The Cottage

Type of visit: POC

On April 30, 2026 Licensing Program Analyst (LPA) B. Miranda arrived at the facility unannounced to conduct a visit regarding POCs. LPA observed 2 residents at the facility (R1 & R2) with 2 staff. While at the facility LPA observed when owner Howard Fergerson arrived at the facility to say good bye to R1. LPA observed facility to be clean, odor free, and clutter free. Lady is working on the proper Administrator Certification and is in constant contact with LPA. Lady has reached out to the Dept handling the certification testing and is waiting for a follow-up. Lady will provide a plan for scheduling staff training by May 8, 2026. Verification of oxygen training will be provided to LPA by May 5, 2026. During the visit LPA observed the following corrections: Tested/Working Carbon Monoxide detector Glue trap has been moved and is no longer with clean dishes Knives are in lock container under the sink R2's centrally stored medication log was current and up to date Resident's P&I is balanced and matches logs Liability insurance is current Licensee purchased a surety bond for facility Residents have updated physician reports LPA reviewed disaster plan LPA reviewed facility's disaster drill log Letters of cleared POCs were generated, printed, and provided to Caregiver Lady Villanueva. Exit interview was conducted and a copy of this report LIC809 was provided to Caregiver Lady Villanueva.the state’s words, verbatim · CDSS document, Apr 30, 2026

Type of visit: Required - 1 Year

Licensing Program Analysts (LPA) B. Miranda conducted an unannounced visit today for the facility’s annual inspection. LPA introduced themselves and was allowed entrance into the facility. LPA met with Amber Land. Facility is licensed for 6 residents and has a current census of 6. There are 2 residents on hospice and they are also receiving home health care through hospice. Plans are current, but facility was not able to provide staff training on Hospice Care Plans. Water temperature was checked in the kitchen which read at 113.5 degrees Fahrenheit. Fire Extinguisher was serviced November 18, 2025 and is within the safety regulation period. Smoke detectors were tested and in working order. Facility does not have carbon monoxide detectors. Facility has kitchen knives stored with cleaning supplies under the sink. Kitchen cabinet has a glue trap stored with clean dishes Administrator Jennifer Thompson is no longer at the facility since February 2026. Currently there is not a qualified administrator in the facility. Staff Amber Land is working on obtaining RCFE Administrator's Certificate. Staff files were reviewed, are not complete. Staff training was conducted by Jennifer Thompson who was not certified as an RCFE Administrator, but as an ARF Administrator. Training verification was missing information regarding explanation of training conducted and hours completed for training. Resident files were reviewed and incomplete. Resident files are missing current and complete physician reports, appraisals/re-appraisals for change in condition. Facility could not provide a log for disaster drills that are conducted quarterly. Facility could not provide a disaster plan or infection control plan. Toxins and cleaning supplies are locked and inaccessible. There is a locked storage for medications. Hygiene products are accessible to resident’s in care; R1’s physician's report indicated R1 is at risk if hygiene products are accessible. LPA inspected the interior and the exterior of the facility including the common living spaces, resident bedrooms, bathrooms, medication storage, kitchen, and outdoor areas. Back fence has a gate making facility accessible to neighbors. Bedrooms were clean, properly furnished, with adequate lighting, and in good repair. Food supply is adequate for 2-day perishable and 7-day nonperishable. Deficiencies observed during today's inspection were cited per California Code of Regulations, Title 22. Owner/operator Howard Ferguson is not listed on the staff roster; follow-up visit may be warranted at a later time to issue citations. Any other deficiencies not cited during today's visit could warrant follow-up visit to cite at a later time. LPA's requested the following documents: LIC 500 Personnel Report, LIC 308 Designation of Administrative Responsibility, LIC 610-E the Emergency Disaster Plan and copy of current Administrator’s Certificate to update the facility file. Listed documents shall be sent to Licensing by April 24, 2026. Exit interview conducted and a copy of this report LIC809, LIC809Ds, and appeal rights were provided to Amber Land.the state’s words, verbatim · CDSS document, Apr 13, 2026

Type of visit: Required - 1 Year

Today, Licensing Program Analyst L. Xiong arrived at the facility unannounced to conduct the Infection Control Inspection. LPAs met with Administrator Jennifer Thompson and inform her the purpose of the visit. LPA toured the facility with staff. Facility appeared clean with no obstruction or fire clearance issues. All common areas have adequate seating and lighting. Resident bedrooms toured, rooms observed to have all required accommodations. Kitchen toured, LPA observed a 2-day supply of perishable and a 7-day supply of non-perishable food available for residents. Smoke detector and carbon monoxide detectors observed operational during inspection. Fire extinguisher present with a service date of 12/2024. Water temperature observed to measure at 110 degrees F. No deficiencies were observed.the state’s words, verbatim · CDSS document, Mar 24, 2025

