Argento Westchester

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Allegation investigated: Facility administrator is unqualified.

On July 10, 2026, the California Department of Social Services/Community Care Licensing (CDSS/CCL) Licensing Program Analyst (LPA), Ernand Dabuet, an unannounced complaint visit. Ashley Shire, Executive Director, greeted the LPA. (LPA) explained that the purpose of the visit is to investigate the allegation mentioned above. The investigation included interviews, record reviews, and a tour of the facility. Interviews were conducted with staff members Staff #1 - Staff #6 (S1-S6) and Witness #1 (W1). The Department reviewed several documents, including the Facility Resident Roster (dated 07/02/26), Personnel Report LIC 500 (dated 07/07/26), (S1’s) Resume, Personnel Record LIC 501 (dated 01/01/26), State of California CDSS Community Care Licensing Division RCFE Administrator Certificate Program #607339540, CPR/First Aid #E57578C5, Criminal Record Statement LI 508 (dated 11/20/25), Emergency Disaster Plan for RCFE (dated 01/01/25), RCFE Medical Relias Training, and other pertinent records associated with the complaint. (Evaluation Report continues LIC 9099-C) Unsubstantiated INVESTIGATION REVEALED THE FOLLOWING: ALLEGATION: Facility administrator is unqualified. It is alleged that the facility Staff #1 (S1) is an unqualified administrator. It is reported that (S1) does not meet the requirements of an administrator for a Residential Care Facility for the Elderly (RCFE), lacking years of college, work experience, or equivalent education. Reports indicate that (S1) has no higher education credentials and only three years of experience as a salesperson. No further detailed information was provided. On July 10, 2026, between 09:00 AM and 01:15 PM, the Department conducted interviews with staff members identified as Staff #1 through Staff #6 (S1-S6). Six (6) of the six (6) staff members were unable to support this claim. (S2-S6) asserted that (S1) fulfills all the essential duties and qualifications required for the role of Executive Director (administrator). Every staff member emphasized that (S1) possesses a deep understanding of regulatory requirements, is consistently present at the facility, takes responsibility, and provides valuable supervision and direction to the staff. Additionally, (S1) effectively addresses residents' needs while supporting staff in their roles. (S1) claimed that (S1) meets all Administrator Qualifications for large Residential Care Facilities for the Elderly (RCFE). (S1) has not only fulfilled the minimum age criteria but also possesses the necessary educational background. (S1) has completed the 80-hour Initial Certification Training (ICTP) and passed the (RCFE) Administrator Examination. Additionally, (S1) has obtained the required criminal clearance and over three years of management experience in licensed (RCFE) facilities, showing a strong dedication to high-quality care for older adults. (S1) held the positions of Sales and Marketing Director and interim Administrator in Training from 2021 to 2025. Before that, (S1) served as the Resident Engagement Manager from 2017 to 2021. On July 10, 2026, between 10:51 AM and 11:00 AM, the Department interview witness member identified as Witness #1 (W1). (W1) verified that (S1) worked as a Resident Engagement Manager from 2017 through 2021. (Evaluation Report continues LIC 9099-C) This report serves as an amendment to clarify finding. It does not supersedes the complaint investigation findings reflected on report created on 07/10/26. The Department reviewed (S1's) service records that included: Personnel Record LIC 501 (dated 01/01/26), State of California CDSS Community Care Licensing Division RCFE Administrator Certificate Program (valid through 12/14/26), CPR/First Aid (valid through 04/25/27), Criminal Record Statement LIC 508 (dated 11/20/25), has a current California Department of Social Services Clearance Background (dated 01/20/26), Emergency Disaster Plan for RCFE (dated 01/01/25), Designation of Facility Responsibility LIC 308 (dated 12/26/25), Application for Community Care Facility or (RCFE) License LIC 200 (dated 12/08/25), Argento Westchester Job Description for Administrator/Executive Director (dated 01/04/26). In addition, a review of Relias In-Service Mandatory Training completion of 284 hours. Records show that (S1) meets the qualifications and duties outlined in Title 22 (87405) Administrator - Qualifications and Duties. Based on the information gathered, there is not enough evidence to support the allegation mentioned above. Based on the information collected from the facility inspection, observations, interviews, and records analysis, the Department found no evidence to support the above allegation. The allegation may have happened or is valid, but there is not a preponderance of the evidence to prove that the alleged violation occurred. Therefore, the allegation is Unsubstantiated. No deficiencies cited. An exit interview was conducted with ASHLEY SHIRE, and copies of the reports were provided. This report serves as an amendment to clarify finding. It does not supersedes the complaint investigation findings reflected on report created on 07/10/26.the state’s words, verbatim · CDSS document, Jul 10, 2026 · control 11-AS-20260706152537

