Agape Senior II

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Sam Haddadin conducted an unannounced required one-year annual inspection using the CARE Inspection Tool. Upon arrival at the facility, LPA Haddadin was greeted and granted entry by Caregiver (CG) Tinny Lengkey. Administrator (AD) Cosmin Surgent arrived shortly thereafter. The facility is licensed to serve five (5) non-ambulatory residents, of which one (1) may be bedridden. The facility also has a hospice waiver for three (3) residents. The facility is a single-story structure located in a residential neighborhood and consists of one (1) staff bedroom, six (6) resident bedrooms, four (4) bathrooms, a living area, dining area, kitchen, outdoor covered patio, and an attached two-car garage. At the time of the visit, there were four (4) residents in care. During the inspection, LPA toured the interior and exterior areas of the facility. All bathrooms were observed to be clean, sanitary, and operational. Hot water was tested and measured between 115.9 degrees Fahrenheit and 116.9 degrees Fahrenheit. The kitchen was observed to be clean and organized, with an adequate food supply, including at least a two-day supply of perishable food and a seven-day supply of non-perishable food. Knives and cleaning supplies were secured in a locked exterior cabinet and inaccessible to residents. All kitchen appliances were observed to be operational and in working condition. Fire extinguishers were observed to be fully charged, with the most recent service date recorded as July 7, 2025. Smoke detectors and carbon monoxide detectors were tested and found to be operational. {***CONTINUE809C***} The first aid kit contained the required supplies. Facility records indicated that the most recent fire drill was conducted on April 10, 2026. Residents’ bedrooms were inspected and contained the required furnishings. The living room was furnished with a couch, chairs, and a television. The backyard included a covered patio with a seating area. No bodies of water were observed. The exit gate was operational, and no hazards or obstructions were observed. A review of resident files revealed no discrepancies. Staff files were also reviewed and found to be complete, with the required documentation maintained in each file. Based on the observations made during the inspection, no deficiencies are being cited pursuant to Title 22, Division 6, of the California Code of Regulations. An exit interview was conducted, and a copy of this report was provided to Administrator Cosmin Surgent at the conclusion of the inspection.the state’s words, verbatim · CDSS document, Jun 10, 2026

Type of visit: Required - 1 Year

On February 14, 2025, at 12:00pm, 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 was greeted and granted entry by Caregiver (CG) Tinny Lengkey. Assistant Administrator (AA) Natalia Surgent arrived at the facility around 12:30pm and LPA Kim explained the purpose of the visit. AA Surgent could not stay for the visit and said that CG Lengkey could sign on their behalf The facility is licensed to operate for five (5) nonambulatory residents, of which 1 may be bedridden, and has a hospice waiver for three (3) residents. The facility is a single-story structure located in a residential neighborhood. It consists of the following: one (1) staff bedroom, six (6) resident bedrooms, four (4) bathrooms, living area, dining area, kitchen, outdoor covered patio, and an attached two car garage. LPA Kim toured inside and outside of the physical plant with AA Surgent. There were no bodies of water or obstructions in the facility. 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. The Resident’s rooms were inspected: Resident Room 1, Resident Room 2, Resident Room 3, Resident Room 4, Resident Room 5, and Resident Room 6. Bathrooms were found to be within Title 22 regulations and were clean and operational. The water temperature measured at 114.8 degrees F to 116.2 degrees F. A comfortable temperature of 78 degrees F was maintained in the facility. LPA Kim observed the facility to be 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. The kitchen was inspected and there is a two-day supply of perishable and seven-day supply of non-perishable food both were available and maintained properly. Evaluation Report Continues on LIC 809-C During the visit, LPA Kim observed the facility's infection control practices, plan of operation, and screening protocols for visitors, staff, and residents. LPA observed the facility has a 30-day supply of Personal Protective Equipment (PPE). All mandated inspection control posters were posted. The smoke detectors and carbon monoxide detectors were operable. A working telephone (714-602-6576) remains available. Last emergency drill was conducted on January 9, 2025, and is conducted quarterly. First aid kit is maintained and contains all the necessary elements. Emergency food, emergency water, and emergency supplies are stored in the garage. The facility has two (2) fire extinguisher that are charged and mounted in the garage and in the dining room. LPA Kim conducted an audit of resident files (R1-R6), staff files (S1-S6), and medication and medication administration record were in all in order and complete. A deficiency was cited during this visit as per Title 22 Division 6 Chapter 8 of the California Code of Regulations. LPA observed the following deficiency: there is an enclosed room with two built walls used for storage in the garage that was not in the facility sketch. An exit interview was conducted, and a copy of this report and appeal rights were provided to Caregiver Tinny Lengkey.the state’s words, verbatim · CDSS document, Feb 14, 2025