensing

Licensing Program Analyst (LPA) Cuadra arrived announced to conduct a Pre-licensing Subsequent Facility Inspection and met with Applicant Phoebe Mungai. A pre-licensing inspection was completed on 03/19/2026. Today, component III was completed. During today’s visit LPA observed the following items: Proof of hot tub in master bathroom is locked and secured. Garbage cans have tight fitting covers. Proof of grab bars in the master bathroom and small bathroom located in the hallway next to the garage. Proof of removal of debris in the backyard. Bedroom #3 has a regular bed. Applicant has satisfied all requirements in accordance with Title 22, California Code of Regulation. LPA will notify Application Unit Pre-licensing inspection is complete to proceed with the process of license. Pre-Licensing items needed to be repaired have been resolved. Pre-Licensing is now complete. No deficiencies cited at today’s inspection. Exit interview conducted with Applicant and a copy of this report was given.the state’s words, verbatim · CDSS document, Mar 23, 2026

Type of visit: Prelicensing

Licensing Program Analyst (LPA) Cuadra arrived announced to conduct a pre-licensing inspection and was greeted by Applicant, Phoebe Mungai. Facility currently does not have residents in care. Once obtained, Applicant will submit proof of required liability insurance. The facility has submitted a dementia care plan. Applicant stated that they have applied for a hospice waiver for two residents, but LPA reviewed documentation provided by the Centralized Application Unit (CAB) and there was no hospice waiver on file. LPA will follow up with CAB Analyst to clarify if the facility does have a hospice waiver on file. The facility received a fire clearance approval on 12/18/2025 by the Santa Rosa Fire Department for total capacity of six (6) residents which five (5) may be non-ambulatory residents in single occupancy rooms #1, #3, #4, #5 and #6; Room #2 is single occupancy and cleared as a bedridden room. LPA/Applicant toured the building and grounds. The facility consists of a single story residence with a total of six bedrooms, two full bathrooms, small bathroom, office/launch room, laundry area located in the garage, kitchen, dining room, living room as common areas an outside sitting and garden area available for residents' use. All residents rooms are connecting to facility dinning room, living room and kitchen area through self unlock closing doors. Room #2 allows access to the backyard and the outside of the home; Room #3 allows exit to the outside of the home and they have auditory alarms installed at the doors that were found operational during the visit. Each room has an alert pendant that it was found operational. The facility was found to be consistent with facility sketch, and at a comfortable temperature. However, Master bathroom houses a hot tub that needs to be locked and secured. This tub will not be used for residents at this time. Also, the applicant will install grab bars in the master bathroom and small bathroom located in the hallway next to the garage. Bathroom located in the hallway will be designated for resident's use for showers, it has grab bars and skid mats available. Continues on LIC809C... Continued from LIC809... All rooms and common area had sufficient lighting, including hallways. The smoke alarms are hardwired and observed operational during inspection. Carbon Monoxide Detector observed and functioning. Indoor and outdoor passageways are free of obstructions and is enough to permit residents with a diagnosis of dementia wander freely and safely. Window screens are clean and in good repair. All resident rooms are furnished per regulation with bed, lamp, bedside table, dressers and chairs. Garage houses gardening tools storage, incontinence care supplies and emergency supply of water. Cleaning supplies will be stored in a cabinet located in the garage, and locked cabinet located under kitchen sink. Sufficient supply of linens and hygiene products observed in linen closet located in the hallway. Kitchen cabinet has locks installed for knives to be inaccessible to residents in care. Locked centralized medication, confidential file storage of personnel and residents records cabinet is located in the kitchen including first aid kit. First aid kit present with all required items. Garbage cans needs to have tight fitting covers, there are sufficient amount of dishes, utensils, cooking pots, etc. Activity calendar and supplies as well as sample of menu was observed. Water temperatures read at: 113 and 113.4 degrees F which is within 105-120 F degrees regulation. Fire extinguishers serviced on December 2025. The Applicant disclosed that there is a camera included in the ring bell system and outside in the backyard, Applicant agreed that they need to include the use of surveillance cameras in common areas outside to their admission agreement to make residents and their responsible parties aware of their use without audio. The facility has a current lease agreement on file. Administrator certificate for administrator Phoebe Mungai #7030487740 expires on 2/9/2027. Contact information reviewed. LPA observed all required postings including the CCL Complaint Poster, Long Term Care Ombudsman Poster, Resident's Rights, and the rights to Resident and Family Councils. Applicant agrees to submit the following items for LPA review: Proof of hot tub in master bathroom is locked and secured. Garbage cans needs to have tight fitting covers. Proof of grab bars in the master bathroom and small bathroom located in the hallway next to the garage. Proof of removal of debris in the backyard. Bedroom #3 needs a regular bed instead of half rail bed currently in room. LPA will conduct inspection after above items are submitted to confirm complete. After confirmed LPA will notify Application Unit pre-licensing inspection is complete and to proceed with licensure. Exit interview conducted with Applicant and a copy of this report was given.the state’s words, verbatim · CDSS document, Mar 19, 2026