Allegation investigated: Staff did not complete required training. Staff are not conducting fire drills.

On 05/28/26 at 9:40 am Licensing Program Analyst (LPA) Villegas conducted an initialcomplaint visit regarding the allegation(s) above. LPA met with Executive Director Ashley Shire (staff #1 S1) as the purpose of today’s visit was explained. The investigation consisted of the following: On 05/28/26 LPA Villegas obtained copies of the staff and resident roster, the emergency disaster plan, facility sign in sheet dated: 05/19/26, copies of the quarterly fire drill reports dated: 01/20/26, disaster drills report dated: 01/20/26, evacuation drills reports dated: 01/20/26, In service sign in sheets dated: 02/26/26, 03/26/26, 04/29/26, 05/20/26, 05/27/26, and reliase training logs for staff #6-11 (S6-S11). On 05/28/26 11am-12pm LPA conducted interviews with staff #1-5 (S1-S5) regarding the allegation above. On 05/28/26 LPA conducted telephone interview with witness #1 (W1), conducted a review of training logs for S6-S11, and conducted a review of quarterly drill reports dated: 01/20/26. The investigation revealed the following: Unsubstantiated Allegation: Staff did not complete required training. It is being alleged that not all caregivers have completed the required ongoing training. On 05/28/26 11am-12pm LPA conducted interviews with S1-S5 regarding the allegation above. 5 of the 5 staff interviewed denied the allegation above and reported that upon hire Reliase training is required before "on the floor" training can begin. Additionally, 5 of the 5 staff interviewed reported that all staff have monthly Reliase training's in addition to in-services. On 05/28/26 LPA conducted a review of training logs for S6-S11. Per Reliase transcripts and in- service sign in sheets, S6-S11 have completed required training's for 2026 thus far. Allegation: Staff are not conducting fire drills. It is being alleged that fire drills have only been conducted on the day shift and have not been completed on all shifts as required. On 05/28/26 11 am-12pm LPA conducted interviews with S1-S5 regarding the allegation above. 5 of the 5 staff interviewed denied the allegation above and reported that drills are conducted quarterly and are conducted during every shift. On 05/28/26 LPA conducted telephone interview with W1 regarding the allegation above. W1 denied the allegation above and reported that drills are conducted quarterly and are conducted in the morning, evening, and night shifts. Furthermore, W1 confirmed that the last drill conducted during all 3 shifts was done on 05/19/26. On 05/28/26 LPA conducted a review of quarterly drill reports dated: 01/20/26. Upon review LPA observed that the quarterly fire drills were conducted at 1:00pm, 2:30pm, and 11:30pm, the quarterly disaster drills were conducted at 1:10pm, 2:40pm, and 11:40pm, and the quarterly evacuation drills were conducted at 1:30pm, 2:50pm, and 11:50pm. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation(s) did or did not occur, therefore the allegation is unsubstantiated. Exit interview conducted, and a copy of this report was provided.the state’s words, verbatim · CDSS document, May 28, 2026 · control 11-AS-20260518162103

Allegation investigated: Staff did not complete required training. Staff are not conducting fire drills.

