A Place Called Home Residential Care 3

Type of visit: Case Management - Other

On 8/24/26 Licensing Program Analyst (LPA) J. Leffall arrived unannounced to conduct an Annual Inspection. LPA introduced self, stated the purpose of the visit, and was greeted by Staff (S1) Liz Jugal . LPA was granted entry. All 6 residents were present during inspection. Administrator (A1) Colin Murchison arrived shortly LPA’s arrival. LPA toured facility with A1. The facility was observed to be at a comfortable temperature, clean, in good repair, and no passageway obstructions or fire hazards were observed inside. An adequate supply of perishable and non-perishable food was observed. Freezer temperature was maintained at -3 degrees F and refrigerator temperature was maintained at 37 degrees F. Fire extinguisher was observed with a service date of 2/7/26. Fire drill last completed on 7/6/26. Washer and dryer observed operational during visit. Carbon monoxide and smoke detectors were tested and observed to be operational. Residents' bedrooms were toured and observed to be adequately furnished with bed, dresser, and adequate lighting. All bathrooms are toured and observed to be operational. Hot water temperature was tested at a temperature range of 113.5 to 116.2 degrees F in 3 bathrooms. Non-skid mat and grab bars observed in bathrooms. Outside of facility toured. Side gate was self-closing and self-latching. Outside was observed with adequate outdoor seatings available for residents. Samples of medications were checked and observed kept locked in the hall closet. Residents’ MARS was reviewed. First aide kit observed with all the required items. Samples of residents and samples of staff files reviewed to have all the required documents. No deficiencies issued during this inspection. Exit Interview conducted. LPA is requesting the following documents be submitted to the Fresno CCL office by 9/7/26: Current copy of Administrator Certificate, Designation of Facility Responsibility (LIC308), Administrator Organization LIC 309, Affidavit regarding Client/Resident Cash Resources LIC 400, Liability Insurance-RCFE, Emergency and Disaster Plan LIC 610E, Personnel Report LIC500, Register of Facility Clients/Residents for LIC9020A A copy of this report was distributed to Administrator whose signature confirms receipt of this report.the state’s words, verbatim · CDSS document, Aug 24, 2026

Type of visit: Required - 1 Year

On 08/14/25 Licensing Program Analyst (LPA) J. Leffall arrived unannounced to conduct an Annual Inspection. LPAs introduced selves, stated the purpose of the visit, and was greeted by Staff (S1) Gillian Ponce. LPA was granted entry. 6 clients were present during inspection. Administrator Colin Murchison (A1) arrived shortly after LPA’s arrival. LPA toured facility with A1. The facility was observed to be at a comfortable temperature, clean, in good repair, and no passageway obstructions or fire hazards were observed inside. An adequate supply of perishable and non-perishable food was observed. Freezer temperature was maintained at -1 degrees F and refrigerator temperature was maintained at 37 degrees F. Cleaning chemicals was observed stored and locked in garage area. Fire extinguisher was observed with a service date of: 2/8/25. Fire drill last completed on 7/10/25. Clients' bedrooms were toured and observed to be adequately furnished with bed, dresser, and adequate lighting. All bathrooms are toured and observed to be operational. Hot water temperature was tested at a range of 113.9 to 114.6 degrees F. in 2 bathrooms. Outside of facility toured. Side gate was self-closing and self-latching. Outside was observed with adequate outdoor seatings available for clients. Medications were checked and observed kept locked in medication cart. Clients’ MARS was reviewed. Samples of medications, and medication logs were reviewed with no errors. Carbon monoxide and smoke detectors were tested and observed to be operational. All clients’ files reviewed to have all the required documents. Samples of staff files were reviewed and observed to have all the required documents. No deficiencies issued during this inspection. Exit Interview conducted. The following documents requested to be updated and submitted to Fresno CCL by 08/28/25: Lic 308, Lic 500, Lic 610D, and Lic 9020. LPA received a copy of current Administrator certificate. A copy of this report was provided to Administrator, whose signature on this form confirms receipt of this report.the state’s words, verbatim · CDSS document, Aug 14, 2025

Allegation investigated: Staff did not ensure supervision was provided resulting in resident sustaining injuries while in care Staff did not ensure reporting requirements were followed

On 2/10/25 at 1:00pm Licensing Program Analyst (LPA) J. Leffall conducted a subsequent complaint visit to deliver findings on above allegations. LPA met with Staff (S1) Liz Jugal and stated purpose of visit. The Department reviewed records and conducted interviews. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did occur, therefore the allegation is Unsubstantiated. No deficiencies were issued. Exit interview conducted. A copy of this report was distributed to Staff which confirms signature of report. Unsubstantiatedthe state’s words, verbatim · CDSS document, Feb 10, 2025 · control 24-AS-20241231112358

