Active Board + Care

Type of visit: Required - 1 Year

On 03/10/2026, Licensing Program Analyst (LPA), Wendy Gibbs, conducted an unannounced Annual Visit to the facility listed above. LPA met with Caregiver, Onelia Sanchez, and the purpose of today’s visit was explained. We were later joined by Licensee/Administrator, Candice Michelson. LPA was granted entry into the facility. The facility is licensed to serve six (6) non-ambulatory residents aged 60 and over, one (1) of which may be bedridden, and with an approved Hospice Waiver for one (1). Physical Plant The facility is a single-story structure in a residential neighborhood. The facility consists of three (3) bedrooms, two (2) bathrooms, living room, dining room, kitchen, staff room, office area, detached garage, and an outside shaded patio with table and chairs. LPA inspected inside and outside the facility. LPA observed the front and back yard maintained and in good repair. LPA observed all walkways around the outside of the facility are clean, clear, and free of debris, hazards, and obstructions. LPA did not observe any bodies of water on the premises. Bedrooms LPA inspected all residents’ bedrooms and observed them clean and in good repair. All rooms have the required furniture including a bed, dresser, nightstand with lamp, chair, and ample storage space for residents’ personal belongings. LPA observed the resident beds have the required linens including a mattress cover, fitted sheets, blanket, comforter and pillows. LPA observed an ample supply of linens in a cabinet in the hallway. All bedrooms were observed with ample lighting. Bathrooms LPA inspected all bathrooms. Bathrooms were found to be within Title 22 regulation and were observed to be clean and operational. All bathrooms have nonskid mats, secured safety handrails, and a shower chair available. LPA observed an ample supply of towels and hygiene products available for residents. The water temperature measured 109.3-degrees and 111.8-degrees Fahrenheit. LPA observed an ample supply of incontinent care supplies stored in resident rooms and an additional supply stored in the garage. Kitchen During the facility inspection, LPA observed the kitchen clean and sanitary. LPA observed all appliance working properly. LPA observed an ample supply of cookware, dishware, and cutlery. LPA observed a 3-day supply of perishable foods and a 7-day supply of nonperishable foods properly stored, labeled and dated. LPA observed all knives, sharps, and cleaning supplies secured in a locked cabinet in the kitchen and are inaccessible to residents. The water temperature measured 108.7-degrees Fahrenheit. Common Areas During the time of visit, LPA observed the facility was appropriately furnished. LPA observed, in the living room two recliners and a couch available for resident use. Additionally, LPA observed an activity table available for residents’ use. In the dining room, LPA observed a large table with chairs to accommodate residents. LPA observed an ample supply of games, activities, crafts, puzzles, and reading material. All common areas, walkways and hallways in the facility were observed with ample lighting. The facility was maintained at a comfortable temperature. File Review LPA reviewed the files for three (3) residents and observed they have the required documents. LPA reviewed the files for the administrator and three (3) staff. LPA observed the files have the required documents, clearance, and certification. LPA observed the administrator’s Administrator Certificate, number 7017246740, is valid till 10/06/2027. LPA received and reviewed the Liability insurance through Sierra Professional Insurance Service, valid till 05/07/2026. LPA observed Licensing Fees are current. Medications LPA observed Centrally Stored Medications secured in a locked cabinet in the dining room. LPA observed medications were in their original packaging. LPA reviewed the medications for three (3) residents and observed they are consistent with properly documented records. Safety LPA observed multiple fully charged fire extinguishers, in the kitchen and garage, purchased in 2025 per receipts. The last emergency drill was conducted on 01/03/26. Smoke detectors and carbon monoxide detectors are operable. The facility has a working landline telephone. LPA observed all required signs and documents posted in the dining room and living room. LPA inspected the First Aid kit and found it had the required items. Infection Control During the visit, LPA observed the facility's infection control practices. At the entrance, LPA observed a sanitizing stations that consists of a Visitor Sign In Log, masks, and hand sanitizer. LPA observed required Infection Control postings throughout the facility. LPA observed a 60-day supply of PPEs stored in the garage. During today’s visit, LPA did not observe or cite any deficiencies. An exit interview was conducted with Licensee/Administrator, Candice Michelson, and a copy of this report was provided.the state’s words, verbatim · CDSS document, Mar 10, 2026

