Aloha House

Type of visit: Required - 1 Year

On September 16 2026 Licensing Program Analyst (LPA) Sarah Benson arrived at the facility unannounced to conduct a Required-1 Year inspection. LPA met with assistant administrator Melanie Carter. The assistant administrator phoned the administrator Mai Thi Nguyen (cert #6074734740 exp.1-29-27) who arrived five minutes after LPA's arrival, LPA explained the purpose of the visit. Administrator certificate is current. Three (3) resident and two (2) staff was present in the facility during the inspection. One (1) client was at day program. LPA Benson and administrator toured the facility together to ensure the health and safety of residents in care. Areas toured include but are not limited to six (6) resident rooms, common areas, four (4) bathrooms, kitchen, storage areas and back yard. Staff and resident files were reviewed. Medications were also reviewed. Medication is locked in a locked closet. All bedrooms had required furniture, bedding, lighting and windows with screens. Cooking/dining equipment and utensils were present. Facility has required (7) seven-day non-perishable and (2) day perishable supply of food. The areas observed were found to be odor-free, clean and in good repair. The facility was observed to be at a comfortable temperature. First aid kit fully stocked and ready for emergency use. Smoke detectors are all operational. Fire extinguisher fully charged and last inspected in 4-23-26. Hot water temperature did not measure within required Title 22 regulations of 105 degrees F and 120 degrees F. All employees requiring background checks are cleared. There is a schedule of activities planned for the clients. All required postings are displayed within the facility. No pools/bodies of water are on the premises. No firearms are on premises. The last disaster drill was conducted and documented on 07-26-26, the facility has been conducting drills every 3 months. LPA interviewed one resident and one staff. The following deficiencies were observed (See LIC 809D) and cited from the California Code of Regulations, Title 22, and California Health and Safety Code. Failure to correct the deficiencies may result in civil penalties. Exit interview conducted, a copy of the report, and appeal rights provided to administrator.the state’s words, verbatim · CDSS document, Sep 16, 2026

From the deficiency page — Deficiency type: Type A · Section cited: CCR 87465(h)(4) · Plan of correction due date: Oct 16, 2026

Incidental Medical and Dental Care (h) The following requirements shall apply to medications which are centrally stored: All centrally stored medications shall be labeled and maintained in compliance with state and federal laws. No persons other than the dispensing pharmacist shall alter a prescription label. This requirement is not met as evidenced by: Based on observation, interview and record review, the licensee did not comply with the section cited above in one out of four residents had expired medicaion. which poses an immediate health, safety or personal rights risk to persons in care.the state’s words, verbatim · CDSS document, Sep 16, 2026

Plan of correction: Administrator will have a medicaion training with staff. Administrator will have staff inventory medicaions for expired medicaion monthly. Administrator will notify LPA when complete.

From the deficiency page — Deficiency type: Type B · Section cited: CCR87303(2) · Plan of correction due date: Oct 16, 2026

Maintenance and Operation: Faucets used by residents for personal care such as shaving and grooming shall deliver hot water. Hot water temperature controls shall be maintained to automatically regulate the temperature of hot water used by residents to attain a temperature of not less than 105 degree F (41 degree C) and not more than 120 degree F (49 degree C). This requirement is not met as evidenced by: The water temp. in resident bathroom tested above regulation requirements. which poses an immediate health, safety or personal rights risk to persons in care.the state’s words, verbatim · CDSS document, Sep 16, 2026

Plan of correction: Administrator will put in a work order to have hot water tank adjusted within regulation requirement. Administrator will notify LPA when completed.

Type of visit: Prelicensing

11/18/2025 10:00 AM Licensing Program Analysts (LPAs) Rebecca Knight and Marisa Chiarelli arrived at the facility to conduct a Pre-Licensing visit for a change of ownership (CHOW) with residents in care. LPAs met with licensee / administrator Mai Thi Nyguen and explained the purpose of the visit. LPAs completed Comp 3 presentation during the visit. The fire marshal has approved the fire safety inspection request. The facility is licensed for a total capacity of 6 non-ambulatory residents. The inside of the facility was observed to be in good condition and repair. The facility has five (5) bedrooms, three (3) bathrooms, kitchen, dining area, living room,office, covered porch, and front and back yards. LPAs observed 1 dining table with ample seating for residents in the dining room. LPAs observed a couch, chairs and recliner in the living room. The hot water registered at 111 F degrees which met the Title 22 requirement within a range of 105 - 120 degrees F. The kitchen was observed to be clean and in good repair. Food storage meets Title 22 regulation requirements. Plates, utensils, pots, and pans were in place during the inspection. Dishwasher, stove, microwave and refrigerator were all present and working. Continued on LIC809-C The facility has three fully charged fire extinguishers. LPAs observed smoke alarms and carbon monoxide detectors fully functioning. Bedrooms were observed to have furniture as required by Title 22 Regulations. All beds were made up with linens and bedspreads. Each bedroom has ample storage. The facility has multiple linen closets which contain sheets, pillowcases, towels and face cloths. Bathrooms were observed to be in good repair. Storage and lighting are adequate in the home. Medications are stored in a locking cabinet. Medications were reviewed. Cleaning supplies and toxins are locked up in a cabinet. Knives are secured. Washer and dryer observed in place and functioning. There is a locking office space where client and staff files are stored. There is a covered / screened in porch with a table and seating for the residents to use. The applicant has passed the pre-licensing portion of the application process. LPA will contact the Central Application Bureau. No deficiencies according to CCR Title 22, Division 6. Exit Interview and copy of report was provided to the licensee.the state’s words, verbatim · CDSS document, Nov 18, 2025

Type of visit: Office

COMP II by CAB successfully completed Method: Phone Call at CAB Applicant/administrator participated in COMP II at CAB telephone call with analyst at CAB. Identification of the applicant and administrator was verified by presenting photo ID via phone. During COMP II, applicant and administrator confirmed the understanding of Title 22. Component II was successfully completed. Applicant and administrator were advised to email/fax signed LIC 809 with copy of photo ID to CAB. During COMP II, CAB analyst confirmed Applicant/Administrator’s understanding of following areas: 1. Facility operation: License type, client/resident populations, and program 2. Staff qualifications and responsibilities 3. Applicant and Administrator qualifications 4. Program policy: Abuse, admission agreement, medication management, reporting incidents to CCL, restricted & prohibited conditions 5. Grievances, Complaints, Community resources 6. Physical plant, food service 7. Application document review and technical assistance: Criminal record clearance, Health screening, Fire clearance, First Aid/CPR certificate, Administrator certificate, Financial verification, Pre-licensing inspection, Compliance history, Control of propertythe state’s words, verbatim · CDSS document, Sep 23, 2025