All Our Love Senior Home

Type of visit: Required - 1 Year

On 02/19/2026, Licensing Program Analyst (LPA) Pang Lee arrived at the facility to conduct an unannounced annual inspection. LPA Lee met with care staff Chat Halasz and explained the purpose of the visit. The care staff called Administrator Erica Panen to inform her that Community Care Licensing (CCL) was present. The Administrator was not able to attend the visit and had the care staff Halasz signed the report. The current census is three with one facility staff. This facility is a single-story building approved for six (6) non-ambulatory residents of which one (1) may be bedridden in bedroom #3 and granted for hospice care for two residents. LPA Lee inspected the physical plant including but not limited to the common area, kitchen, dining area, resident bedrooms, resident bathrooms, garage and outside courtyards of the facility to ensure compliance with Title 22 regulations. LPA Lee observed the facility to be free of odor, clean and in good repair. LPA Lee observed bedrooms to be properly furnished with appropriate bedding and lighting. There are no bodies of water present. LPA Lee toured the kitchen and observed sufficient seven-day non-perishable and two-day perishable food supplies. Hot water temperature was measured at 111.0 degrees Fahrenheit in resident bathroom sink, which is within the required regulation of 105 to 120 degrees Fahrenheit. The smoke and carbon monoxide detectors are in compliance with fire safety. The fire extinguisher is located in the kitchen and was last serviced on 11/04/2025. LPA Lee observed the facility has a has a public telephone in the dining room and the facility has the required posters posted. CONTINUED LIC 809-C Facility thermostat was observed at 70 degrees Fahrenheit, which is within the required regulation of 68 to 85 degrees Fahrenheit. LPA Lee observed toxins located in the kitchen cabinet and kept locked and inaccessible to residents. LPA Lee observed sharp knives kept locked in the kitchen cabinet and inaccessible to residents. LPA Lee checked medication storage and found medication to be locked away and inaccessible to residents. The first aid kit was checked and contained the required components. LPA Lee reviewed three out of three resident files, and they were complete. LPA Lee reviewed 2 staff files and they were also complete. Furthermore, today’s visit was also conducted in response to an incident report that occurred on 01/02/2026 through 01/06/2026 and was received by the Department on 01/20/2026. Based on the incident report and interviews with Administrator Panen and care staff Halasz, Resident 1 (R1) was administered Digoxin 125 mg incorrectly. The physician’s order states that R1 is to receive one tablet by mouth every two days; however, staff administered one tablet daily for five consecutive days. LPA Lee audited the medications for three out of three residents by comparing the medications on hand with the Medication Administration Records (MARs) and confirmed that all records were accurate and complete. LPA reviewed staff criminal record clearances, and a review of staff records indicates that all facility staff or other individuals who require caregiver background checks are fingerprint cleared and associated with the facility. The following documents will be emailed to LPA Lee by 02/26/2026 at the end of day at 5:00 PM. (1) LIC 308 Designation of Administrative Responsibility (2) Copy of Administrator Certificate (4) LIC 610 Current Emergency Disaster Plan (5) Proof of Current Liability Insurance (6) LIC 500 Current Personnel Report As a result of this annual visit, the facility is not in compliance with Title 22 Regulation, and the deficiency can be found on the LIC 809-D page. An exit interview was conducted with care staff Halasz and a copy of these LIC 809 reports, LIC 809-D page, and Appeals rights were provided to the facility.the state’s words, verbatim · CDSS document, Feb 19, 2026

The state marks this report as 5 pages; the online copy we transcribed has 4. You can request the full file from the county licensing office.

Allegation investigated: Staff did not allow resident to access common areas in the facility. Staff spoke to resident in an inappropriate manner. Staff did not provide resident with adequate food service. Staff did not ensure facility was free from pests. Staff did not ensure facility was properly maintained. Staff did not ensure kitchen utensils were properly maintained. Staff did not ensure resident was provided a clean mattress.