On 05/28/26 at 9:40 am Licensing Program Analyst (LPA) Villegas conducted an initialcomplaint visit regarding the allegation(s) above. LPA met with Executive Director Ashley Shire (staff #1 S1) as the purpose of today’s visit was explained. The investigation consisted of the following: On 05/28/26 LPA Villegas obtained copies of the staff and resident roster, the emergency disaster plan, facility sign in sheet dated: 05/19/26, copies of the quarterly fire drill reports dated: 01/20/26, disaster drills report dated: 01/20/26, evacuation drills reports dated: 01/20/26, In service sign in sheets dated: 02/26/26, 03/26/26, 04/29/26, 05/20/26, 05/27/26, and reliase training logs for staff #6-11 (S6-S11). On 05/28/26 11am-12pm LPA conducted interviews with staff #1-5 (S1-S5) regarding the allegation above. On 05/28/26 LPA conducted telephone interview with witness #1 (W1), conducted a review of training logs for S6-S11, and conducted a review of quarterly drill reports dated: 01/20/26. The investigation revealed the following: Unsubstantiated Allegation: Staff did not complete required training. It is being alleged that not all caregivers have completed the required ongoing training. On 05/28/26 11am-12pm LPA conducted interviews with S1-S5 regarding the allegation above. 5 of the 5 staff interviewed denied the allegation above and reported that upon hire Reliase training is required before "on the floor" training can begin. Additionally, 5 of the 5 staff interviewed reported that all staff have monthly Reliase training's in addition to in-services. On 05/28/26 LPA conducted a review of training logs for S6-S11. Per Reliase transcripts and in- service sign in sheets, S6-S11 have completed required training's for 2026 thus far. Allegation: Staff are not conducting fire drills. It is being alleged that fire drills have only been conducted on the day shift and have not been completed on all shifts as required. On 05/28/26 11 am-12pm LPA conducted interviews with S1-S5 regarding the allegation above. 5 of the 5 staff interviewed denied the allegation above and reported that drills are conducted quarterly and are conducted during every shift. On 05/28/26 LPA conducted telephone interview with W1 regarding the allegation above. W1 denied the allegation above and reported that drills are conducted quarterly and are conducted in the morning, evening, and night shifts. Furthermore, W1 confirmed that the last drill conducted during all 3 shifts was done on 05/19/26. On 05/28/26 LPA conducted a review of quarterly drill reports dated: 01/20/26. Upon review LPA observed that the quarterly fire drills were conducted at 1:00pm, 2:30pm, and 11:30pm, the quarterly disaster drills were conducted at 1:10pm, 2:40pm, and 11:40pm, and the quarterly evacuation drills were conducted at 1:30pm, 2:50pm, and 11:50pm. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation(s) did or did not occur, therefore the allegation is unsubstantiated. Exit interview conducted, and a copy of this report was provided.the state’s words, verbatim · CDSS document, May 28, 2026 · control 11-AS-20260518162103

Allegation investigated: Licensee does not ensure there is sufficient staff to meet the needs of residents who require a two person assist.

