Davis Guest Home #8

Type of visit: Required - 1 Year

Licensing Program Analysts (LPA) Kesha Lewis arrived at this facility unannounced to conduct a Required 1 Year Annual Inspection Visit. LPA was met by administrator. LPA explained the purpose of the visit. LPA and administrator inspected the physical plant including but not limited to the kitchen, dining room, resident bedrooms; resident bathrooms, laundry area, living area and other common areas, as well as outside of the facility to ensure compliance with Title 22 regulations. Facility is a 80 bed facility with a current census of 77. There is entry door is leading to the living room, kitchen with a hallway to the bedrooms and bathrooms. Chemicals and medications noted to be locked to residents in care. No bodies of water were observed at the facility. Hot water temperature was measured at 105 F degrees Fahrenheit in resident bathroom sink, which is within the required range of 105 to 120 degrees Fahrenheit. LPA observed the following posted on the facility wall: Facility license, sketch, See Something Say Something poster, Ombudsman poster, Theft and Loss Policy, Resident Bill of Rights, Rights of Resident/Family Councils. LPA observed the facility to have adequate food supply of 7 days non-perishables and 2 days perishables in place. Resident rooms were sanitary and had the required furniture and furnishings. LPA observed, fire extinguishers inspected on 08/06/2026 and current, smoke and carbon monoxide detectors, central heating and air in the facility. The first aid kit was found in compliance. The facilities Ansel system was inspected on 08/06/2026 and is in compliance. LPA reviewed four (4) staff files. All staff is fingerprint cleared and associated to the facility and staff have current First Aid or CPR certifications on file. Facility is conducting initial and continuing training as required. LPA reviewed eight (8) resident facility files, All necessary documents were in place. Exit interview held with staff and copies of report was given.the state’s words, verbatim · CDSS document, Sep 23, 2026

Allegation investigated: Staff issued an eviction notice to the resident without providing a proper explanation

Licensing Program Analyst, LPA Noel wolf petersen, arrived unannounced to the facility to conduct complaint investigation. The LPA met with the administrator, Ariel Thomas to explain purpouse of vist. Record review of the recent eviction notices served. 1 of 1 notices served in the last three months has a date issued, a reasoning for the notice, and some specific reasonings of house rule 3, 5, and 13 not being followed. LPA notes there is not a signature from either the client or the conservator on the notice itself. Record review of The eviction reasonings have references in the the hygenine logs, and some personal anacdotes about langauge used against staff and peers and requireing exessive prompting to go to meal times in the progress notes. Interview with R1, reported that she was not served written notice at all and did not recive the reasoning or evidence specifically. Based on LPAs interviews which were conducted and record review(s), the preponderance of evidence standard has been met, therefore the above allegation(s) is found to be SUBSTANTIATED. California Code of Regulations,are being cited on the attached LIC 9099D. A copy of the report and appeal rights were left with the adminsitrator, exit interview was conducted. Substantiatedthe state’s words, verbatim · CDSS document, Aug 20, 2026 · control 27-AS-20260818152941

From the deficiency page — Deficiency type: Type B · Section cited: CCR 87224(a)(5) · Plan of correction due date: Aug 27, 2026

87224 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)Change of use of the facility. Not following this requirement is evidenced by: record review of the eviction notice not being signed by resident, interviews gave a concensus statement of the resident r1 not being provided with the writen notice of eviction which contained the reasoning and evidence. not following this requirement posed a risk to the personal rights of residents in care.the state’s words, verbatim · CDSS document, Aug 20, 2026

Plan of correction: LPA is reccomending the administrator read and send back a signed copy of 87224 Eviction Procedures. Reissue of the notice to evict was served 8/20/2026 in front of the LPA to the resident at 330.

Allegation investigated: Staff do not allow resident to possess personal belonging Staff did not provide a safe environment for resident