On Auguest 22, 2025, Licensing Program Analyst (LPA) Pang Lee arrived unannounced to this facility to conduct a complaint visit. LPA met with care staff Edgar Panen and explained the purpose of the visit. A brieft conversatoin was conducted via telephone with administrator Erica Panen. LPA Lee explained the purpose of this visit is to deliver complaint findings for the above allegations and went over the allegations with the administrator Panen. The current census is one. It was alleged that staff did not allow residents access to the common areas in the facility. The investigation included interviews with staff, residents, resident responsible parties, and outside agencies, as well as direct observations. All four staff members interviewed stated that residents are permitted to access all areas of the facility except for the garage, which contains chemical materials. Two residents were interviewed. One of the two residents stated they have no concerns with the allegation. CONTINUED LIC9099-C Unsubstantiated Two out of two family members who frequently visit reported that they have observed residents freely accessing the common areas and expressed no concerns. Two out of two representatives from outside agencies confirmed they have witnessed residents in the common areas. During a site visit on 06/18/2025, LPA Lee and Ombudsman Byron Toliver observed a resident in the dining and in the kitchen. Based on interviews and statements conducted during the investigation process as well as direct observations, LPA Lee was unable to corroborate the allegation that staff did not allow residents to access the common areas in the facility. An allegation was made that staff spoke to residents in an inappropriate manner. The investigation included interviews with facility staff, residents, resident responsible parties, and outside agencies, along with direct observations. Four staff members were interviewed. All four denied that any staff had spoken inappropriately to residents under their care. Two residents were interviewed. One of the two residents stated they had not witnessed staff speaking inappropriately to residents and expressed no concerns regarding the behavior of facility staff. Two family members reported that they had not witnessed any inappropriate communication from staff toward residents and shared that their experiences have only been kindness from the facility staff. Two representatives from outside agencies stated that they had not observed any instances of inappropriate communication between staff and residents, and they expressed no concerns. Direct observations were made during a site visit. On 06/18/ 2025, LPA Lee, accompanied by Ombudsman Byron Toliver, did not observe any inappropriate communication between staff and residents. Based on interviews and statements conducted during the investigation process as well as direct observations, LPA Lee was unable to corroborate the allegation that staff spoke to residents in an inappropriate manner. It was alleged that staff did not provide residents with adequate food service. This investigation consisted of interviews with staff, residents, and resident responsible party as well at direct observations. Four staff members were interviewed. All four staff denied that staff are not providing adequate food service to residents in care. Two residents were interviewed. One of the two residents stated they have no concern regarding the adequate amount of food being provided and are content with the meals provided. CONTINUED LIC 9099-C Two family members reported that they also had no concerns about the food provided to the residents in care and stated that meals and snacks were "more than generous." Two representatives from outside agencies stated that they have no concerns with the food service being provided to the residents and have witnesses residents being provided with adequate food. Direct observations were made during a site visit. On 06/18/ 2025, LPA Lee, accompanied by Ombudsman Byron Toliver toured the kitchen observed that there was an adequate supply of food, including a minimum of seven days’ worth of non-perishable and two days’ worth of perishable food supplies. Moreover, these supplies were accessible to the residents in care. Based on interviews and statements conducted during the investigation process as well as direct observations, LPA Lee was unable to corroborate the allegation that staff did not provide residents with adequate food service. An allegation was made that staff did not ensure the facility was free from pests. The investigation included interviews with facility staff, residents, residents responsible parties, and outside agencies, along with direct observations during two separate site visits. Four staff members were interviewed. All four denied that there was any pest in the facility. Two residents were interviewed. One of the two residents stated they had not witnessed any pest in the facility and expressed no concern. Two family members reported that they had not witnessed any pest in the facility and also have no concern. Two representatives from outside agencies stated that they had not observed any pests in the facility and they expressed no concern. Direct observations were made during two site visits. On 06/18/ 2025, LPA Lee, accompanied by Ombudsman Byron Toliver, did not observe evidence of pest in the facility as well as today’s visit, 08/22/2025. Based on interviews and statements conducted during the investigation process as well as direct observations, LPA Lee was unable to corroborate the allegation that staff did not ensure the facility was free from