Type of visit: Required - 1 Year

Today, Licensing Program Analyst L. Xiong arrived at the facility unannounced to conduct the Annual Inspection. LPA met with staff Alicia Ledesma an spoke to Administrator Jennifer Thompson and inform her the purpose of the visit. LPA toured the facility with staff. Facility appeared clean with no obstruction or fire clearance issues. All common areas have adequate seating and lighting. Resident bedrooms toured, rooms observed to have all required accommodations. Kitchen toured, LPA observed a 2-day supply of perishable and a 7-day supply of non-perishable food available for residents. Smoke detector and carbon monoxide detectors observed operational during inspection. Fire extinguisher present with a service date of 12/2023. Water temperature observed to measure at 117 degrees F. No deficiencies were observed.the state’s words, verbatim · CDSS document, Apr 30, 2024

Type of visit: Case Management - Health Checks

Licensing Program Analyst (LPA) L. Xiong conducted a Case Management visit for the purpose of Health and Safety check of residents in care. LPA observed two residents and one staff working during facility visit. LPA allowed entrance by Direct Care Staff, Lady Villanueva. Per staff, there is currently one (1) resident receiving hospice services and no home health services. A tour of the facility was conducted. Adequate food supply to meet the needs of residents. Facility observed to be clean and odor free. Facility temperature comfortable. LPA observed two (2) residents at the facility and was informed four (4) went to day program. LPA obtained updated LIC 9020 (Register of Facility Clients/Residents) during the visit. No deficiencies cited during this visit.the state’s words, verbatim · CDSS document, Apr 12, 2024

Type of visit: Office

On 12/20/23, this Department conducted a office meeting to follow up on previous meeting held on 12/15/23. Present during meeting were Brenda White, Regional Manager, Melinda Medina, Licensing Program Analyst, and Howard Ferguson. The Department has received the following documents provided by Howard Ferguson during office visit: LIC 200, LIC 308, LIC 309, Lease Agreement, Appointment Letter for Administrator, Certificate of Liability Insurance, and Articles of Incorporation with Statement of Conversion. This Department will review documents received and will advise if any additional information is needed. A copy of this report was provided to Howard Ferguson during meeting.the state’s words, verbatim · CDSS document, Dec 20, 2023

Type of visit: Office

On 12/15/23, this Department conducted a office meeting to discuss control of property for facility. Present during meeting were Brenda White, Regional Manager, Melinda Hoffmann, Licensing Program Manager, Melinda Medina, Licensing Program Analyst, Howard Ferguson, and Terry Overstreet via telephone. The Department has requested the following documents be submitted no later than 12/20/23: LIC 200, LIC 308, LIC 309, Lease Agreement, Appointment Letter for Administrator to be completed by Licensee, Terry Overstreet. This report will be emailed as Licensee was in attendance via telephone.the state’s words, verbatim · CDSS document, Dec 15, 2023

Type of visit: Required - 1 Year

On 12/06/2023, Licensing Program Analyst (LPA) M. Medina made an unannounced Annual Required Inspection. LPA was allowed entrance by staff, Jennifer Thompson. During the inspection it was stated that Jennifer Thompson is Administrator, however, this Department has not received any paperwork. Currently, six (6) residents in care. Residents attend day program Monday-Friday 6:45 am - 3:15 pm, All residents were at Day program at time of inspection. Facility tour began in resident bedrooms. Rooms observed to have all required accommodations. All areas of the facility have sufficient lighting. Residents bathrooms observed to be clean and in good repair. Bath/tub are have non-skid mats and grab bars. Hot water tested in both bathrooms with a water temperature of 108 degrees F. Dining room and living room have adequate seating and lighting for all residents in care. Tour of kitchen conducted. LPA observed adequate food supply for the residents in care. LPA observed leftovers stored in the refrigerator and/or freezer observed to be properly stored and labeled. Medications observed to be locked in small cabinet in hallway. All medications observed to have original labels and administered as prescribed. Smoke Alarms tested observed operational at time of inspection. Carbon monoxide detector present in dining room and observed operational at time of inspection. Fire extinguisher has a purchase date of 12/06/23. All cleaning supplies observed to be locked and secured under kitchen sink. Facility has no proof of liability insurance on site. Outside areas toured. All exits open freely and observed to be free of obstruction. No hazards observed. Due to time constraints, file reviews and interviews will be conducted at a later time. Facility to submit updated LIC 309, LIC 500, LIC 610E, Deficiencies cited on attached 809D. Exit interview conducted, appeal rights and copy of report provided for facility records.the state’s words, verbatim · CDSS document, Dec 6, 2023