On 05/12/2026 at 8:15am the Department conducted a initial visit at this facility to conduct the complaint investigation. During today's visit, the Department met with Ashley Shire (Adminstrator) and explained the purpose of the visit On 05/12/2026, between the hours of 8:00 AM – 10:35 AM, the Department interviewed Administrator (A1), Staff (S1–S7), and Residents (R1–R7). The Department requested and obtained copies of the staff roster (dated 05/05/2026) and resident roster (dated 04/26/2026). The Department also obtained resident records for R1–R7 which include: LIC 601: Identification & Emergency Information, LIC 602A: Physician’s Report for RCFE, LIC 603A: Preplacement Appraisal, Service Plans and Dementia Plan of Care Policies & Procedures Addendum. Investigation Findings continue on LIC 9099-C Unsubstantiated The investigation revealed the following: Allegation: Licensee does not ensure there is sufficient staff to meet the needs of residents who require a two person assist. It was alleged that the licensee has chronic understaffing on both floors, including floors where multiple residents require full two-person assistance. It was further alleged that staffing shortages have persisted despite concerns raised by staff, that agency staffing has not been utilized, and that new residents continue to be admitted without ensuring adequate staffing levels. On 05/12/2025, between the hours of 8:35am – 8:51am, the Department interviewed the Administrator in regards to the allegation. A1 denied the allegation. A1 reported that the facility has 60 residents, with four (4) residents requiring a two-person assist, and stated that current staffing levels which include seven (7) caregivers, one medtech, and administrative support such 1 administrator, 1 assisted living director, 1 activities director, 1 activities assistant, and 1 assistant administrator that are sufficient to meet resident needs. A1 stated that caregivers are assigned as four (4) caregivers upstairs and three (3) caregivers downstairs, with two (2) caregivers provides two person assistance when required. A1 reported that overtime is offered during shortages and that the facility began using outside agency staff as of 05/08/2026. A1 further stated that staffing concerns are taken into consideration and that new resident admissions are evaluated through assessment to ensure the facility can meet care needs. On 05/12/2025, between the hours of 9:40am – 10:41am, the Department interviewed seven (7) staff regarding the allegation. Two (2) out of seven (7) staff confirmed the allegation. Five (5) out of seven (7) staff denied the allegation. Of the staff who confirmed the allegation reported prior shifts where staffing was insufficient to consistently provide two person assistance, resulting in delays and the need to prioritize higher need residents. Of the staff who denied the allegation stated that current staffing levels are sufficient and reported no awareness of residents missing required two person assistance. Investigation findings continues on LIC 9099-C On 05/12/2025, between the hours of 8:54am – 9:27 am, the Department interviewed seven (7) residents regarding the allegation. Three (3) out of seven (7) residents confirmed the allegation. Three (3) out of seven (7) residents denied the allegation. One (1) out of seven (7) resident did not confirm nor deny the allegation and was unable to provide reliable responses due to cognitive impairment. Of the 3 residents who confirmed the allegation stated waiting long periods for assistance, needing two staff but receiving only one or none, or not receiving the care and attention they felt they needed. Of the three (3) residents who denied the allegation reported receiving timely assistance, stated they did not wait long for care, and denied needing two-person assistance. On 05/12/2026, between the hours of 12:00pm – 2:00pm, the Department conducted a records review for Residents R1–R7. The review included LIC 602A Physician’s Reports (dated 09/14/2023, 12/30/2024, 03/19/2025, 02/20/2026, 04/15/2026, 04/21/2026, and 08/27/2024), LIC 603A Preplacement Appraisals (dated 09/13/2024, 12/29/2024, 01/17/2025, 03/19/2025, 02/20/2026, and 04/15/2026), and current Service Plans (dated 01/07/2026, 04/21/2026, and 05/12/2026). Record review showed that the majority of residents (R1, R2, R4, R5, R6, R7) were documented as independent or requiring only one‑person assistance with transfers and mobility. These records consistently reflected needs such as verbal cueing, observation, walker use, or one person hands on assistance, but no documentation indicated a two person assist requirement for any of these residents. One resident (R3) was documented as requiring full assistance with transfers and mobility, including hands on support, fall management, and use of mobility equipment; however, R3’s LIC 602A, LIC 603A, and Service Plan did not identify a two person assist requirement. Across all seven (7) resident files reviewed, none of the LIC 602A forms, LIC 603A appraisals, or Service Plans documented a need for a two person assist for any resident at the time of the investigation. Additionally, according to the facility’s Plan of Operation for Dementia Care (Policies and Procedures Addendum), the facility is required to maintain an adequate number of direct care staff to support each resident’s physical, social, emotional, safety, and health care needs as identified in their current appraisal. The Plan of Operation also states that the facility will have at least one awake night staff if any resident with dementia requires night supervision. Investigation findings continues on LIC 9099-C Also the LIC 500 Personnel Report (dated 05/05/2026) the facility employs 35 direct care staff, consisting of 31 caregivers and 4 MedTech/Caregivers. Staffing schedules show 11 caregivers assigned to the AM shift (6:00 AM – 2:30 PM), 9 caregivers assigned to the PM shift (2:00 PM – 10:30 PM), and 7 caregivers assigned to the NOC shift (10:00 PM – 6:30 AM), with an additional six (6) caregivers listed as variable or TBD. AM schedules include staff working Sunday–Thursday, Wednesday–Sunday, and Tuesday–Saturday. PM schedules include Monday–Wednesday, Thursday–Monday, Wednesday–Thursday, Tuesday–Friday, Friday–Sunday, and Tuesday–Saturday. NOC schedules include Thursday–Saturday, Sunday–Thursday, Monday–Friday, Sunday–Wednesday, and variable overnight assignments. Overall, staffing patterns reflect routine shift coverage supplemented by variable schedule caregivers. Based on information gathered through interviews and record reviews, there is not enough evidence to support the allegation. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur. Therefore, the allegation is UNSUBSTANTIATED. Exit interview conducted with Ashley Shire (Administrator) and a copy of this report was provided.the state’s words, verbatim · CDSS document, May 12, 2026 · control 11-AS-20260508135653