pest. It was alleged that staff did not ensure the facility was properly maintained and that staff did not ensure kitchen utensils were properly maintained. The investigation included interviews with facility staff, residents, resident responsible parties, and outside agencies, along with direct observations during two separate site visits. Four staff members were interviewed. All four staff denied that the facility and kitchen utensils are not properly maintained. Two residents were interviewed. One of the two residents stated they had not witnessed the facility and kitchen utensils not properly maintained and expressed no concern. CONTINUED LIC 9099-C During the visit, LPA Lee and Ombudsman Toliver reviewed residents’ medication on hand and Medication Administration Record (MAR) logs for two residents. The review revealed that resident 1 (R1)’s MAR log was incomplete, with staff initials missing for three separate medications across three different days. Further, a medication audit for R1 showed that the medications listed on the MAR did not match the medications physically present. It was learned that R1 kept part of their medication supply in their personal room, while the rest was stored by the facility in a locked cabinet. This dual storage system contributed to confusion of what R1’s prescribed medications are. A review of R1’s LIC 602 Physician’s Report and LIC 603A Resident Appraisal confirmed that R1 requires assistance with medication management. However, the documents also indicate that R1 is able to manage, administer, and store their own medications, creating confusion around the level of responsibility shared between R1 and the facility as R1 stores some of R1’s medication in R1’s room and the facility store some of R1’s medication in the facility lock cabinet. During the interview process, facility administrator Erica was unable to clearly state which medications were currently prescribed to R1. Based on interviews and statements conducted during the investigation process as well as direct observations, LPA Lee was able to corroborate the allegation that staff did not dispense resident’s medication as prescribed. As a result, this allegation is SUBSTANTIATED. A finding that the complaint is substantiated means that the allegations are valid because the preponderance of the standard has been met. Deficiencies cited on the LIC 9099-D, per Title 22 Regulations. An exit interview was conducted with care staff Edgar Panen and a copy of this LIC 9099, LIC 9099-D page and appeal rights provided to facility. Two family members reported that they also have no concern with the facility and kitchen utensils not properly maintained and expressed that the facility is very clean, feels very lucky and comfortable that their loved one is house at the facility and feels that the residents is very well taken care of. Two representatives from outside agencies stated that they had not observed any concerns with the facility not being maintained. Direct observations were made during two site visits. On 06/18/ 2025, LPA Lee, accompanied by Ombudsman Byron Toliver observed that the facility was clean, free of odors, and in good repair. No signs of mold were found in the residents’ showers, under the kitchen sink, or on the windowsills. No cracks were observed on the floors throughout the facility, and the bathroom walls showed no signs of peeling. The dishwashing sponge was also observed to be clean. Based on interviews and statements conducted during the investigation process as well as direct observations, LPA Lee was unable to corroborate the allegations that staff did not ensure the facility was properly maintained and that staff did not ensure kitchen utensils were properly maintained. It was alleged that staff did not ensure residents were provided with clean mattresses. The investigation included interviews with facility staff, residents, responsible parties, and outside agencies, along with direct observations during two separate site visits. Four staff members were interviewed. All four denied residents are not provided with clean mattresses. Two residents were interviewed. One of the two residents stated they have no concern that they are not provided with a clean mattress. Two family members reported that they had not witnessed residents with unclean mattresses and had no concern. Two representatives from outside agencies stated that they had not observed any residents with unclean mattresses and they expressed no concern. Direct observations were made during two site visits. On 06/18/ 2025, LPA Lee, accompanied by Ombudsman Byron Toliver inspected mattresses in six resident rooms and did not observe the mattress to be dirty and having any stains as well as today’s visit, 08/22/2025. Based on interviews and statements conducted during the investigation process as well as direct observations, LPA Lee was unable to corroborate the allegation that staff did not ensure residents were provided with clean mattresses. The investigation revealed the preponderance of evidence standards have not been met; therefore, the above allegations are found to be UNSUBSTANTIATED. A finding that the complaint allegations are UNSUBSTANTIATED means that although the allegations may have happened or are valid, there is not a preponderance of the evidence to prove that the alleged violation(s)occurred. Per California Code of Regulations (CCRs) - Title 22, Division 6, Chapter 6, no deficiencies were cited. A copy of this report was provided to care staff Edgar at the end of the visit.the state’s words, verbatim · CDSS document, Aug 22, 2025 · control 27-AS-20250616145518

