Augustin Gardens

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Ruth Martinez arrived at the facility unannounced for the purpose of conducting the Required 1-Year annual evaluation. LPA was greeted and granted entry by Caregiver and explained the reason for the visit. Tyana Fisk, Administrator arrived shortly after and met with LPA. The following was observed during the inspection: This is a single story property located in a residential neighborhood comprised of six private resident bedrooms and four resident bathrooms. Facility operates within the conditions and limitations specified on the license. LPA observed six residents in care with two residents receiving hospice service. LPA observed two caregivers on duty and verified fingerprint clearance and association statuses for the caregivers and administrator. All common areas were inspected including the attached garage. LPA toured the interior portion of the facility. The fireplace is properly screened. LPA observed and inspected the six private resident bedrooms. The resident bedrooms' were appropriately furnished, beds and bedding supplies were in good condition, adequate lighting was provided, and sufficient storage space for each residents' personal belongings were observed. All bathrooms were found be in compliance, clean, and operational. The hot water temperature measured 113.3 degrees Fahrenheit in the bathrooms. Toxins, disinfectants, sharps, and medications were secured and inaccessible. LPA observed ample two-day supply of perishables and seven-day supply of non-perishable food. LPA toured the exterior portion of the facility. The outdoor passageway is free of obstruction. The two exit gates on each side of the property were operational and there were sufficient seating and shading in the patio area. The fire extinguisher was mounted, charged, and Continued on LIC809-C serviced on November 07, 2025. The auditory devices and smoke/carbon monoxide detectors were tested and operational. LPA observed the emergency food/water and supplies in the kitchen. The first aid kit had all necessary elements. LPA inspected that medication is centrally stored in a safe locked storage cabinet located in the laundry unit. LPA reviewed medication and observed medication was labeled and stored inaccessible to residents in care. Emergency drills logs were observed and drills are being conducted. LPA observed the required posting throughout the facility. The facility has an available clean supply of linens. . LPA reviewed three employee records. All employees present have a criminal record clearance and are associated to the facility. LPA observed records reviewed have a current First Aid certificate. LPA reviewed three resident records. All the required documentation was present and current in the residents’ files reviewed. Based on the observations made during today’s visit, no deficiencies were noted today in the areas inspected per Title 22 Division 6 of the California Code of Regulations. This report was reviewed with the Administrator and a copy of this report was provided to the facility.the state’s words, verbatim · CDSS document, Jun 18, 2026

Type of visit: Case Management - Deficiencies

Licensing Program Analyst (LPA) Jessica Cho arrived unannounced on a Case-Management visit for the purpose of issuing a deficiency. LPA met with Administrator (Admin) Tyana Fisk and explained the reason for the visit. During the annual inspection conducted on September 18, 2025, LPA observed structural modifications were found within the facility. A partition wall was constructed within the garage designating one side as an office and the other as a resting area for the caregivers evidenced by the stacked mattresses and personal belongings. The current garage layout per review of the facility sketch submitted to the Department was not approved by the Fire Marshall which shows that the space was functioning as a garage. Facility is not in compliance with the fire clearance, therefore a deficiency and an Immediate Civil Penalty are being issued. An exit interview authorized by Administrator Tyana Fisk, was conducted with Caregiver Evelyn Macalino, and a copy of this report including the appeal rights were provided at exit.the state’s words, verbatim · CDSS document, Oct 2, 2025

From the deficiency page — Deficiency type: Type A · Section cited: CCR 87202(a) · Plan of correction due date: Oct 3, 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. This requirement was not met as evidenced by: Based on observation and record review, structural modications were found within the garage which was not approved during the initial fire clearance cleared on 6/26/02. CIVIL PENALTY ASSESSED.the state’s words, verbatim · CDSS document, Oct 2, 2025

Plan of correction: Licensee stated that they will request a new fire clearance inspection in writing, submit a LIC200, and provide a copy of the new facility sketch to the Department by POC due date.