Type of visit: Required - 1 Year

On 02/06/2025 at 10:00 AM, Community Care Licensing Division (CCLD) conducted an unannounced annual inspection visit at the Active Board and Care Facility. CCLD staff was allowed entry into the facility by Administrator Candice Michelson. Administrator Michelson asked infection control questions and took CCLD staff temperature prior to entrance into the facility. The facility is licensed for (6) non-ambulatory residents and (1) bedridden residents. The facility has an approved hospice waiver for (1) residents. Currently, there are four (4) residents residing in the facility. CCLD staff explained to Administrator Michelson, the purpose of the one-year Annual Inspection visit, and escorted CCLD staff on a tour of the entire inside and outside facility grounds. As part of the inspection, CCLD staff reviewed: Four (4) residents service records, four (4) residents medication records (MAR), three (3) staff records, and inspected the inside facility and outside grounds. The facilities’ last fire drill was conducted on 12/15/2024. The one-story residential home consists of three (3) resident bedrooms, two (2) resident bathrooms, living room, dining room, kitchen, staff room, office area, attached garage with washer and dryer/ storage area, backyard with table and chairs. No weapons are stored in the premises. Kitchen was inspected and observed to be clean and operational. A two-day supply perishable and seven-day supply of non-perishable foods are present in the facility. Emergency Water Storage is in the garage and kitchen area. CCLD staff observed that all facility rooms are clean and in good repair. A comfortable temperature was observed, and the facility has central air and heating. CCLD staff observed the following during inspection of resident’s rooms: mattresses are in good condition, adequate lighting present, plenty of dresser/closet space is present, and all bed linens present. All bedrooms contain furniture, lighting fixtures and personal storage space as required, all beds have the required amount of linen and mattress covers, CCLD staff observed fully stocked closet with bedding, towels, and toiletries supplies. Bathroom fixtures are clean, in good repair, and working properly and contain the required nonskid mats and grab bars. CCLD staff observed bathrooms were found to be within Title 22 regulation. Bathroom #1 hot water temperature properly measured at 113 degrees Fahrenheit; bathroom #2 hot water temperature properly measured at 111 degrees Fahrenheit. Kitchen hot water temperature properly measured at 115 degrees Fahrenheit. Facility (5) Carbon Monoxide and (5) Smoke Detectors hard wired operated and connected were tested and are working properly. The facility three (3) Fire Extinguishers was checked and found to be fully charged and accessible. All exit doors in the facility have alarm systems. The facility has a working landline telephone. All toxins and knifes are locked/secured and inaccessible to residents. Medications are centrally stored and in a locked storage cabinet. Facility 2 first aid kit is fully stocked with manuals was checked and in order. All Exits/ Walkways around the home were free of debris and hazards. Outside patio accessible to residents. Four (4) resident files were reviewed and found to be complete. CCLD staff reviewed four (4) resident medications (MAR) and they were all found to be administered according to doctor's orders. Three (3) staff files were checked and have the required documents. CCLD staff noted the Administrator Candice Michelson Certification # 6049748740 expiration date of 10/06/2023 was NOT valid at time of inspection. The facility does not handle residents money/cash resources and no surety bond is needed. Commercial General Liability Policy #484A9DCCD13D1 policy period from 05/07/2024 to 05/07/2025 underwritten by Primary Insurance Company, coverage 1,000,000/3,000,000 is valid at time of inspection. Administrator Michelson to email CCLD staff a full copy of the commercial insurance policy including all endorsements no later than 02/15/2025. All the required documents are posted in the facility in a clearly visible area. During the visit, CCLD staff observed the facility infection control practices. CCLD staff observed screening protocols for visitors, staff, and residents, sanitizing stations (Located in common areas and restrooms). CCLD staff observed staff and residents were NOT wearing face coverings. CCLD staff observed the facility has a 30-day supply of Personal Protective Equipment (PPE). CCLD staff reviewed LIC500 and all staff associated to facility. CCLD staff advised the Administrator Michelson to continuously monitor the Centers for Disease Control (CDC) website and Community Care Licensing Provider Informational Notices (PIN) for any updates relating to COVID-19 guidance. According to the California Code of Regulations (Title 22, Division 6, Chapter 8), CCLD staff did not observe any deficiencies therefore no citations were issued at this time. Annual Licensing Fee is CURRENT. An exit interview was conducted, and a copy of the Facility Evaluation Report was provided to Administrator Candice Michelson.the state’s words, verbatim · CDSS document, Feb 6, 2025

Type of visit: Annual/Random

On 2/22/2024, Licensing Program Analyst (LPA) Alfonso Iniguez conducted an unannounced annual required visit using the CARE Inspection Tool. LPA met with Candice Michelson/Administrator. LPA explained the purpose of today’s visit. Facility is licensed for (6) non-ambulatory residents and (1) bedridden residents. The facility has an approved hospice waiver for (1) residents. The facility is a single-story structure located in a residential neighborhood. It consists of the following: 3 bedrooms, 2 bathrooms, family room/dining room, kitchen, living room, shaded area, indoor and outdoor activity area, laundry room and detached garage. LPA Iniguez toured the physical plant with caregiver. There were no bodies of water or obstructions on the premises. A total of (3) rooms were inspected. Beds and bedding supplies were in good condition, adequate lighting was provided, and storage for the resident’s personal belongings was observed. Bathrooms were found to be within Title 22 regulations and were operational. LPA inspected the carbon monoxide detectors combo were in operable condition. The water temperature did not properly measure between: 105°F-120°F: Kitchen 127.0°F, Bathroom #1:125.0°F. Evaluation Report Continues LIC 809-C LPA Iniguez observed the facility to be clean, sanitary, and appropriately furnished at the time of the visit. Storage areas for personal hygiene were observed. Sharps objects and cleaning agents were locked and not accessible to residents. The kitchen was inspected and there is sufficient perishable and non-perishable food available at the property. All fire extinguishers were charged and were operable. A review of (2) resident records and (2) staff records were conducted. LPA checked (2) Medication Administration Records (MAR) and no discrepancies were found. The first AID kit was checked. The last facility disaster drill was: 12/12/2023. LPA observed the facility's infection control practices. A copy of the liability insurance will be emailed to LPA. Facility annual fee current. Deficiency cited under California Code of Regulations, Title 22, Division 6, Chapter 8. See details below: -Water temperature above 120F.(kitchen sink and restroom #1). -No health screening and TB test on file for S#1 - No medical assessment and TB test on file for R#2. -No appraisal and SPV form for R#1. An exit interview was conducted, and a copy of the Facility Evaluation Report was provided to Candice Michaelson/Administrator.the state’s words, verbatim · CDSS document, Feb 22, 2024