A Haveli Care

Type of visit: Case Management - Other

On 12-22-2025, Licensing Program Analyst (LPA), Abdoulaye Zerbo made an announced visit for the purpose of conducting the final facility closure visit. LPA was greeted and granted entry by the Administrator, Alissa Gales. The Department was notified of the facility’s intent to close on December 16, 2025. The Licensee informed the Department that the closure was voluntary and due to relocation. During today’s visit, LPA toured both the interior and exterior of the facility and observed four (4) resident bedrooms to be all vacant. The facility never admitted any residents; therefore, no resident's relocation was necessary. The Licensee surrendered their original License on 12-17-25 (Effective Date: 12-22-2025). The LPA explained to licensee that the license will no longer be valid, and therefore no required care and supervision should be provided in the home unless the state approves licensure in the future. An exit interview was conducted, and a copy of this report was provided to the Administrator, Alissa Gales.the state’s words, verbatim · CDSS document, Dec 22, 2025

Type of visit: Prelicensing

Licensing Program Analyst (LPA) Abdoulaye Zerbo conducted an announced pre-licensing inspection at the facility and met with Administrator Alissa Gales Application: The inspection is new application for a Residential Care Facility for Elderly (RCFE). The Riverside County Fire Department approved a fire clearance on 10-24-2024 for six (6) non-ambulatory clients. Buildings and Grounds: The facility is composed of four (4) residents bedrooms, one (1) staff bedroom, three (3) bathrooms, a living room and a kitchen area. Water temperature was measured at 115.1 F. The interior and exterior walkways of the facility were observed to be clutter free with no obstructions present. Smoke and Carbon Monoxide detectors are hard wired in working order. There is a no pool and there are no weapons stored in the facility. Client bedrooms are fully furnished, and privacy is available. Outdoor areas have sufficient room for activities and leisure. A washing machine and dryer were available and in working order. The facility has a working phone witnessed by calling the phone number. Storage and Supplies: Medications, residents and staff files will be stored in a locked cabinet in the hallway, inaccessible to any unauthorized individuals. A complete first aid kit was observed to be available. Cleaning supplies will be stored in a in the laundry. Linens, and equipment appeared to be in good repair and sufficient for the approved census. Fire extinguishers were available and fully charged with an expiration date of August 18th, 2025. Food Service: Utensils and dishware are sufficient for the requested capacity. The refrigerator and freezer are in working order. Sharps knives will be stored in a locked cabinets in the kitchen area, available only to authorized individuals. Forms: The following signs were observed to be posted at the facility: Personal Rights, Complaint information, Emergency disaster plan, the facility sketch, ombudsman poster. LPA verified the Administrator's Certification, with an expiration date of 10-02-26, and CPR certification with the expiration date of 07-28-26. LPA observed that the physical plant is clean, in good repair, and to be hazard-free during today’s visit. The applicant will be contacted by the regional office to schedule the Comp III. LPA determined the facility meets the operational requirements for licensure. The Pre-licensing inspection is complete and has satisfied all requirements in accordance with Title 22, California Code of Regulations. An exit interview was conducted, and this report was discussed and a copy was provided to Administrator Alissa Gales.the state’s words, verbatim · CDSS document, Jan 8, 2025

Type of visit: Office

Facility Type: RCFE Application Type: Initial Capacity: 6 Method: Telephone call with CAB COMP II Participants: Gales, Alissa On 11/27/24, 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, Nov 27, 2024