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Jessica Cho arrived at the facility unannounced for the purpose of conducting the Required 1-Year annual evaluation using the CARE Inspection Tool. LPA was greeted and granted entry by Caregiver Katherine Borja followed by Administrator (Admin) Tyana Fisk after stating the reason for the visit. The administrator's certificate for Tyana Fisk is valid expiring on May 29, 2026. The following was observed during the inspection: This is a single story property located in a residential neighborhood comprised of six private resident bedrooms and four resident bathrooms. Facility operates within the conditions and limitations specified on the license. LPA observed six residents in care with four residents receiving hospice service. LPA observed two caregivers on duty and verified fingerprint clearance and association statuses for the caregivers and administrator. All common areas were inspected including the attached garage which was converted into an office/storage and resting area for staff evidenced by the two mattresses in which the alteration occurred approximately 2020 per administrator. The two spaces in the garage share a wall which was built during this time. LPA toured the interior portion of the facility. The fireplace is properly screened. LPA observed and inspected the six private resident bedrooms what used to be five private resident bedrooms and one staff bedroom per administrator and review of the initial/current facility sketches. LPA observed that the caretaker's suite is now occupied by Resident #5 (R5). The resident bedrooms' were appropriately furnished, beds and bedding supplies were in good condition, adequate lighting was provided, and sufficient storage space for each residents' personal belongings were observed. All bathrooms were found be in compliance, clean, and operational. The hot water temperature measured within range at 113.0, 116.2, 116.6/116.7 (shared), and 113.3 degrees Fahrenheit in the bathrooms. Toxins, disinfectants, sharps, and medications were secured and inaccessible. LPA observed ample two-day supply of perishables and seven-day supply of non-perishable food. LPA toured the exterior portion of the facility. The outdoor passageway is free of obstruction. The two exit gates on each side of the property were operational and there were sufficient seating and shading in the patio area. The fire extinguisher was mounted, charged, and serviced on June 9, 2025. The auditory devices and smoke/carbon monoxide detectors were tested and operational. LPA observed the emergency food/water and supplies in the kitchen. The first aid kit had all necessary elements. Emergency drills were conducted once this year with the last date on April 21, 2025. LPA observed the required 'See Something, Say Something' (PUB475) poster posted in an incorrect size in the entry way. LPA interviewed two out of six residents as residents were sleeping or participating in an activity. One out of two staff interviews were conducted as the second staff was preparing dinner. LPA reviewed six out of six resident files and three personnel files in which no discrepancies were found. Medications were audited for two out of six residents in which no discrepancies were found. Admin was advised on the following: to conduct quarterly disaster drills and to enlarge the PUB475 that meets the 20" x 26" requirement. Admin was also advised that LPA may follow up on a later date regarding the structural changes. Based on the observations made during today's visit, no deficiency is being cited. Advisory Notes are being issued. An exit interview was conducted with Administrator Tanya Fisk, and a copy of this report was provided at exit.the state’s words, verbatim · CDSS document, Sep 18, 2025

The state marks this report as 5 pages; the online copy we transcribed has 3. You can request the full file from the county licensing office.

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Ruth Martinez is conducting this unannounced visit for the purpose of completing an annual required inspection. LPA arrived at the facility and was greeted and granted entry by caregiver and LPA explained the nature of the visit. Tyana Fisk, Administrator arrived shortly after and met with LPA. There are six residents at the facility and there is one resident receiving hospice services currently. LPA began the tour of the inside and outside of the facility. LPA observed required department postings throughout the facility. Facility stays within the capacity limitations. There is a minimum of one week of non-perishables foods and two days of perishables foods available. The facility is maintained at a comfortable temperature. LPA inspected that medication is centrally stored in a safe locked storage cabinet located in the laundry unit. LPA reviewed medication and observed medication was labeled and stored inaccessible to residents in care. LPA inspected the bathroom and LPA measured the hot water temperature which measured 119.8 Fahrenheit degrees. All bathrooms observed to have a supply of soap, toilet paper and towels. Bathrooms are equipped with required safety measures such as non-skid mats and grab bars. Lighting is sufficient to ensure safety and comfort. The facility is equipped with sufficient hand hygiene, cleaning, and disinfecting supplies. The facility has an available clean supply of linens. LPA inspected residents’ bedrooms which has sufficient lighting to ensure the safety and comfort. All bedrooms observed to have all required components. Storage space is provided for residents in their bedroom. Smoke detectors were tested and found to be operational. LPA toured the outside of the facility and observed outdoor passageways are free of obstructions. LPA observed there are several shaded seating areas for residents’ enjoyment. LPA observed a fire extinguisher with service date of June 04, 2024, in kitchen. Fire drills are conducted every three months. LPA began review of records. LPA reviewed three resident records. All the required documentation was present and current in the residents’ files reviewed. LPA reviewed two employee records. All employees present have a criminal record clearance and are associated to the facility. LPA observed records reviewed have a current First Aid certificate. Based on the observations made during today’s visit, no deficiencies were noted today in the areas inspected per Title 22 Division 6 of the California Code of Regulations. This report was reviewed with the Administrator and a copy of this report was provided to the facility.the state’s words, verbatim · CDSS document, Jun 13, 2024