Cathedral Care Home - Oakley

Type of visit: Required - 1 Year

On 12/17/2025 at 12:08PM, Licensing Program Analyst (LPA) T. Syess-Gibson arrived unannounced to conduct Required 1 Year Annual inspection. LPA met with Kenneth David, Caregiver and explained the purpose of the visit. Kenneth contacted Marivic Datuin, Administrator to advise of visit. Administrator gave authorization for Kenneth to sign report. The facility’s fire clearance was approved for five (5) non-ambulatory and one (1) bedridden resident. LPA toured facility with Kenneth including but not limited to bedrooms, bathrooms, kitchen, common area and backyard. The facility consists of six (6) bedrooms, three (3) bathrooms. All outdoor and indoor passageways are kept free of obstruction. There are no bodies of water observed. A comfortable temperature is maintained at 80 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 109.9 degrees Fahrenheit. Residents’ bathrooms are equipped with grab bars and non-skid mats. There is a minimum of 7-day supply of nonperishable and 2 days of perishable foods. Smoke detectors and carbon monoxide detectors were in operating condition during visit. Fire extinguisher was last purchased on 11/07/2025. First aid kit was observed to be complete. Fire drill was last conducted on 10/10/2025. Emergency disaster plan last updated 10/10/2025. Continues on LIC809C.... Continued from LIC809. Five (5) staff records were reviewed; all five (5) staff have FirstAid/CPR and were associated. LPA also reviewed all six (6) resident records, and they were complete. LPA requested the following documents to be submitted to CCLD by 12/24/2025 LIC 308 Designation of Administrative Responsibility LIC 309 Administrative Organization LIC 500 Personnel Report LIC 610E Emergency Disaster Plan Liability Insurance Updated Facility Sketch LPA observed no deficiencies during visit. Exit interview conducted a copy of this report provided.the state’s words, verbatim · CDSS document, Dec 17, 2025

Type of visit: Prelicensing

On 12/11/2024 at 10:20 AM, Licensing Program Analyst (LPA) T. Syess-Gibson arrived announced to conduct a pre licensing visit. LPA met with Administrator, Marivic Datuin and explained the purpose of the visit. The facility currently has no residents. The facility’s fire clearance was approved for five (5) non-ambulatory and one (1) bedridden resident. LPA toured facility with Administrator, Marivic Datuin including but not limited to six (6) bedrooms, three (3) bathrooms, kitchen, common areas and backyard. Bedrooms and living rooms were equipped with the proper furniture. Bathrooms were equipped with grab bars and non-skid mats. Linens and hygiene supplies were observed inside a cabinet. There is sufficient lighting throughout facility. Room temperature was maintained at 70 degrees F and hot water temperature was maintained at 114.3 degrees F. First-aid kit was observed to be complete. Smoke detectors and carbon monoxide were operational. Fire extinguisher was last purchased on 09/14/2024. Continued on LIC809C Continued from LIC809 The applicant was reminded of the statute that requires CCL to be notified within 5 business days of admitting their first resident. This notification may be done by phone, by mail, or by fax. No issues 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, Dec 11, 2024

Type of visit: Case Management - Other

On 12/11/2024 at 10:20AM Licensing Program Analyst (LPA) T. Syess-Gibson conducted an announced pre-licensing inspection with a Comp III and met with Marivic Datuin, Administrator. Comp III was waived per Licensing Program Manager (LPM) Y. Flores-Larios. Exit interview conducted and a copy of this report provided.the state’s words, verbatim · CDSS document, Dec 11, 2024

Type of visit: Office

Component II completion: Successful Facility Type: RCFE Application Type: INITIAL Capacity: 6 Census (if any clients in care): 0 COMP II Participants: Name - Marivic Dautin CEO/Administrator Interview Method: Telephone interview On November 1, 2024, Applicant/Administrator participated in COMP II. Identification of the applicant and administrator was verified through interview questions based on photo ID and other identifying personal information. During COMP II, applicant and administrator confirmed that they have read and understand community care facility licensing laws included in the Health and Safety Codes and the California Code of Regulations Title 22. Signed LIC 809 with copy of photo ID have been obtained. During COMP II, CAB analyst confirmed Applicant/Administrator’s understanding of the 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, Nov 1, 2024