Allegation investigated: Facility is in disrepair.

On 5/11/2026, LPA Alfonso Iniguez conducted an unannounced initial complaint visit. LPA Iniguez met Ashely Shire/Administrator. LPA Iniguez explained the purpose of this visit. Investigation Consisted of: the department conducted the following interviews: Administrator Interview (A#1), Maintenance Director Interview (M#1) and Staff Interviews (S#1-S#3). The department gathered the following documents: copy of client roster and staff roster dated:5/11/26, and a Health and Safety check of the facility. Evaluation Report continues LIC 9099-C Unsubstantiated Investigation Revealed the Following: Allegation: Facility is in disrepair. The details of the complaint alleged that the emergency exit door by courtyard is in disrepair. On May 11, 2026, at approximately 1:00 PM, during a Health and Safety check of the facility, the Department observed the emergency exit gate located by the courtyard. The Department requested that the administrator (A#1) operate the gate, and (A#1) entered the access code on the keypad located beside the gate. The gate opened upon entry of the code. The Department did not observe the gate to be in disrepair at the time of the visit. On May 11, 2026, at approximately 2:00 PM, the Department interviewed the facility administrator (A#1) regarding the condition and operation of the emergency exit gate located in the courtyard near the golfing area. When asked to describe the current condition and functionality of the gate, (A#1) stated that the gate is locked and is functioning appropriately, and that it can be opened by entering a code on the keypad located beside the gate. When asked about the facility’s procedures for inspecting and maintaining emergency exit gates and when this specific gate was last checked, (A#1) stated that the maintenance director (M#1) conducts a daily walkthrough to check the doors and ensure they are working properly. When asked whether any reports or concerns had been received regarding the gate not opening properly during routine use or emergency preparedness activities, (A#1) stated that no reports had been brought to their attention. On May 11, 2026, at approximately 2:30 PM, the Department interviewed the maintenance director (M#1) regarding the inspection and operability of the emergency exit gate located in the courtyard near the golfing area. When asked when the gate was last inspected and what the findings were at that time, (M#1) stated that they check all gates, including the courtyard gate, every day. When asked whether any issues with this gate had been identified recently and whether any repairs or maintenance had been required or scheduled, (M#1) stated that no issues had been identified. Evaluation Report continues LIC 9099-C When asked about the facility’s procedures for ensuring that emergency exit gates remain operable and whether there had been any challenges maintaining this gate, (M#1) stated that daily checks are performed. On May 11, 2026, at approximately 3:00 PM, the Department interviewed facility staff (S#1–S#3), (3) out of (3) stated that they had not observed any difficulties opening or operating the emergency exit gate located in the courtyard near the golfing area during their shifts. In addition, staff stated that if an emergency exit gate is not functioning properly, the expected procedure is to report the issue to the maintenance director and the administrator immediately. Also, staff reported that they had not submitted any reports related to this gate. During this investigation, LPA did not find sufficient evidence to support the above-mentioned allegation(s). Based on the evidence gathered, interviews conducted, and records reviewed, the preponderance of evidence standard has been met; therefore, the above-mentioned allegation(s) are found to be UNSUBSTANTIATED. Although the allegations may have happened or are valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur. An exit interview was conducted, and a copy of the Complaint Report was given to Ashley Shire /Administrator.the state’s words, verbatim · CDSS document, May 11, 2026 · control 11-AS-20260506115800

Allegation investigated: Staff did not keep the emergency exits free of obstruction.