From the deficiency page — Deficiency type: Type A · Section cited: CCR 8741(d)(5) · Plan of correction due date: Feb 11, 2025

(d) All personnel shall be given on the job training or have related experience in the job assigned to them. This training and/or related experience shall provide knowledge of and skill in the following, as appropriate for the job assigned and as evidenced by safe and effective job performance: (5) Knowledge necessary in order to recognize early signs of illness and the need for professional help. This requirement was not met by based on interviews conducted and records review, R1 complained of pain after being found on the floor off of her wheelchair and staff did not seek medical attention or contact R1’s Physician which poses an immediate health and safety risk to residents in care.the state’s words, verbatim · CDSS document, Feb 10, 2025

Plan of correction: Administrator states will exercise Appeal rights at a later date. Administrator intends to file a complaint on the Investigator who conducted the Investigation.

Type of visit: Required - 1 Year

On 08/27/24 Licensing Program Analysts (LPA) J. Leffall and V. Gorban arrived unannounced to conduct an Annual Inspection. LPAs introduced selves, stated the purpose of the visit, and was greeted by Staff (S1) Leizel Jugal. LPAs was granted entry. 6 clients were present during inspection. Administrator Colin Murchison (A1) arrived shortly after LPA’s arrival. LPAs toured facility with A1. The facility was observed to be at a comfortable temperature, clean, in good repair, and no passageway obstructions or fire hazards were observed inside. An adequate supply of perishable and non-perishable food was observed. Freezer temperature was maintained at 0 degrees F and refrigerator temperature was maintained at 37 degrees F. Cleaning chemicals was observed stored and locked in garage area. Fire extinguisher was observed with a service date of: 2/8/24. Fire drill last completed on 6/14/24. Clients' bedrooms were toured and observed to be adequately furnished with bed, dresser, and adequate lighting. All bathrooms are toured and observed to be operational. Hot water temperature was tested 118 degrees F. in 3 bathrooms. Outside of facility toured. Side gate was self-closing and self-latching. Outside was observed with adequate outdoor seatings available for clients. Medications were checked and observed kept locked in medication cart. Clients’ MARS was reviewed. Samples of medications, and medication logs were reviewed with no errors. Carbon monoxide and smoke detectors were tested and observed to be operational. All clients’ files reviewed to have all the required documents. A sample of staff files were reviewed and observed to have all the required documents. No deficiencies issued during this inspection. Exit Interview conducted. The following documents requested to be updated and submitted to Fresno CCL by 09/1/24: Lic 308, Lic 500, Lic 610D, and Lic 9020. LPA received a copy of current Administrator certificate. A copy of this report was provided to Administrator, whose signature on this form confirms receipt of this report.the state’s words, verbatim · CDSS document, Aug 27, 2024

Type of visit: Required - 1 Year

On 10/27/23, Licensing Program Analyst (LPA) M. Yang arrived unannounced to conduct an annual visit. introduce self, stated the purpose of the visit and met caregiver Leizel “Liz” Jugal. LPA toured facility with caregiver. Licensee/Administrator David Murchison was called and arrived shortly during tour. All six residents were present during inspection. The facility was observed to be at a comfortable temperature, clean, in good repair, and no passageway obstructions or fire hazards were observed inside or outside. An adequate supply of perishable and non-perishable food was observed. The temperature is maintained for refrigerator at 40 degrees F and freezer at -2 degrees F. Fire extinguisher was observed with a service date of: 02/09/23. Fire drill last completed:10/06/23. LPA and Licensee observed medications that were ordered to be destroyed with former resident’s medication bottles were observed unlocked under kitchen counter. MARs were reviewed. Cleaning supplies and chemicals stored and locked in garage and laundry room. Washer and dryer observed operational during inspection. All bedrooms were observed to have the required furnishings and with adequate lightening. The bathrooms were toured. Bathrooms were observed operational during inspection. Non-skid mat and grabbed bars were observed. Hot water temperature was tested at 115.5 degree F in the bathroom 1, 115 degree F in bathroom 2, and 114.3 degree F in bathroom 3. Outside of facility toured and observed to be free of debris. Side gate observed self-closing and self-latching. Adequate outdoor seatings available for residents. Carbon monoxide and smoke detectors were tested and observed to be operational. All residents’ files were reviewed to have all the required documents. Staff are fingerprinted clear and associated to the facility. A deficiency is being cited on the attached Lic 809D in accordance to California Code of Regulations, Title 22, Division 6. Exit Interview conducted. The following documents are requested and submitted to Fresno CCL by: 11/02/23. Forms requested: Lic 308, Lic 500, Lic 610E, and current liability insurance. A copy of this report and appeal rights was provided to Licensee, whose signature on this form confirms receipt of this report.the state’s words, verbatim · CDSS document, Oct 27, 2023