Southwood Senior Living

Type of visit: Required - 1 Year

On 09/17/2026 at 1:50PM, Licensing Program Analyst (LPA) Carol Fowler conducted an unannounced 1-Year Required inspection. LPA met with caregiver Gloria Rodrin and explained the purpose of the visit. LPA spoke with Administrator Nancy Uy via phone call. The Administrator currently holds a certificate (#7035655740) that expires on 12/12/2026. The facility currently houses 1 resident out of the licensed capacity of 6. LPA toured the facility with Caregiver including but not limited to bedrooms, bathrooms, kitchen, common area, garage and backyard. The facility consists of 3 bedrooms. No bodies of water observed. A comfortable temperature is maintained in the home at 72 degrees Fahrenheit. LPA observed lighting in all rooms are adequate for the comfort and safety of the resident. The hot water temperature in the residents’ shared bathroom was measured at 113.5 degrees Fahrenheit. Residents’ bathrooms are equipped with grab bars. There is a minimum of 7-day supply of non-perishable and 2-day of perishable foods. Smoke detectors and carbon monoxide were in operating condition during visit. Fire extinguisher was last serviced on 11/4/2024. First aid kit was observed to be complete. Continued on LIC809C... Continued from LIC809 LPA reviewed one (1) resident file found to be incomplete, and two (2) staff files, which are incomplete and 1 file missing. Facility has an emergency disaster plan last updated 05/13/2025. The facility last conducted emergency drills 5/18/2025. LPA observed the following deficiencies: At 11:00AM, LPA observed cleaning solutions located in the dining area unlocked sitting on a desk. At 11:10AM, LPA observed 2 expired fire extinguishers. At 11:12AM, LPA observed an unlocked file cabinet in the dining area with pre-poured medication. At 11:18AM, LPA observed unlocked scrubbing bubbles, and tide fabric spray located in the bathroom cabinet. At 11:25AM, LPA observed unlocked cabinet in the unlocked garage paint, windex, pledge, lysol, raid bug spray, WD-40, can spray paint, medication and other chemicals. At 11:30AM, LPA observed unlocked wheelbarrow, ladder and dolly located in the back and side yard. At 12:00PM, LPA observed missing file for 1 staff member and a missing file for a volunteer, one resident file and 2 staff files incomplete. (staff files missing health screening, TB test and training's) At 12:10PM, LPA observed Administrator and volunteer are not associated to the facility. CONTINUE ON LIC 809C CONTINUE FROM LIC 09C LPA asked for updated copies of the following forms to the Department by : 9/24/26 LIC 308 Designation of Administrative Responsibility LIC 309 Administrative Organization LIC 500 Personnel Report LIC 610E Emergency Disaster Plan Liability Insurance The deficiencies were observed (see LIC809D) and cited from the California Code of Regulation, Failure to submit proof of corrections (POC) by plan of correction due date and/or any repeat deficiencies within a 12-month period may result in civil penalties. Exit interview conducted. A copy of appeal rights and this report provided.the state’s words, verbatim · CDSS document, Sep 17, 2026

Type of visit: Required - 1 Year

On 09/02/2025 at 10:15AM, Licensing Program Analysts (LPAs) Carol Fowler and Andrew Christy conducted an unannounced 1-Year Required inspection. LPA met with caregiver Agnus Smith and explained the purpose of the visit. Administrator Elaine Johnson arrived at 11:00AM, the Administrator currently holds a certificate (#7003239740) that expired on 01/17/2026. The facility currently houses 4 residents out of the licensed capacity of 6. LPAs toured the facility with Caregiver including but not limited to bedrooms, bathrooms, kitchen, common area, garage and backyard. The facility consists of 3 bedrooms. No bodies of water observed. A comfortable temperature is maintained in the home at 72 degrees Fahrenheit. LPAs observed lighting in all rooms are adequate for the comfort and safety of the residents. The hot water temperature in the residents’ shared bathroom was measured at 108.2 degrees Fahrenheit. Residents’ bathrooms are equipped with grab bars. There is a minimum of 7-day supply of non-perishable and 2-day of perishable foods. Smoke detectors and carbon monoxide were in operating condition during visit. Fire extinguisher was last serviced on 11/7/2024. First aid kit was observed to be complete. Continued on LIC809C... Continued from LIC809 LPAs reviewed four (4) resident files and four (4) staff files, all found to be complete. Facility has an emergency disaster plan last updated 05/13/2025. The facility last conducted emergency drills 5/18/2025. LPA observed the following deficiencies: At 10:55AM, LPAs observed cleaning solutions Windex, Ajax, Cascade, and Ajax in the outside storage unlocked. At 11:15AM, LPAs observed several expired cans of food in the garage. As well, laundry detergent was observed to be out in the open. Child locks were used to lock a cabinet containing cleaning chemicals like Comet, Lysol, and carpet cleaner At 11:30AM, an unlocked drawer in the kitchen was found to contain one pair of scissors and two lighters. LPAs asked for updated copies of the following forms: LIC 308 Designation of Administrative Responsibility LIC 309 Administrative Organization LIC 500 Personnel Report LIC 610E Emergency Disaster Plan Liability Insurance The deficiencies were observed (see LIC809D) and cited from the California Code of Regulation, Failure to submit proof of corrections (POC) by plan of correction due date and/or any repeat deficiencies within a 12-month period may result in civil penalties. Exit interview conducted. A copy of appeal rights and this report provided.the state’s words, verbatim · CDSS document, Sep 2, 2025

The state marks this report as 5 pages; the online copy we transcribed has 4. You can request the full file from the county licensing office.