On 06/09/2026, Licensing Program Analysts (LPAs) Arielle Pascua and Sulma Lopez arrived unannounced to this facility to deliver complaint findings for the allegations above. LPAs met with Facility Designated Administrator (FDA), Ariel Thomas and explained the purpose of the visit. Current census was 78. A brief interview with FDA Thomas was conducted. Allegation: Staff do not allow resident to possess personal belongings. It was alleged that staff do not allow resident to possess personal belongings. During the course of this investigation, the department conducted interviews and reviewed facility records. Based on interviews conducted, it was determined that the facility confiscated a resident's cell phone due to the resident's failure to comply with established house rules. Further interviews revealed that the resident acknowledged retaining the cell phone beyond the agreed-upon time and using it in a manner that violated facility guidelines. The cell phone agreement and house rules were provided to both the resident and their conservator upon admission, and both agreed to these terms at that time. Unsubstantiated Additionally, interviews were conducted with three other residents, all of whom reported that they are permitted to retain personal belongings, including their cell phones. A review of the facility's house rules and cell phone agreement further confirmed that residents are allowed to keep their personal belongings, subject to compliance with established facility policies and agreements. Based on the information gathered, there is not sufficient evidence to prove that the staff do not allow resident to possess personal belongings. Allegation: Staff do not provide a safe environment for resident It was alleged that staff do not provide a safe environment for resident. During the course of this investigation, the department conducted interviews with facility staff and residents. Based on interviews conducted with facility staff, it was denied that any incident occurred between Resident 1 (R1) and Resident 2 (R2). Staff reported that R2 tends to keep to themselves and has not exhibited any issues with residents or staff within the facility. Staff further stated that R1 has approached R2 on occasion, alleging that R2 had harmed them; however, no such incidents have been observed or witnessed by facility staff.An interview with R2 was conducted, during which R2 denied having conversations or interactions with R1. Additionally, an interview with R1 was conducted, and R1 provided conflicting statements regarding the alleged incidents involving R2. Furthermore, interviews were conducted with five residents. All five residents denied that staff fail to provide a safe environment for residents in care. Based on the information gathered, the department cannot prove that staff do not provide a safe environment for the residents. As a result of this investigation, this Department found the allegations to be UNSUBSTANTIATED. A complaint allegation finding of Unsubstantiated meant that although the allegations may have happened or was valid, there was not a preponderance of the evidence to prove that the alleged violation occurred. There were no deficiencies observed or cited at this time. An exit interview was conducted, a copy of the 9099 and 9099-C was provided to the facility.the state’s words, verbatim · CDSS document, Jun 9, 2026 · control 27-AS-20260428161737

Allegation investigated: Staff did not do an inventory of a resident's personal belongings Staff did not keep facility free of insects Staff withheld resident's money

Licensing Program Analyst (LPA) Jason Lund arrived unannounced to complete a complaint investigation. LPA Lund met with Admistrator Ariel Thomas and explained the reason for the visit. Census: 80 Staff did not do an inventory of a resident's personal belongings- Based on records reviewed, staff interviewed, and interview with reporting party. The facility did initial Client/Resident Personal Property & Valuables with Resident (R1) on 3/11/2025. The facility did follow up Client/Resident Personal Property & Valuables with Resident checks on 4/16/20205 and 6/18/2025. R1 stated that no valuables were missing. Unsubstantiated Based on records reviewed, staff interviewed, and interview with reporting party the information provided, it was unclear if staff did not do an inventory of a resident's personal belongings therefore the allegation was deemed UNSUBSTANTIATED. Staff did not keep facility free of insects- Based on records reviewed, interviews with Staff, Reporting Party and Resident’s in care. LPA Lund observed the facility free on insects during visits on 8/15/2024, 9/17/2025, 12/1/2025 and 12/29/2025. The facility has Total Pest Management and does regulatory visits once a month. LPA Lund reviewed Total Pest Management invoices for 9/19/2025 and 10/22/2025. Staff interviewed stated that they have not seen insects inside the facility. Residents in care stated they have not seen insects inside of the facility. Based on records reviewed, interviewed Staff, Reporting Party and Resident’s in care on the information provided, it was unclear if staff did not keep facility free of insects therefore the allegation was deemed UNSUBSTANTIATED. Staff withheld resident's money- Based on records reviewed, interviews with Staff, Residents and Reporting Party. The resident facilities handbook states that residents in care have the opportunity to get access to P&I funds every morning at 9am. Residents in interviewed stated that they are allowed access to their P&I funds at that time. LPA Lund reviewed Resident (R1) P&I funds from 8/30/2025 through 12/1/2025 showing that R1 was withdrawing money on a daily basis. Based on records reviewed, interviews with Staff, Residents and Reporting Party the information provided, it was unclear if staff withheld resident's money therefore the allegation was deemed UNSUBSTANTIATED. The Department (CCLD) has found the allegations. Unsubstantiated. A finding that the complaint allegation(s) are UNSUBSTANTIATED means that although the allegation(s) may have happened or is valid, there is not a preponderance of the evidence to prove that the alleged violation(s) occurred. Exit interview was conducted with and report left.the state’s words, verbatim · CDSS document, Apr 13, 2026 · control 27-AS-20251124150722

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Jason Lund arrived unannounced to conduct an annual/required visit. LPA was met by Administrator Ariel Thomas and explained the purpose of the visit. Census:78 LPA Lund reviewed 8 residents files. 8 out of 8 resident files were current and up to date. LPA reviewed 5 staff files. 5 staff files were current and up to date. A tour/Inspection of the facility was conducted with Administrator Ariel Thomas & LPA Jason Lund. The facility has 3 separate wings that house residents who are in shared bedrooms at this time. A tour of the facility resident rooms was conducted. Resident furniture and furnishings were observed to be sufficient and able to meet the needs of the residents at this time. Resident restrooms were toured and observed to be able to meet the needs of the residents at this time. Hot water temperatures were taken and measured to make sure that they were within the allowed range of 105-120 degrees at this time. Medication carts were observed to be present. Policies and procedures were discussed with facility staff in terms of dispensing, documenting, and overall administration of resident medications. First aid kits were observed to be present and contained all of the necessary components at this time. Living area, dining area, and all other areas intended for resident use were toured and observed to be in compliance at this time. Fire extinguishers, located throughout this facility, were observed to have been annually inspected on 08/5/2025 by the local fire extinguisher company. Laundry rooms were toured. Chemicals, detergents, and bleaches were observed to be locked and made inaccessible to the residents at this time. The food supply was conducted to make sure that there was a sufficient amount of 2-day perishable and 7-day nonperishable quantities at all times. A commercial washer was also present in this area to wash and clean bedding for all facility residents. Additional cleaning supplies, detergents, and bleach were observed to be stored in this area as well.Exterior grounds of this facility were toured. A review of the facility perimeter fence, side gate, and exits was conducted. No deficiencies observed or cited during today's annual visit. An exit interview was conducted, and a copy of this report was provided.the state’s words, verbatim · CDSS document, Sep 17, 2025

