Purple Villa Assisted Living

Type of visit: Required - 1 Year

On 05/26/2026 at 11:13AM, Licensing Program Analyst (LPA) T. Syess-Gibson conducted an unannounced 1-Year Required inspection. LPA met with Arvin Perez, Caregiver and explained the purpose of the visit. Kavitha Pramod, Administrator arrived at 12:00PM. LPA explained purpose of visit. Administrator currently holds a certificate (#7016877740) that expires on 07/20/2026. The facility’s fire clearance was approved for six (6) non-ambulatory residents. LPA toured the facility with Arvin, caregiver including but not limited to bedrooms, bathrooms, kitchen, common area and back yard. The facility consists of six (6) bedrooms and three (3) bathrooms. LPA did not observe any bodies of water. A comfortable temperature is maintained at 73 degrees Fahrenheit. LPA observed lighting in all rooms is adequate for the comfort and safety of the residents. The hot water temperature in the resident’s shared bathroom was measured at 122.5 degrees Fahrenheit. Residents’ bathrooms are equipped with grab bars and non-skid mats. Smoke detectors and carbon monoxide were in operating condition during visit. Fire extinguisher was last serviced on 08/15/2025. Emergency Disaster Plan was last posted on 01/10/2026. First aid kit was observed to be complete. Fire drill was last conducted on 02/15/2026. Continue on LIC809C... Continued from LIC809 LPA reviewed five (5) resident records, and five (5) staff records, and they were current and complete. LPA requested the following documents to be submitted to CCLD by 06/02/2026. LIC 308 Designation of Administrative Responsibility LIC 309 Administrative Organization LIC 500 Personnel Report LIC 610E Emergency Disaster Plan Liability Insurance LPA observed the following deficiencies during visit: At 11:18AM, LPA observed a latch lock on facility’s front door At 11:31AM, LPA observed missing knob on residents’ armoire closet At 11:33AM, LPA observed resident in hospital bed with bed rails that extend the entire length of the bed. At 11:37AM, LPA observed water temperature in residents shared restroom was 122.5 degree F. At 11:42AM, LPA observed an unlocked kitchen cabinet with comet w/ bleach. At 11:43AM, LPA observed broken kitchen drawer. At 11:44AM, LPA observed pre-poured medication in medication cabinet located in facility’s kitchen. continued on LIC809C... Continued from LIC809C At 11:45AM, LPA observed Tide laundry detergent pods in an unlocked cabinet in facility’s laundry room. At 11:46AM, LPA observed medication in an unlocked mini refrigerator inside facility’s laundry room. At 11:48AM, LPA observed, toilet commodes, Hoyer lift, television, sofa, chairs, walkers, mattress, chest of drawers and ladder in facility’s garage. Deficiencies are cited per Title 22 California Code of Regulations and listed on LIC809D. 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. *The total amount of civil penalties assessed on today's date is $500.00 for Fire Clearance. Exit interview conducted. A copy of this report, LIC421IM and the appeal rights provided to Kavitha Pramod.the state’s words, verbatim · CDSS document, May 26, 2026

The state marks this report as 10 pages; the online copy we transcribed has 9. You can request the full file from the county licensing office.

Type of visit: Prelicensing

On 04/10/2025 at 9:58AM, Licensing Program Analyst (LPA) T. Syess-Gibson conducted an unannounced pre-licensing inspection. LPA met with Kavitha Pramod, Administrator and explained the purpose of the visit. The facility has an approved fire safety clearance for six (6) non ambulatory residents. LPA inspected the facility inside and out including but not limited to the bedrooms, bathrooms, common living areas, kitchen, garage, back yard. The facility has six (6) bedrooms and three (3) bathrooms. No bodies of water observed. There is sufficient lighting around the facility. Residents rooms are equipped with the proper furniture, bedding, and lighting. Bathrooms showers/tubs were equipped with non-skid mats. Passageways and hallways are free of obstruction. LPA observed medications, disinfectants, toxins and sharps in locked cabinets. Hot water temperature is measured at 108.9 degrees Fahrenheit in shared residents' bathroom. Fire extinguisher was last serviced on 08/30/2024. There is a minimum of 7-day non-perishables and 2-day perishables foods. First Aid kit was complete. Carbon monoxide and smoke detectors present. Facility inspection matches the sketch that was provided. No Issues were noted during inspection. LPA observed that facility is ready to be licensed. This report will be submitted to the Central Applications Unit (CAU) and a final review of the application will be conducted. This facility is not yet licensed and is subject to final approval by CAU. Additional requirements may still be required. Exit interview conducted and a copy of this report provided.the state’s words, verbatim · CDSS document, Apr 10, 2025

The state marks this report as 3 pages; the online copy we transcribed has 2. You can request the full file from the county licensing office.

Type of visit: Case Management - Other

On 04/10/2025 at 01:20PM, Licensing Program Analyst (LPA) T. Syess-Gibson conducted a Component III Review, for the Pre-licensing Inspection which was conducted on this date. LPA reviewed Component III with Administrator Kavitha Pramod. A license has not yet been granted to this facility. Licensure is subject to final review and approval by the Centralized Applications Unit. See LIC809 (Pre-licensing Inspection) Report dated 04/10/2025, for the Pre-licensing Inspection conducted in relation to this reportthe state’s words, verbatim · CDSS document, Apr 10, 2025

Type of visit: Office

Facility Type: RCFE Application Type: CHOW Capacity: 6 Census: 5 Method: Telephone call with CAB COMP II Participants: Pramod, Kavitha On 2/25/25, the applicant/administrator participated in COMP II at CAB via telephone call with analyst at CAB. Identification of the applicant and administrator was verified by confirming driver’s license number. During COMP II, applicant and administrator confirmed the understanding of Title 22. Component II was successfully completed. Applicant and administrator were advised to email/fax signed LIC 809 with copy of photo ID to CAB. During COMP II, CAB analyst confirmed Applicant/Administrator’s understanding of following areas: 1. Facility operation: License type, client/resident populations, and program 2. Admission Policies 3. Staffing requirements & Training 4. Restrictive/Prohibited Health Conditions 5. General provisions 6. Emergency Preparedness 7. Complaints & Reporting 8. Pre-licensing readinessthe state’s words, verbatim · CDSS document, Feb 25, 2025