From the deficiency page — Deficiency type: Type A · Section cited: CCR 87465(c)(2) · Plan of correction due date: Aug 29, 2025

87465(c)(2) 87465 Incidental Medical and Dental Care (c) If the resident's physician has stated in writing that the resident is unable to determine his/her own need for nonprescription PRN medication… (2) Once ordered by the physician the medication is given according to the physician's directions. This was not met as evidence by: Based on interviews, record review and auditing residents’ medications on hand there were multiple discrepancies. One resident (MAR) listed medications were not initial as being administered; however, those medications were not found in the residents stored medications box; however, it was listed on the MAR logs as having been administered to the residents throughout the month.the state’s words, verbatim · CDSS document, Aug 22, 2025

Plan of correction: The administrator will conduct in-service training to ensure that residents’ medications are given to residents per physician’s order. During today’s visit it was learned that R1 has moved out of the facility. The administrator will provide LPA Lee with proof of training along with materials used for the training with staff sign-in sheets and a statement of understanding and acknowledgement of the regulation cited. POC due to LPA Lee 09/05/2025 end of day 5:00 PM.

Type of visit: Case Management - Other

On 8/22/2025 at 11:25 AM Licensing Program Analyst (LPA) Shakaricka Hughes and Licensing Program Manager (LPM) Czarrina Camilon-Lee arrived at the facility to conduct a case management visit to the facility to deliver an Order to Licensee/Facility of Immediate Exclusion from Facility. LPA met with facility staff Imelda and explained the purpose of today's visit. LPA Hughes handed the Order to Licensee/Facility of Immediate Exclusion from Facility letter to Imelda and explained that facility staff (S1), if present in the facility needed to leave immediately. Facility staff (S1) is to be removed from all shifts and disassociated from the facility in Guardian. An exit interview was held with Imelda and a copy of this report was provided.the state’s words, verbatim · CDSS document, Aug 22, 2025

Type of visit: POC

On 07/03/2025, Licensing Program Analyst (LPA) Pang Lee arrived unannounced to this facility to conduct a Plan of Correction (POC) visit. LPA met with direct care Edgar Panen and explained the purpose of the visit. A telephone call was made to the administrator Erica Panen who was not present during today’s visit. LPA Lee explained the purpose of the visit to the administrator Erica and direct care staff Edgar. The current census is 2 with 1 facility staff present. The purpose of this visit was to follow up on the prior deficiency and plan of correction that were due on 06/20/2025 from a post-licensing conducted on 06/18/2025. During today's visit, LPA Lee toured the facility and inspected residents bedrooms with direct care staff Edgar. Based upon this inspection, the LPA observed the following: 1. The deficiency cited under Title 22 Regulation 87202(a)(2) Fire Clearance has been cleared. The Licensee/Administrator did comply with the terms of the POC and the resident 1 (R1) was moved to bedroom #3 which is cleared for a bedridden resident. A POC letter was not generated and provided to the licensee. An exit interview was conducted, and a copy of this report was provided to care staff Edgarthe state’s words, verbatim · CDSS document, Jul 3, 2025

Type of visit: Post Licensing

On 06/18/2025, Licensing Program Analyst (LPA) Pang Lee made an unannounced visit to this facility to conduct a post required inspection. LPA Lee met direct care staff Imelda Panen and explained the purpose of the visit. Facility staff called to informed Administrator Erica Panen that CCLD was present. Administrator arrived at the facility approximately two hours later to assist the visit. The facility has a fire clearance to accommodate six non-ambulatory residents, including approval for one bedridden resident in room #3, and is licensed for two hospice waivers. LPA Lee was met by Ombudsman Byron Toliver. Together, LPA Lee, Ombudsman Bryon and Imelda inspected the physical plant, including but not limited to the kitchen, dining room, resident bedrooms and bathrooms, laundry room, garage, and outside courtyards, to assess compliance with Title 22 regulations. LPA Lee observed the facility was clean, odor-free, and in good repair. Resident bedrooms were properly furnished with appropriate bedding and lighting and were found to be sanitary. The fire extinguishers, smoke detectors, and carbon monoxide detectors were in good working condition. The exterior of the home was free of debris, and the emergency exit gate was functional and in good repair. The kitchen was clean and sanitary. LPA Lee observed adequate food supplies, including a seven-day supply of non-perishable food and a two-day supply of perishable food, both of which were accessible to residents. A review of records for Resident #1 (R1) indicated that R1 is both non-ambulatory and bedridden. This was confirmed through interviews with R1 and R1’s responsible party. However, it was discovered that R1 is currently housed in Bedroom #2, which does not have fire clearance for a bedridden resident. The facility is only approved to house a bedridden resident in Bedroom #3. Continued LIC 809-C LPA Lee reviewed two resident files and it was found to be complete. A medication review was also conducted for Resident #2 (R2). It was unclear what medications are currently prescribed to R2. Based on R2's LIC 602 Physicians Report, R2 needs assistance in these areas; however, R2 is able to manage own medications , administer own medications, and store their own medications. It was also learned that R2 stores part of R2's medications in their room, while the facility stores the remaining medications in a locked cabinet. Clarification is still needed regarding R2’s prescribed medications. LPA Lee will follow-up on this on complaint control # 27-AS-20250616145518. As a result of this post-licensing visit, the facility is not in compliance with Title 22 Regulation, and the deficiency can be found on the LIC 809-D page. The facility was also assess an immediate civil penalty. An exit interview was conducted, and a copy of these LIC 809 reports, LIC 809-D page, LIC 421 IM and Appeals rights were provided to the facility.the state’s words, verbatim · CDSS document, Jun 18, 2025

