Caccam's Stanton Residence

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Zabel Chochian arrived at the facility to conduct a Required Annual visit. Upon arrival, LPA met with staff and explained the reason for the visit. Administrator/Licensee Venis Caccam arrived shortly after. At approximately 10:00 a.m.,LPA and Administrator toured the physical plant areas inside and outside to ensure there are no health and safety hazards and the facility is in compliance with Title 22 Regulations. At the time of the visit, the common area furniture's were observed to be in good condition. The LPA observed required postings throughout the common areas. LPA observed board games, books and other activities stored in various locations inside the home. The facility maintained a comfortable temperature of 78 degrees Fahrenheit. Smoke detector(s) and carbon monoxide detector were operational at the time of the visit. LPA observed fire extinguisher to be fully charged and last serviced 04/17/2026. LPA observed four (4) resident bedrooms and two (2) staff rooms. All resident rooms observed furnished appropriately with clean linens, appropriate furnishings and sufficient lighting. Staff rooms observed inaccessible during todays visit. The resident bathrooms were observed to be clean and sanitary and in operating condition with grab bars and non-skid surfaces. The bathrooms were sufficiently stocked with supplies, toilet paper and paper towels. The hot water temperature was measured between 113.7 - 114.3 degrees Fahrenheit. A sufficient supply of clean linen and towels were observed stored in a hallway closet. There is a cabinet adjacent to the living room with resident’s personal hygiene items locked at the time of the visit. All exits have functioning auditory devices and were operational at the time of the visit. The dining/kitchen/food service area. Kitchen appliances appeared clean and to be in operable condition at the time of the visit. The facility has a sufficient supply of perishable and non-perishable food. Food labels were inspected and checked for dates and expiration dates. The knives and sharp objects were observed locked and inaccessible to residents in care underneath the sink. (Continue to LIC809c) There is an attached garage observed inaccessible to residents in care. LPA observed an additional refrigerator with food in good condition. There is a washer and dryer inside the garage. Cleaning supplies, detergents, and toxins were observed in a locked cabinet inaccessible to residents in care. Facility has an adequate amount of emergency food and water. The backyard has a covered outdoor area equipped with furniture including a table and chairs for resident use. The LPA observed two (2) side gates with clear passageways clear of obstruction. There were no bodies of water observed during the visit. Infection control/Emergency Disaster Plan: Infection plan was reviewed. The facility’s policies and procedures as it pertains to infection control are adequate. Signs observed posted that promotes good hand hygiene and symptoms of a communicable disease. The facility has an adequate supply of Personal Protection Equipment (PPE), and the facility is able to obtain additional supplies as needed. The facility’s cleaning protocol as stated in the plan is sufficient. Emergency disaster plan observed - emergency disaster drills conducted quarterly as per regulation; the last fire drill was conducted on 08/28/2026. Records Review 10:45 a.m.:, four (4) resident records were reviewed for, but not limited to: appraisals, medical records, admissions agreement, consent forms. At approximately 11:30 a.m., three (3) Personnel records were reviewed for, but not limited to: personnel records, health assessments, criminal record clearances, first aid/CPR training, and the appropriate training. All files were observed to be in order at this time. Medication cabinet was located next to the dining room. LPA observed cabinet to be locked and inaccessible to residents in care. Medications review conducted at approximately 12:00 p.m. All medications including PRNs were labeled, stored and inaccessible to residents in care. Medications were observed to be administered as prescribed at this time. LPA requested Administrator/Licensee to submit the following documents: Current LIC500 Personnel Report, LIC9020 Client Roster, and facility’s liability insurance Exit interview conducted. Copy of the report was provided.the state’s words, verbatim · CDSS document, Sep 11, 2026

