Adair Loving Care

Type of visit: Required - 1 Year

On July 6, 2026, at 9:00 AM, Licensing Program Analyst (LPA) Edward Kim conducted an unannounced required 1-Year annual visit using the CARE Inspection Tool. Upon arrival at the facility, LPA Kim met with Operations Manager (OPMAN) Irene Infante and explained the purpose of the visit The facility is licensed to have a capacity of six (6) nonambulatory residents, of which one may be bedridden, and a hospice waiver for five(5) residents. LPA Kim observed the following. The facility is a one-story house with five (5) resident bedrooms, three bathrooms, dining room, a kitchen, a living room, and multiple outdoor shaded areas. LPA Kim toured inside and outside of the physical plant with OPMAN Infante. There are no obstructions or bodies of water on the premises. All rooms were inspected. Beds and bedding supplies were in good condition, adequate lighting was provided, storage for each resident’s personal belongings was observed. Bed linens, comforters, and bath towels were adequately stocked at the time of visit. All bedrooms were inspected: Resident room 1, Resident Room 2, Resident Room 3, Resident Room 4, and Resident Room 5. Bathrooms were found to be clean and operational. The water temperature measured between 122.5 degrees F and 122.9 degrees F. During the visit, the facility would adjust the water temperature to be measured between 114.6 degrees F to 119.3 degrees F. A comfortable temperature of 74 degrees F was maintained in the facility. LPA Kim observed the facility to be sanitary and appropriately furnished at the time of visit. Storage areas for personal hygiene, cleaning supplies, toxins, and sharps objects were stored and not accessible to residents Evaluation Report Continues on LIC 809-C During the visit, LPA Kim observed the facility's infection control practices. LPA observed screening protocols for visitors, staff, and residents, and sanitizing stations in common areas. LPA observed the facility has a 30-day supply of Personal Protective Equipment (PPE). The kitchen was inspected and there is a two-day supply of perishable and seven-day supply of non-perishable food available and maintained properly. Emergency food, emergency water and emergency supplies are stored in the kitchen. All mandated inspection control posters were posted. The facility has smoke detectors and carbon monoxide detectors that were operable. The Certificate of Liability Insurance is effective from November 25, 2025 to November 25, 2026. The facility conducts Fire/Safety Drills quarterly and was last conducted on July 1, 2026. One (1) fire extinguisher is mounted in the resident hallway that was last inspected on June 26, 2026. A working telephone (949-299-2425) and tablet device dedicated to the residents both remain available. First Aid Kit contained all the necessary elements. LPA Kim conducted an audit of five (5) residents (R1-R5) files, and six(6) staff (S1-S6) personnel files, and medication and medication administration records. LPA observed S1, S2, and S3 did not have any completed training hours for 2026. LPA conducted interviews with two residents and two staff. Based on today’s visit, deficiencies were cited as per the Title 22 Division 6 Chapter 8 of California Code of Regulations (CCR). LPA observed resident bathrooms hot water temperature measured between 122.5 degrees F to 122.9 degrees F. During the visit, the facility adjusted the water temperature and LPA measured it from 114.6 degrees F to 119.3 degrees F. LPA observed S1, S2, and S3 did not have any training hours completed for 2026. An exit interview was conducted, and a copy of this report and appeal rights were provided to Operations Manager Irene Infante.the state’s words, verbatim · CDSS document, Jul 6, 2026

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Ruth Martinez is conducting this unannounced visit for the purpose of completing an annual required inspection. LPA arrived at the facility and was greeted and granted entry by staff. LPA met with Irene Infante, Administrator explained the nature of the visit. There are five residents at the facility and there is two (2) residents receiving hospice services currently. LPA accompanied by Administrator began the tour of the inside and outside of the facility. LPA observed required department postings throughout the facility. Facility stays within the capacity limitations. There is a minimum of one week of non-perishables foods and two days of perishables foods available. The facility is maintained at a comfortable temperature. LPA inspected that medication is centrally stored in a safe locked storage cabinet located in the bedroom hallway. LPA reviewed medication and observed medication was labeled and stored inaccessible to residents in care. LPA observed the two first aid kit closet storage. LPA inspected the facility bathrooms and LPA measured the hot water temperature which measured 118.7 Fahrenheit degrees. All bathrooms observed to have a supply of soap, toilet paper and towels. Bathrooms are equipped with required safety measures such as non-skid mats and grab bars. Lighting is sufficient to ensure safety and comfort. The facility is equipped with sufficient hand hygiene, cleaning, and disinfecting supplies. LPA observed that toxic chemicals, cleaning solutions and disinfectants are stored locked in a storage cabinet located in the backyard patio. The facility has an available clean supply of linens. LPA Continued on LIC809-C inspected residents’ bedrooms which has sufficient lighting to ensure the safety and comfort. All bedrooms observed to have all required components. Storage space is provided for residents in their bedroom. Smoke detectors/carbon monoxide detectors were tested and found to be operational. LPA toured the outside of the facility and observed outdoor passageways are free of obstructions. There is a covered patio in the backyard with a kitchenette, and the laundry unit is adjacent to patio. LPA observed there are shaded seating areas for residents’ enjoyment in the front yard as well as the backyard of the facility. LPA observed a fire extinguisher charged and mounted in the hallway. LPA observed fire drill documentation. LPA began review of records. LPA reviewed five resident records. All the required documentation was present and current in the residents’ files reviewed. LPA reviewed three employee records. All employees present have a criminal record clearance and are associated to the facility. LPA observed records reviewed have a current First Aid certificate. LPA as a reminder provided annual fee dues information. Based on the observations made during today’s visit, no deficiencies were noted today in the areas inspected per Title 22 Division 6 of the California Code of Regulations. This report was reviewed with the Administrator and a copy of this report was provided to the facility.the state’s words, verbatim · CDSS document, Jul 10, 2025

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Ruth Martinez is conducting this unannounced visit for the purpose of completing a 1 year required inspection. LPA arrived at facility was greeted at the door by Robert Adair, Administrator and granted entry. During today’s visit, LPA explained the reason for visit. LPA toured the facility and inspected the physical plant of the facility; no residents were observed at facility. LPA was informed there are no residents currently residing at facility and only occupant is administrator. LPA observed that facility is being renovated and is currently being worked on. LPA was notified earlier this year that the garage had been converted to a bedroom and added on to the footprint of the facility. LPA received a new footprint of the facility with conversion and was informed Licensee was coordinating with Fire Authority for the approval of the conversion. Administrator is taking the proper channels for the revision and once completed LPA will do a final inspection. LPA was informed that nothing has changed with the facility since last annual of 2022 and facility has no residents since it was licensed. Licensee will contact Community Care Licensing (CCL) to inform of when they are ready to accept new residents or if there are any changes with the license. As a reminder LPA gave information for annual fees due to be paid to Administrator. At this time there were no deficiencies to report in the facility. As noted above, Licensee will contact CCLD once residents are being admitted. In an effort to update the facility file, the Administrator is required to submit to the licensing agency a copy of the following: - An updated Personnel Report (LIC500). - Copy of Administrator Certificate. This report was reviewed with administrator and a copy of this LIC809 report was providedthe state’s words, verbatim · CDSS document, Jul 10, 2024