From the deficiency page — Deficiency type: Type A · Section cited: CCR 87202(a)(2) · Plan of correction due date: Jun 20, 2025

87202 Fire Clearance (a) All facilities shall maintain a fire clearance approved by the city, county, or city and county fire department, or district providing fire protection services, or the State Fire Marshal. (2) Bedridden persons This requirement was not met as evidenced by: A review of records for Resident #1 (R1) indicated that R1 is both non-ambulatory and bedridden. This was confirmed through interviews with R1 and R1’s responsible party. However, it was discovered that R1 is currently housed in Bedroom #2, which does not have fire clearance for a bedridden resident. The facility is only approved to house a bedridden resident in Bedroom #3.the state’s words, verbatim · CDSS document, Jun 18, 2025

Plan of correction: Administrator Erica stated that she will talk to R1 and R1’s responsible party to have R1 move to the fire cleared bedroom #3 for bedridden resident. POC will be cleared by visit. Administrator will review the regulation cited and email LPA Lee a statement of acknowledgement of understanding the regulation by POC date of 06/20/25 end of day 5:00 PM

Type of visit: Prelicensing

On 02/07/25 at 8:31 AM, Licensing Program Analyst (LPA) Pang Lee arrived announced to conduct a Pre-Licensing Inspection follow-up of the facility to ensure compliance with Title 22 regulations. LPA met with applicant Erica Panen who assisted in today’s inspection. Erica Panen will be the administrator to this facility. Administrator certificate number # is 7026719740 and will expire on 11/17/25. The facility has a fire clearance for 6 non-ambulatory residents to accept and retain at any given time, which 1 resident can be bedridden in rear right bedroom #3. The facility will not employ staff who are live-in and will ensure there are care in place for 24/7. There were no residents in care at this time. LPA informed applicant that the physical plant cannot be changed without notifying the department and that the submitted facility sketch needs to be adhere at all times. The applicant has completed the following deficiencies. · LPA observed two-emergency exit that are self-closing latches in the courtyard. · LPA observed the emergency exit is not obstructed and that the new sliding door leaning against the wall is removed. · LPA observed a designated area for staff file made inaccessible. · LPA observed complaint poster PUB 475 in the size of 20”X26” is posted in the common area. · Applicant will continue to be the administrator to the facility and have coverage for childcare and sufficient staffing. Continued LIC 809-C The following will be follow-up with applicant’s Centralized Applications Bureau Analyst · Licensee/Administrator will ensure that an updated plan of operation to include cameras in the dining area and common area. Plan of operation will also include the purpose of the camera, who can view the camera, how long is the recording and that there is no audio. · Licensee/Administrator will ensure that an updated facility sketch to include the shed in the courtyard and what the shed is used for and where cameras in the facility will be located. LPA reviewed Component 3 with the applicant. The applicant has passed the pre-licensing component of the application process. LPA will notify the CAB that the pre-licensing has been completed and passed. An exit interview was conducted, and a copy of this report was given to the applicant.the state’s words, verbatim · CDSS document, Feb 7, 2025