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Brian Balisi arrived at the facility unannounced to conduct a required annual visit. Upon arrival, LPA met with staff and explained the reason for the visit. Administrator Venis Caccam arrived shortly after. LPA toured the physical plant areas inside and outside to ensure there are no health and safety hazards and the facility is in compliance with Title 22 Regulations. At approx 09:30 a.m. The LPA inspected the kitchen/food service area. Kitchen appliances appeared clean and to be in operable condition at the time of the visit. The facility has a sufficient supply of perishable and non-perishable food. Food labels were inspected and checked for dates and expiration dates. The knives and sharp objects were observed locked and inaccessible to residents in care underneath the sink. Medication cabinet was located next to the dining room. LPA observed cabinet to be locked and inaccessible to residents in care. LPA observed four (4) resident bedrooms , which were furnished appropriately with clean linens, appropriate furnishings and sufficient lighting. The resident bathrooms were observed to be clean and sanitary and in operating condition with grab bars and non-skid surfaces. The bathrooms were sufficiently stocked with supplies and paper towels. The hot water temperature was measured between 105 - 120 degrees Fahrenheit. The fire door was observed to be closed during the visit. There are two (2) staff rooms. LPA observed staff rooms to be empty as well as locked and inaccessible to residents in care. At the time of the visit, the common area furniture's were observed to be in good condition. A sufficient supply of clean linen and towels were observed stored in a hallway closet. There is a cabinet adjacent to the living room with resident’s personal hygiene items locked at the time of the visit.The facility maintained a comfortable temperature of 72 degrees Fahrenheit. Smoke detector(s) and carbon monoxide detector were operational at the time of the visit. LPA observed fire extinguisher to be fully charged and last serviced 05/05/2025. There is an office area located next to living room. Facility files were observed stored inaccessible to residents in care. LPA observed board games, books and other activities stored in various locations inside the home. All exits have functioning auditory devices and were operational at the time of the visit. The LPA observed required postings throughout the common areas. There is an attached garage observed inaccessible to residents in care. LPA observed an additional refrigerator with food in good condition. There is a washer and dryer inside the garage. Cleaning supplies, detergents, and toxins were observed in a locked cabinet inaccessible to residents in care. Facility has an adequate amount of emergency food and water. LPA observed a thirty (30) day supply of Personal Protection Equipment (PPE). The backyard has a covered outdoor area equipped with furniture including a table and chairs for resident use. The LPA observed two (2) self-latching gate with clear passageways clear of obstruction. There were no bodies of water observed during the visit. Records review, four (4) resident records were reviewed for, but not limited to: appraisals, medical records, admissions agreement, consent forms. Four (4) Personnel records were reviewed for, but not limited to: personnel records, health assessments, criminal record clearances, first aid/CPR training, and the appropriate training. All files were observed to be in order at this time . Last emergency disaster drill was conducted on 09/03/2025. Medications review, all medications including PRNs were labeled, stored and inaccessible to residents in care. Medications were observed to be administered as prescribed at this time. Infection control: Upon entry, the facility has a central entry point for symptom screening, temperature checks, and sanitation station. At this time, the staff will continue to keep up signs that promotes good hand hygiene and symptoms of a communicable disease. The facility has an adequate supply of Personal Protection Equipment (PPE), and the facility is able to obtain additional supplies as needed. The facility’s cleaning protocol is sufficient. If needed, the facility has the capacity to designate a single isolation room if the facility has a confirmed case of an infectious disease. The facility’s policies and procedures as it pertains to infection control are adequate. LPA obtained the following documents at the time of visit: LIC500 Personnel Report, LIC9020 Client Roster, and facility’s liability insurance Interviews were conducted during the visit. Exit interview conducted. A copy of the report was provided.the state’s words, verbatim · CDSS document, Sep 12, 2025