On 01/21/2026 Licensing Program Analyst (LPA) Troy Watson conducted an initial complaint visit for the allegation listed above. LPA Watson explained to the Administrator Shire Ashely the purpose of the visit. LPA Troy Watson was allowed entry into the facility. Investigation consisted of the following: On 01/21/2026 LPA Watson requested and received the following documents: Staff Roster dated 01/04/2026 and Resident Roster dated 12/02/25, Evacuation Plan, Fire Safety Inspection Request dated 09/04/2025, Fire Drill Report dated 01/20/2026, Emergency Disaster Plan dared 01/01/2026, Daily Safety Checklists Walk Through Logs dated 01/01/2026. On 01/21/2026 LPA Watson interviewed the Administrator (A1) and Staff #1-Staff# 3 (S1–S3). A tour of the facility grounds was conducted with the Administrator and found to be clean and in good repair. CONTINUED ON LIC9099-C Unsubstantiated Investigation revealed the following: Allegation: Staff did not keep the emergency exits free of obstructions. It is being alleged that the emergency exit in the facility’s kitchen office area is always partially blocked, and that kitchen staff do not wear hairnets while working in the kitchen, creating an ongoing safety hazard and restricting clear egress during an emergency. On 01/21/2026, LPA Troy Watson interviewed Administrator Ashley Shire (A1). During the interview conducted on 01/21/2026, Administrator Ashley shire (A1) stated during the interview that hairnets are required by all facility staff to be worn before entering the kitchen. A1 also stated that the emergency exit in the kitchen is never blocked are obstructed with boxes, chairs or anything because It would be considered a fire hazard. A1 denied the allegation that staff did not keep the emergency exits free of obstructions. On 01/21/2026, LPA Troy Watson interviewed Staff #1 -Staff#3 (S1–S3). Out of those interviewed 4 out of 4 staff members denied the above allegation. On 01/21/2026 LPA Troy Watson obtained and reviewed the facilities Evacuation Plan and observed on the Evacuation Plan two exits clearly marked for evacuation of the facility in case of an emergency. LPA Watson also obtained and reviewed the Fire Safety Inspection Request, and it showed a stamped approved clearance for 88 residential occupants. LPA Watson toured the facility with the Administrator and observed that all exits were free of obstructions. Based on the information gathered from the facility inspection, observations, interviews, and records analysis, the Department found no evidence to support the above allegation. The allegation may have happened or is valid, but there is not a preponderance of evidence to prove that the alleged violations occurred. Therefore, the allegation is Unsubstantiated. An exit interview was conducted with the Administrator Ashley Shire and copies were provided.the state’s words, verbatim · CDSS document, Jan 21, 2026 · control 11-AS-20260115093403