Type of visit: Prelicensing

On 01/02/2025 at 12:58 PM, Licensing Program Analyst (LPA) Pang Lee arrived announced to conduct a Pre-Licensing Inspection of the facility to ensure compliance with Title 22 regulations. LPA Lee met with Licensee Ericia Panen and licensee’s spouse Edel Panen. Licensee assisted LPA Lee in today’s inspection. This Applicant is seeking licensure for a 6-bed non-ambulatory Residential Care Facility for the Elderly (RCFE) to accept and retain at any given time, in one of which may be bedridden in bedroom #3. The facility has a waiver granted for 2 hospice care residents. The facility will not have live in staff and provide 24/7 care and supervision at all times. There were no residents at this time. Ericia Panen will be the Administrator of this facility. The facility administrator’s certificate # 7026719740 and will expire 11/17/25. It was learned that the applicant is pregnant and is expected to be due any day. The applicant will work on finding administrator coverage while the applicant is out on maternity leave. The facility has an infection control plan and an emergency disaster plan completed and provided to Licensing for approval. LPA Lee toured the facility with the applicant. LPA Lee observed a camera in the dining area. It was learned that the camera is not on the facility sketch and plan of operation. The applicant is requesting to have a waiver to obtain cameras in the dinning and common area. The facility interior sketch aligns with the layout of the building. LPA Lee inspected the kitchen area. Cabinets and drawers were opened and reviewed at this time. Silverware, plates, and utensils were observed to be sufficient to meet the needs of the residents at this time. Knives, cleaning agents, and bleach were observed to be locked and made inaccessible to the residents at this time. The food storage unit, facility refrigerator, was observed to be functional and in good repair at this time. Food supplies were reviewed for adequate 2-day perishables and 7-day non-perishable quantities, and they both were observed sufficient. Common area and dining area were observed to be furnished and sufficient to meet the needs of the residents. LPA Lee observed a telephone made available to residents in the common area. Continued LIC 809-D The facility smoke detectors, carbon monoxide detectors and fire extinguisher were observed to be in good condition. The fire extinguisher was last serviced on 10/22/24. Linen closet was observed sufficient supply of sheets, bedding, pillowcases, and blankets to meet the needs of the residents at this time. Residents’ bedrooms were toured, and furniture and furnishings were observed to be sufficient and able to meet the needs of the residents. The water temperature measured at 117.1 degrees Fahrenheit, and the facility temperature measured at 68 degrees. LPA Lee advised the applicant that the facility temperature regulations is between 68 * F to 85 * F. LPA Lee observed the centrally stored medication areas to be locked. LPA Lee inspected the first aid kit, and it was complete. LPA Lee observed supplies of hygiene items on the premises made available to residents in care. LPA lee observed facility has a designated area for residents and staff files; however, they are made accessible and not lock. LPA Lee also observed complaint poster PUB 475 posted; however, it needs to be in the size of 20” X 26” per regulation. LPA Lee did observe activity supplies made available for residents at this time. LPA Lee toured garage and the courtyard. LPA Lee observed a shed out in the courtyard. It was observed to have children play items. Per applicant the shed was used for play area for the grandchildren. LPA Lee advise the applicant that the shed cannot be used for play area or for any individual to live in. It was also learned that the shed was not on the courtyard facility sketch. Applicant stated that they are going to use the shed for storage purpose. LPA Lee observed the outdoor equipped for outdoor use. The two emergencies did not have self-closing latches. It was also observed one of the exits was unobstructed with new sliding doors leaning on the side of the wall. The applicant will work on the following deficiencies observed: · Licensee/Administrator will ensure that an updated plan of operation to include cameras in the dining area and common area. Plan of operation will also include the purpose of the camera, who can view the camera, how long is the recording and that there is no audio. · Licensee/Administrator will ensure that an updated facility sketch to include the shed in the courtyard and what the shed will be used for. Continued LIC 809-C · Licensee/Administrator will ensure that the two-emergency exit has self-closing latches. · Licensee/Administrator will ensure that the emergency exit is not obstructed and that the new sliding door leaning against the wall is removed. · Licensee/Administrator will ensure that there is a designated area for staff file made inaccessible. · Licensee/Administrator will ensure that a complaint poster PUB 475 in the size of 20”X26” is posted. · Licensee/Administrator will ensure that there is an administrator coverage is in place while the applicant is on maternity leave. The Applicant has not passed the pre-licensing component of the application process. The applicant will correct issues and inform LPA Lee when the corrections have been completed. An exit interview was conducted, and a copy of this report was provided to the applicant.the state’s words, verbatim · CDSS document, Jan 2, 2025

Type of visit: Office

Component II completion: Successful Facility Type: RCFE Application Type: INTL Capacity: 6 Census : 0 Method: Telephone call with CAB COMP II Participants: Erica Panen (Administrator/Licensee) & Tammy Edwards (Analyst). Administrator/Licensee participated in COMP II via telephone call with CAB analyst. Identification of the Administrator/Licensee was verified by confirming driver’s license number. During COMP II, Administrator/Licensee confirmed the understanding of Title 22. Component II was successfully completed. Administrator/Licensee was advised to email signed LIC 809 with copy of photo ID to CAB. During COMP II, CAB analyst confirmed Administrator/Licensee's understanding of following areas: 1. Facility operation: License type, client/resident populations, and program 2. Admission Policies 3. Staffing requirements & Training 4. Restrictive/Prohibited Health Conditions 5. General provisions 6. Emergency Preparedness 7. Complaints & Reporting 8. Pre-licensing readinessthe state’s words, verbatim · CDSS document, Dec 20, 2024