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Martha Arroyo arrived at the facility unannounced to conduct a required annual visit today. Upon arrival, there were two (2) staff present. The four (4) clients were in day program at the time of the inspection. LPA was greeted by facility staff who contacted the Administrator via telephone. The Administrator, Venis Caccam arrived at 10:00am. Entrance interview conducted. At 10:05am, the LPA along with the Administrator toured the physical plant areas inside and outside to ensure there are no health and safety hazards and facility is in compliance with Title 22 Regulations. The following was observed: KITCHEN: The LPA inspected the kitchen/food service area at 10:15am. Knives and sharps were observed locked and inaccessible under the kitchen sink. Kitchen appliances were in operable condition. The facility has a sufficient supply of perishable and non-perishable food; properly stored. Refrigerator and food pantry were checked for proper labels and expiration dates; labels had dates clearly marked. COMMON AREAS: This includes the living room and dining room area. The common areas were furnished appropriately, and all furniture was observed to be in good condition at the time of the visit. The facility maintained a comfortable temperature. LPA observed required postings throughout the common space. There is a cabinet adjacent to the living room with resident’s personal hygiene items locked at the time of the visit. Activities were observed in the living room. LPA observed auditory alarms at the time of the visit. There is a working telephone on premises. No obstructions or hazards were observed inside or out. Report Continued on LIC 809C... Report Continued from LIC 809... RESTROOMS: The two (2) resident restrooms were clean and sanitary and in operating condition with grab bars and non-skid surfaces. The bathrooms were sufficiently stocked with supplies and paper towels. Hand washing signs were observed posted inside the bathrooms. The hot water temperature was measured; the first bathroom measured at 116.2 degrees Fahrenheit at 10:09am; and the second bathroom measured at 115.3 degrees Fahrenheit at 10:13am. BEDROOMS: There are four (4) bedrooms for resident use all of which are designated as private resident rooms. All resident rooms were observed to be furnished appropriately with a chair, dresser, and a bed with clean linens, appropriate furnishings, and sufficient lighting. Additional clean linens, towels, and washcloths were observed in the hallway closet. There are two (2) staff rooms on premises. GARAGE: The garage is maintained inaccessible to residents in care. LPA observed an additional refrigerator with food in good condition. There is a washer and dryer inside the garage. Cleaning supplies, detergents, and toxins were observed in a locked cabinet inaccessible to residents in care. Facility has an adequate amount of emergency food and water. LPA observed a thirty (30) day supply of Personal Protection Equipment (PPE). BACKYARD: The backyard has a covered patio area with furniture including a table and chairs for resident use. The exterior passageways were clean and clear of any obstructions at the time of the visit. LPA observed two (2) self-latching gates. There were no bodies of water noted at the time of the visit. RECORDS: LPA reviewed Resident Records at 10:32am and Personnel Records at 11:15am. Four (4) resident files were reviewed for, but not limited to, the following: signed admission agreements, current medical assessments with TB results, LIC627(c) Consent for Treatment form, and current needs and services plan / individual program plan. All files were complete. Report Continued on LIC 809C... Report Continued from LIC 809C... Four (4) personnel files including the Administrator’s file were reviewed for, but not limited to: personnel records, health assessments, criminal record clearances, first aid / CPR training, and the appropriate yearly training. All records were in order. The Administrator certificate is valid until 01/26/2025. The facility is vendored by Tri-Counties Regional Center (TCRC) as a level 3-i home. During today’s visit, the LPA conducted interviews with two (2) staff and obtained copies of the following documents: LIC 500, LIC 9024, LIC 610E, and limited liability insurance. INFECTION CONTROL/EMERGENCY DISASTER PLANNING: During today's visit, LPA reviewed the facility's infection control policy as well as the emergency disaster plan. The facility’s policies and procedures as it pertains to infection control are adequate. Fire extinguisher was observed to be fully charged and last serviced 04/27/2024. At 10:06am, the smoke detectors and carbon monoxide detector were tested and operational at the time of the visit. Emergency disaster drills conducted quarterly as per regulation; the last fire drill was conducted on 08/03/2024. MEDICATIONS: Medications review began at approximately 12:05pm. The medications are locked in a file cabinet adjacent to the dining room. All medications including PRNs were labeled, stored, and locked inaccessible to residents in care. PRNs have physicians order on file. Medications appeared to be given as prescribed at the time of the visit. No deficiencies cited at this time. Exit interview conducted. A copy of the report was issued.the state’s words, verbatim · CDSS document, Sep 10, 2024