Beverly Residential Care

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Michael Tea conducted an unannounced annual required inspection of the facility. Upon arrival, LPA Tea was greeted by Administrator (AD) Kevin Dinh, who granted entry into the facility. LPA Tea explained the purpose of the visit. The facility is licensed to serve six (6) non-ambulatory residents, of which one (1) may be bedridden in Room #3. The facility also has an approved hospice waiver for six (6) residents. At the time of the inspection, six (6) residents were in care, three (3) of whom were receiving hospice services. LPA Tea reviewed six (6) resident files and two (2) staff files. The files reviewed contained the required documentation. AD Dinh's Administrator Certificate expires on October 14, 2027. LPA Tea and AD Dinh toured the facility. The single-story home consists of three (3) resident bedrooms, one (1) staff room, three (3) bathrooms, a living room, dining area, kitchen, laundry area, detached garage, and backyard. Smoke detectors and carbon monoxide detectors were tested and found to be operational. Resident bedrooms were observed to be clean and furnished with the required furniture, bedding, and adequate storage space. Resident bathrooms were clean and in good repair. Toilets, sinks, and showers were functioning properly. Grab bars were securely installed, and no mold or mildew was observed. Hot water measured at 116.4 degrees Fahrenheit. Towels, toiletries, and personal hygiene supplies were adequately stocked. (Annual inspection continued on LIC809-C) Common areas were clean, orderly, and free of hazards. Hallways and exits were unobstructed. The first aid kit contained the required supplies. Kitchen appliances were operational. Perishable and nonperishable food supplies met regulatory requirements. Sharps and toxic substances were locked and inaccessible to residents. Fire extinguishers were fully charged and properly maintained. The facility's most recent emergency disaster drill was conducted on July 1, 2026. Emergency food and water supplies were available. Outdoor areas were clean and safe and provided shaded seating for residents. An exit gate was located on the right side of the property and was observed to be functioning properly. Medications were stored in a locked cabinet in the kitchen area and were administered according to physicians' orders. LPA Tea interviewed residents regarding the quality of care and spoke with staff regarding the services provided at the facility. During the inspection, residents were observed watching television and participating in exercises. AD Dinh reported that, depending on their physical abilities and condition, residents participate in activities that include exercising, listening to music, walking, and spending time in the backyard. Based on observations, record reviews, and interviews conducted during today's inspection, the facility was found to be in compliance with the areas inspected. No deficiencies were cited under Title 22, Division 6 of the California Code of Regulations. This report was reviewed with the facility. Copies of the LIC809, LIC809-C, LIC858, and LIC859 were provided to the facility.the state’s words, verbatim · CDSS document, Aug 18, 2026

Type of visit: Prelicensing

Licensing Program Analyst (LPA) Michael Tea made an announced visit to the facility for the purpose of conducting a pre-licensing inspection. LPA Tea met with designated Administrator (AD) Kevin Dinh. An application to operate a Residential Care Facility for the Elderly (RCFE) was received by our agency on January 2, 2025, for a total capacity of five non-ambulatory residents and one bedridden resident. The fire clearance was approved by a fire inspector from the Orange County Fire Authority on March 10, 2025. The facility is a one-story home with three resident bedrooms that will be shared, one staff room, three bathrooms, a living room, a kitchen with a breakfast nook, a dining area, and a detached car garage. There is one entry gate to the property that is unlocked and slides open. Resident bedrooms had the required furnishings. LPA observed bedrooms with sliding doors had working door alarms. All beds had the required linens and blankets. Hot water temperatures in the bathrooms measured around 106.7 to 109.4 Fahrenheit degrees. Bathrooms were observed to be operational and have a working toilet, wash basin, and bathtub/shower, as well as grab bars and non-skid surface/mat. A supply of perishable and non-perishable food was observed. Toxins were secured and locked underneath the kitchen sink and in a storage closet in the laundry area. Sharps are secured in a drawer. Gas stove burners, dishwasher, refrigerator, microwave are operational. There is a laptop in the kitchen for the residents to use as well as an iPads provided to residents for activities and productivity. AD Dinh said the residents will be playing games and activities on the laptop and iPad. His residents at the other facilities play games and do activities electronically on the iPads. He will also have musical therapy. A phone is in the kitchen for residents to use. LPA observed Administrator certificate, Facility sketch and Emergency Disaster (Pre-licensing Report continuation on LIC809-C) Plan and required posters in the facility mounted on the wall in the kitchen. In the backyard there is plenty of shaded seating area for residents and LPA did not observe any obstacles or hazards. Emergency food and water and additional supplies were observed to be well stocked in the garage. The fire extinguisher in the kitchen is fully charged. Smoke detectors and carbon monoxide detectors tested operational. Medications will be stored in a locked cabinet by the kitchen area. The first aid kit with all the required elements and first aid guidebook was observed in the medication cabinet as well. Records will also be stored alongside medication in the locked cabinet. The facility is ready to be licensed. LPA conducted the Component Three Orientation with Administrator Kevin Dinh. Facility was notified that the final application approval will be issued by the Centralized Applications Bureau in Sacramento. An exit interview was conducted, and a copy of this report was provided to the Administrator.the state’s words, verbatim · CDSS document, Aug 7, 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, Jun 12, 2025