Type of visit: Prelicensing

On 12/17/25 Licensing Program Analysts (LPA) Alfonso Iniguez conducted a pre-licensing evaluation for an RCFE facility type. Today’s pre-licensing evaluation was conducted with Linda Cho/License. The licensee has applied for a license to serve (88) elderly residents ages 59 and older. The fire clearance is approved for (88) non-ambulatory and (8) bedridden. Pending hospice waiver for (40). The facility is a two-story commercial building located in a business and residential neighborhood which consisted of the following: There is a hand washing station, reception area, check-in station, lobby, cameras in common areas, 48 resident rooms to accommodate 88 residents, 7 public restrooms, living/family rooms, commercial kitchen; 2 bistro kitchens, dining rooms, staff lounge, mechanical room, maintenance room, nurses’ stations, conference room, offices, medication rooms, sitting areas, activity room, media lounge, physical therapy room, solarium room, salon, locked supply closets, locked laundry rooms, shaded areas, courtyards, indoor/outdoor activity areas, and a parking lot. The evaluation Report continues on the next page, LIC 809-C... The following was observed during this visit: MEDICATIONS There is a locked centralized storage area for Resident medications. PHYSICAL PLANT Facility is clean, sanitary, and in good repair. Protective devices are in place. Indoor and outdoor passageways, stairways, open porches, and other areas of potential hazard are free of obstructions. All window screens are clean and in good repair. Facility temperature is between 68 degrees and 85 degrees. Open porches, and areas of potential hazard are well-lit and equipped with sturdy hand railings. Smoke alarms operate properly. Carbon monoxide detectors operate properly. BEDROOMS No client bedroom is a passageway to another room, bath or toilet. There is a bed for each client with a mattress, mattress pad, bedsprings, and pillow(s) which are clean and in good repair. Mattresses and pillows are flame-retardant. There is dresser and closet space for each client that includes at least two (2) drawers or eight (8) cubic feet of dresser space per client. There is a chair and lamp for each client and at least one (1) nightstand per two (2) clients. The evaluation Report continues on the next page, LIC 809-C... BATHROOMS There is at least one (1) toilet and washbasin per six (6) clients, family, and personnel. There is at least one (1) shower or bathtub per ten (10) clients, family, and personnel. Hot water temperature is between 105-120 degrees Fahrenheit. Bathroom is located near client bedrooms. There are nightlights in the hallways outside non-private bathrooms. SUPPLIES There are client personal hygiene supplies to include soap, toothpaste, toilet paper, and comb. There is a sufficient supply of clean linens to permit weekly changing or more of client top sheets, bottom sheets, bedspreads, blankets, pillowcases, mattress covers, bath towels, hand towels, and washcloths. FOOD SERVICE Dining room is near kitchen. Refrigerator(s) and freezer(s) are clean and large enough for the storage of at least two (2) days of perishable foods. Freezer is 0 degrees Fahrenheit. Refrigerator is a maximum of 45 degrees Fahrenheit. A seven (7) day supply of non-perishable food is present. There are sufficient amounts of tableware, tables, dishes, and utensils. There are sufficient amounts of equipment for the storage, preparation, and service of food. All equipment, dishes, and utensils are clean and well maintained. All kitchen, food storage, and preparation areas are clean. The evaluation Report continues on the next page, LIC 809-C... RECORDS There is confidential storage of personnel records at the facility. There is confidential storage of client records at the facility. ADMINISTRATION The emergency exiting plan and emergency phone numbers are posted. Client Personal Rights are posted. Posting both sides of the Personal Rights form LIC 613 meets this requirement. Facility Visiting Policy is posted. Licensing Complaint Poster is posted. There is space available for resident council meetings and resident council postings. ACTIVITIES There is an outdoor activity space with a shaded area and furnished for outdoor use. There is at least one common room available to clients for visitors. There are activity supplies to include board games and electronic gaming system. MISCELLANEOUS There are first-aid supplies to include sterile first-aid dressings, bandages, adhesive tapes, scissors, tweezers, thermometer, antiseptic solution, and a current first-aid manual. There is space and equipment for laundry. There is a space for clean linen storage and a separate space for soiled linen. There is an operating telephone available to clients. Emergency lighting and supplies to include flashlights with batteries. During this pre-licensing inspection, LPA did not find corrections are needed. LPA conducted the Component III Orientation with the Licensee and copy of this report was provided. A copy of the facility evaluation report will be available to the Central Applications Unit (CAU) for review.the state’s words, verbatim · CDSS document, Dec 19, 2025

Type of visit: Office

Facility Type: RCFE Application Type: CHOW Capacity: 88 Census (if any clients in care): 55 COMP II Participants: Ashley Shire, Administrator Scott Jang, Corp Mem 7501 Osage Mgt LLC Linda Cho, Corp Mem Collwood Terrace Stellar Care Inc James Kim, 7501 Osage Mgt LLC Brandon Cho, Collwood Terrace Stellar Care Inc Brian Choi, 7501 Osage Mgt LLC Interview Method: Virtual interview (Teams) On 12/10/2025, applicant/administrator participated in COMP II. Identification of the applicant and administrator was verified through interview questions based on photo ID and other identifying personal information. During COMP II, applicant and administrator confirmed that they have read and understand community care facility licensing laws included in the Health and Safety Codes and the California Code of Regulations Title 22. Signed LIC 809 with copy of photo ID have been obtained. During COMP II, CAB analyst confirmed Applicant/Administrator’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 9, 2025