Agape Home for the Elderly

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Hannah Rodgers conducted an unannounced Required Annual Inspection. The facility file was reviewed prior to the visit. LPA was welcomed by and discussed the purpose of the visit to Administrator William Farris. The facility's license shows a maximum capacity of five (5) non-ambulatory residents, of whom one (1) may be bedridden in Room #1 or Room #3. Hospice waiver for three (3). During today’s inspection there were three (3) residents in care. LPA with Administrator Farris toured the interior and exterior of the facility and inspected each room. Pathways were free of obstruction and slip hazards. Resident bedrooms contained the required furnishings. Doors, windows, screens, toilets, and showers were in working order. Extra linens and hygiene supplies were present. The facility had sufficient space and equipment to facilitate dining, laundry, visitation, meetings, and client activities. The facility contained at least 2 days of perishable food, and at least 7 days non-perishable food, all safely stored. Cooking, dining equipment, and utensils were present. No toxic chemicals or poisons were accessible to residents. Medications were labeled, as required, and stored in locked areas. The swimming pool on the premises was gated, locked, and inaccessible to residents. Per Administrator Farris, no firearms or ammunition are kept at the facility. Carbon monoxide detectors, emergency lighting, fire extinguishers, and facility telephone were all in working order. First aid kits were complete and readily accessible. Required licensing postings were observed in visible areas of the facility. LPA reviewed facility records. The files reviewed by LPA contained required documents. Confidential records were stored in locked areas. No deficiencies were cited during the inspection. An exit interview was conducted with Administrator Farris to whom a copy of this report and the Licensee/Appeal Rights (LIC9058 03/22) were provided.the state’s words, verbatim · CDSS document, Mar 20, 2026

Type of visit: Required - 1 Year

On 03/13/2025 at 10:30 AM, Licensing Program Analyst (LPA) Melody Brown made an unannounced visit to the facility. The purpose of the visit was to conduct the required comprehensive annual inspection. LPA Brown met with a staff and was granted entry to the facility. Licensee/Administrator William Farris was informed of the visit. LPA Brown informed Licensee/Administrator Farris of the purpose of the visit. At the time of the visit there were two (2) staff present, and four (4) residents present. The facility is a six (6) bedroom, four (4) bathroom home with a kitchen/dining area, living room/activity room, laundry room and an attached garage. LPA brown noted that the pool in the backyard was locked and with the required fenced. The facility is Residential Care Facility for the Elderly (RCFE). The facility is licensed for a capacity of five (5) non-ambulatory residents of which one (1) may be bedridden. The facility’s approved for three (3) hospice waiver. The current census is four (4) residents. LPA Brown was accompanied by Licensee/Administrator Farris to conduct a general overall inspection, which included, but was not limited to the following: Physical Plant: The facility is operating in the capacity approved by Community Care Licensing Division (CCLD). There are no obstructions to indoor and outdoor passageways. The facility is maintained at a comfortable temperature of 68 degrees Fahrenheit (F). LPA Brown inspected resident bedrooms; they are equipped with required furniture such as: mattresses, night stands, storage space, and sufficient lighting; bathrooms were clean, and appliances were operating appropriately. LPA Brown observed sufficient furniture and lighting throughout the facility. LPA Brown measured and observed the water temperature in the resident bathroom to be at 107 degrees F. The facility is equipped with operating smoke detectors and carbon monoxide alarms. Charged fire extinguishers were also observed at the facility. Posters such as personal rights, the CCLD complaint poster, Ombudsman poster, and the disaster plan were posted in a common area. Cleaning supplies, toxins, sharps, and other dangerous items were kept inaccessible to residents in care. There was a designated storage space for resident/staff files. ***Continuation in LIC809C *** There is a medicine closet with the resident’s medications locked. LPA Brown observed the complete first aid kit and first aid book at the facility. Moreover, LPA Brown noted that the facility has the required emergency supplies, emergency food and emergency water maintained. Food Service: More than seven (7) days’ supply of non-perishable foods and more than two (2) days’ supply of perishable food supply were observed and sufficient for the number of residents in care. Care & Supervision: The facility has an Administrator present at the facility with appropriate and enough hours to appropriately manage the facility. The facility has sufficient number of staff to provide care and supervision to the residents in care. LPA Brown noted that the facility has a staff scheduled to work at night, awake and on duty as required for facility with dementia residents. Record Review: LPA Brown noted that the facility has an updated Infection Control Plan, Emergency Disaster Plan and updated Liability Insurance. LPA Brown reviewed four (4) resident files for admission agreements, updated physician reports, pre-placement appraisals, centrally stored medication list/physician orders and needs and services plans. LPA Brown observed resident files reviewed were complete. In addition, LPA Brown noted that Resident #2 (R2) and Resident #3 (R3) half bed rail have written orders from their physician indicating the need for half bed rail for mobility. LPA Brown reviewed three (3) staff files for First Aid/CPR certification, criminal record clearance, trainings, and health screenings with tuberculosis (TB) test result. LPA Brown observed that staff files reviewed were complete. During medication audit, LPA Brown observed that staffs at the facility did not assist Resident #2 (R2) with R2's one (1) self administered medication. Deficiency will be issued. Based on the observations made during today’s visit, one (1) deficiency was cited per Title 22, Division 6, Chapter 8 of the California Code of Regulations (CCR). An exit interview was conducted, and this report (LIC809), LIC809D, and Appeal Rights were discussed and provided to Licensee/Administrator William Farris.the state’s words, verbatim · CDSS document, Mar 13, 2025

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Ryan Gardner made an unannounced visit to the facility. The purpose of the visit was to conduct a required comprehensive annual inspection. LPA met with Administrator William Farris and was granted entry to the facility. The facility is a Residential Care Facility for the Elderly (RCFE) licensed for a capacity of five (5) non-ambulatory residents, one (1) resident may be bedridden. The current census is three (3) residents. LPA was accompanied by Administrator to conduct a general overall inspection, which included, but was not limited to, the following: The facility is operating in the capacity approved by Community Care Licensing (CCL). There are no obstructions to interior and exterior passageways. The facility is maintained at a comfortable temperature. LPA inspected resident bedrooms; they are equipped with required furniture such as: mattresses, nightstands, storage space, and sufficient lighting; bathrooms were clean, and appliances were operating appropriately. LPA observed sufficient furniture and lighting throughout the facility. LPA measured and observed the water temperature in the bathrooms to be at 111.2 degrees F. The facility is equipped with operating smoke detectors and carbon monoxide alarms. Postings such as the facility license, personal rights, the CCL complaint poster, and the disaster plan were posted in a common area. The cleaning supplies, toxins, sharps, and other dangerous items were kept inaccessible to the residents in care. There was a designated storage space for resident files and staff files. The medications are stored in a kitchen cabinet inaccessible to the residents. The non-perishable and perishable food supply is sufficient for the residents in care. The gate/fence to the pool and the spa in backyard is locked and inaccessible to the residents. LPA reviewed three (3) residents files for admission agreements, updated physician reports, and needs and services plans. LPA reviewed five (5) staff files for First Aid/CPR certifications, criminal record clearances, trainings, and health screenings. Based on the observations made during today’s visit, no deficiencies were cited per Title 22, Division 6, of the California Code of Regulations. An exit interview was conducted, and this report (LIC809) was discussed and provided to Administrator William Farris.the state’s words, verbatim · CDSS document, Feb 20, 2024