A Family of Care

Allegation investigated: Staff leave residents in bed for extended periods of time. Staff wrongfully evicted resident.

On 01/14/2026 at 3:30PM Licensing Program Analyst (LPA), T. Syess-Gibson arrived unannounced to conduct an investigation and deliver complaint findings for allegations above. LPA met with Zariah Charles, House Manager, and explained the reason for the visit. Allegation: Staff wrongfully evicted resident. Interviews with S1, S2 and W1 revealed R1 was not evicted from the facility. R1 was removed from the facility by family member. Record review revealed R1 was not evicted, W1 removed R1 from the facility. Continue on LIC9099C..... Unsubstantiated Continued from LIC9099 Allegation: Staff leave residents in bed for extended periods of time. Interviews with S1 and S2 revealed there is no set bedtime for the residents, residents usually go into their rooms around 8:30pm, after dinner and evening activities. Interviews with R2, R3 and R4 revealed there is not a set bedtime for residents and residents are allowed to get out of bed as they like. Based on interviews conducted and records reviewed, the preponderance of evidence standard has not been met, therefore the allegation is found to be UNSUBSTANTIATED, meaning that although the allegation may have happened or is valid, there is not a preponderance of evidence to prove it did or did not occur. Exit interview conducted and a copy of this report provided.the state’s words, verbatim · CDSS document, Jan 14, 2026 · control 15-AS-20250918134246

Type of visit: Required - 1 Year

On 09/22/2025 at 10:30AM, Licensing Program Analyst (LPA) T. Syess-Gibson conducted an unannounced 1-Year Required inspection. LPA met with Mark Taylor and explained the purpose of the visit. Licensee asked Jadah Rougely, Caregiver to assist LPA during visit. The Administrator currently holds a certificate (#7016298740) Expires 08/05/2026. The facility’s fire clearance was approved for three (3) ambulatory and four (4) non ambulatory residents. LPA toured the facility with Caregiver, Jadah Rougely including but not limited to bedrooms, bathrooms, kitchen, common area and back yard. The facility consists of seven (7) bedrooms, one (1) occupied by staff and four (4) bathrooms. All outdoor and indoor passageways are kept free of obstruction. LPA observed a pool behind a properly secured locked gate in the backyard. A comfortable temperature is maintained at 81 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 114.2 degrees Fahrenheit. Residents' bathrooms are equipped with grab bars and nonskid mats. There is a minimum of 7-day supply of non-perishable and 2-day of perishable foods. Continued LIC809C. Continued from LIC809 Smoke detectors and carbon monoxide were in operating condition during visit. Fire extinguisher was last purchased on 11/21/2024. Emergency Disaster Plan was last updated on 09/02/2025. First aid kit was observed to be complete. Fire drill conducted with residents on 09/03/2025. LPA reviewed six (6) resident records and five (5) staff records during visit The following forms are to be updated and submitted to CCLD by 09/29/2025: LIC 500 Personnel Report LIC 400 Affidavit Regarding Client/Resident Cash Resources LIC 402 Surety Bond LIC610E Emergency Disaster Plan LIC308 Designation of facility responsibility LPA observed the following deficiency: At 11:13AM LPA observed 2 knives in a kitchen drawer. At 11:21AM, LPA observed two (2) out of the three (3) residents’ shared bathroom did not have nonskid mats. Deficiency is 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. Exit interview conducted and a copy of this report and appeal rights provided.the state’s words, verbatim · CDSS document, Sep 17, 2025

Type of visit: Required - 1 Year

On 10/24/2024 at 10:11AM, Licensing Program Analyst (LPA) T. Syess-Gibson conducted an unannounced 1-Year Required inspection. LPA met with Caregiver, Carla Page and explained the purpose of the visit. The Administrator currently holds a certificate (#7016298740) in pending status per CCLD Portal. The facility’s fire clearance was approved for three (3) ambulatory and four (4) non ambulatory residents. LPA toured the facility with Caregiver, Carla Page including but not limited to bedrooms, bathrooms, kitchen, common area and back yard. The facility consists of seven (7) bedrooms, One (1) occupied by staff and four (4) bathrooms. All outdoor and indoor passageways are kept free of obstruction. LPA observe a pool behind a properly secured locked gate in the backyard. A comfortable temperature is maintained at 81 degrees Fahrenheit. 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 118.7 degrees Fahrenheit. Residents' bathrooms are equipped with grab bars and nonskid mats. 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 purchased on 10/19/2024. Emergency Disaster Plan was last posted on 11/09/2023. First aid kit was observed to be complete. No fire drill conducted with residents as of today. Continued LIC809C. Continued from LIC809. LPA reviewed five (5) resident records and five (54) staff records during visit The following forms to be updated and submitted to CCLD by 10/31/2024: · LIC 500 Personnel Report · LIC 400 Affidavit Regarding Client/Resident Cash Resources · LIC 402 Surety Bond · LIC610E Emergency Disaster Plan · LIC308 Designation of facility responsibility LPA observed the following deficiency: · At 10:55AM LPA observed the following items in laundry room in an unlocked cabinet: Cutter& Repel Sportsman- Insect Repellent, Swan- Rubbing Alcohol and Marquee- Hydrogen Peroxide Deficiency is 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. Exit interview conducted and a copy of this report and appeal rights provided to Carla Page Continued LIC809Dthe state’s words, verbatim · CDSS document, Oct 24, 2024

Type of visit: Required - 1 Year

On 10/24/2023 at 9:10 AM, Licensing Program Analyst (LPA) P. Watson arrived unannounced to conduct Required 1 Year Annual inspection. Upon arrival LPA was greeted by caregiver, Simone Mladinich. LPA spoke with Administrator, Kathleen Taylor and explained the purpose of the visit. Administrator was unable to join the visit and allowed caregiver to sign report. The facility’s fire clearance was approved for 3 Ambulatory and 4 Non-Ambulatory. LPA toured facility with Simone including but not limited to bedrooms, bathrooms, kitchen, common area and backyard. The facility consists of 7 total bedrooms which 6 bedrooms are occupied by the residents and 1 bedroom is occupied by staff. All outdoor and indoor passageways are kept free of obstruction. LPA observed a locked fence surrounding the pool area. A comfortable temperature is maintained at 77 degrees Fahrenheit. LPA observed lighting in all rooms are adequate for the comfort and safety of the residents. The hot water temperature in the residents’ shared and private bathrooms were measured within range of 105-120 degrees Fahrenheit. Residents’ bathrooms are equipped with grab bars and non-skid mats. There is a minimum 7 day supply of nonperishable and 2 day of perishable foods. Centrally stored medication and sharps were locked and inaccessible to residents. Smoke detectors and carbon monoxide detectors were in operating condition during visit. Fire extinguisher was last purchased in 02/2023. First aid kit was observed to be complete. Report continues on 809 C At 9:40 AM, LPA reviewed 6 of 6 residents records. At 10:23 AM, LPA reviewed 6 of 6 staff records and 6 of 6 have current first aid training and associated to the facility. At 11:06 AM, LPA reviewed a sample of 6 of 6 resident’s medications. Updated copies of the following documents were requested for facility file and are to be submitted to CCL by 11/14/2023: LIC 308 Designation of Administrative Responsibility LIC 309 Administrative Organization LIC 500 Personnel Report LIC 610E Emergency Disaster Plan Liability Insurance Current Administrator’s Certificate No deficiencies cited during visit. Exit interview conducted and a copy of this report provided.the state’s words, verbatim · CDSS document, Oct 24, 2023