Allegation investigated: Illegal eviction

Licensing Program Analyst (LPA) Jason Lund arrived unannounced to complete a complaint investigation. LPA Lund met with Administrator Misty Speegle and explained the reason for the visit. Census: 72 Illegal eviction- Based on records reviewed, staff interviewed, and attempted interviews with reporting party. On 5/20/2024 Clinet (C1) was aggressive towards staff swinging and punching at staff, due to C1’s behaviors C1 was sent out to the hospital. On 5/22 at 3:58pm facility management was having a meeting, during the meeting the facility called C1’s conservator who gave a verbal order for the bed to be discharged as of 5/20/24 when C1 went to the hospital. After the call, conservator order was executed at the facility. LPA Lund attempted to call and email the Tulare County conservator office and got no response. Unsubstantiated Based on records reviewed, staff interviewed, and attempted interviews with reporting party the information provided, it was unclear if there was an Illegal eviction therefore the allegation was deemed UNSUBSTANTIATED. The Department (CCLD) has found the allegations. Unsubstantiated. A finding that the complaint allegation(s) are UNSUBSTANTIATED means that although the allegation(s) may have happened or is valid, there is not a preponderance of the evidence to prove that the alleged violation(s) occurred. Exit interview was conducted with and report left.the state’s words, verbatim · CDSS document, Aug 15, 2024 · control 27-AS-20240523081721

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Jason Lund arrived unannounced to conduct an annual/required visit. LPA was met by Administrator Misty Speegle and explained the purpose of the visit. Census:72 This facility is licensed to serve and retain 80 residents who are 60 and over. Of which 12 may be non-ambulatory in rooms 15-20 only. Census 72 LPA Lund reviewed 7 residents files. 7 out of 7 resident files were current and up to date. LPA reviewed 7 staff files. 7 staff files were current and up to date. A tour/Inspection of the facility was conducted with Administrator Misty Speegle & LPA Jason Lund. The facility has 3 separate wings that house residents who are in shared bedrooms at this time. A tour of the facility resident rooms was conducted. Resident furniture and furnishings were observed to be sufficient and able to meet the needs of the residents at this time. Resident restrooms were toured and observed to be able to meet the needs of the residents at this time. Hot water temperatures were taken and measured to make sure that they were within the allowed range of 105-120 degrees at this time. Medication carts were observed to be present. Policies and procedures were discussed with facility staff in terms of dispensing, documenting, and overall administration of resident medications. First aid kits were observed to be present and contained all of the necessary components at this time. Policies and procedures were discussed in relation to narcotics and medications that required a separate count and documentation by incoming staff and outgoing staff. Living area, dining area, and all other areas intended for resident use were toured and observed to be in compliance at this time.Fire extinguishers, located throughout this facility, were observed to have been annually inspected on 08/1/2024 by the local fire extinguisher company, Jorgenson Co, and observed to be in compliance at this time. Laundry rooms were toured. Chemicals, detergents, and bleaches were observed to be locked and made inaccessible to the residents at this time. Kitchen area was toured. A review of the food supply was conducted to make sure that there was a sufficient amount of 2-day perishable and 7-day nonperishable quantities at all times. A commercial washer was also present in this area to wash and clean bedding for all facility residents. Additional cleaning supplies, detergents, and bleach were observed to be stored in this area as well. Exterior grounds of this facility were toured. A review of the facility perimeter fence, side gate, and exits was conducted. Based on the observations made during this visit, there were no deficiencies observed or cited during today's annual visit. An exit interview was conducted, and a copy of this report was provided.the state’s words, verbatim · CDSS document, Aug 15, 2024

Type of visit: Case Management - Other

Licensing Program Analyst (LPA) Jason Lund arrived to the facility unannounced to conduct a case management visit and met with Administrator Zachary Davis and explained the reason for the visit. Census: 78 On May 15, 2024, CCL received an Unusual Incident/Injury Report and Death report that Client (C1) had passed away of natural causes. LPA Lund discussed situation with the facility and requested paperwork from the facility. An exit interview and report left.the state’s words, verbatim · CDSS document, May 20, 2024