Type of visit: Required - 1 Year

On 09/02/2025 at 10:15AM, Licensing Program Analysts (LPAs) Carol Fowler and Andrew Christy conducted an unannounced 1-Year Required inspection. LPA met with caregiver Agnus Smith and explained the purpose of the visit. Administrator Elaine Johnson arrived at 11:00AM, the Administrator currently holds a certificate (#7003239740) that expired on 01/17/2026. The facility currently houses 4 residents out of the licensed capacity of 6. LPAs toured the facility with Caregiver including but not limited to bedrooms, bathrooms, kitchen, common area, garage and backyard. The facility consists of 3 bedrooms. No bodies of water observed. A comfortable temperature is maintained in the home at 72 degrees Fahrenheit. LPAs observed lighting in all rooms are adequate for the comfort and safety of the residents. The hot water temperature in the residents’ shared bathroom was measured at 108.2 degrees Fahrenheit. Residents’ bathrooms are equipped with grab bars. There is a minimum of 7-day supply of non-perishable and 2-day of perishable foods. Smoke detectors and carbon monoxide were in operating condition during visit. Fire extinguisher was last serviced on 11/7/2024. First aid kit was observed to be complete. Continued on LIC809C... Continued from LIC809 LPAs reviewed four (4) resident files and four (4) staff files, all found to be complete. Facility has an emergency disaster plan last updated 05/13/2025. The facility last conducted emergency drills 5/18/2025. LPA observed the following deficiencies: At 10:55AM, LPAs observed cleaning solutions Windex, Ajax, Cascade, and Ajax in the outside storage unlocked. At 11:15AM, LPAs observed several expired cans of food in the garage. As well, laundry detergent was observed to be out in the open. Child locks were used to lock a cabinet containing cleaning chemicals like Comet, Lysol, and carpet cleaner At 11:30AM, an unlocked drawer in the kitchen was found to contain one pair of scissors and two lighters. LPAs asked for updated copies of the following forms: LIC 308 Designation of Administrative Responsibility LIC 309 Administrative Organization LIC 500 Personnel Report LIC 610E Emergency Disaster Plan Liability Insurance The deficiencies were observed (see LIC809D) and cited from the California Code of Regulation, Failure to submit proof of corrections (POC) by plan of correction due date and/or any repeat deficiencies within a 12-month period may result in civil penalties. Exit interview conducted. A copy of appeal rights and this report provided.the state’s words, verbatim · CDSS document, Sep 2, 2025

The state marks this report as 5 pages; the online copy we transcribed has 4. You can request the full file from the county licensing office.

Type of visit: Required - 1 Year

On 08/20/2024 at 1:20PM, Licensing Program Analyst (LPA) Carol Fowler conducted an unannounced 1-Year Required inspection. LPA met with Mariazita Jardeleza and explained the purpose of the visit. Velba Villanueva, Administrator arrived at 2:50pm, the Administrator currently holds a certificate (#6024026740) that expired on 05/18/2024. The facility’s fire clearance was approved for four (4) non-ambulatory residents. LPA toured the facility with Caregiver including but not limited to bedrooms, bathrooms, kitchen, common area, garage and backyard. The facility consists of three (3) total bedrooms which one (1) bedroom is occupied by staff. No bodies of water observed. A comfortable temperature is maintained in the home. LPA observed lighting in all rooms are adequate for the comfort and safety of the residents. The hot water temperature in the residents’ shared bathroom was measured at 113.7 degrees Fahrenheit. Residents’ bathrooms are equipped with grab bars. There is a minimum of 7-day supply of non-perishable and 2-day of perishable foods. Smoke detectors and carbon monoxide were in operating condition during visit. Fire extinguisher was last serviced on 05/04/2022. First aid kit was observed to be complete. Continued on LIC809. Continued from LIC809. LPA reviewed three (3) staff files all are complete. One (1) resident file was reviewed and complete. LPA observed the following deficiencies: At 2:00pm, LPA observed cleaning solutions Windex, Ajax, Fabuloso in the bathroom cabinet and Cascade and Ajax in the kitchen cabinet unlocked. At 2:07pm, LPA observed the fire extinguisher was expired. At 2:20pm, LPA observed 5 unlocked storage doors unlocked, 3 ladders, paint, large tool box unlocked with tools, electric saw, wood planks, pick hoe garden tool, 3 shovels, wheelbarrow, and 3 scooters, located in the open porche area LPA requested the following documents to be submitted to CCLD by 09/10/2024. Resident Roster LIC 308 Designation of Administrative Responsibility LIC 309 Administrative Organization LIC 500 Personnel Report LIC 610E Emergency Disaster Plan Liability Insurance Copy of Administrator Certificate The deficiencies were observed (see LIC809D) and cited from the California Code of Regulation, Failure to submit proof of corrections (POC) by plan of correction due date and/or any repeat deficiencies within a 12-month period may result in civil penalties. Exit interview conducted. A copy of appeal rights and this report provided.the state’s words, verbatim · CDSS document, Aug 20, 2024

The state marks this report as 5 pages; the online copy we transcribed has 4. You can request the full file from the county licensing office.