Bk House of Grace 2

Type of visit: Case Management - Annual Continuation

Licensing Program Analysts (LPA) B. Miranda conducted a visit today January 29, 2026 for the facility’s annual inspection. LPA introduced themselves and was allowed entrance into the facility. LPA met with Administrator Jaswant Bajwa. LPA observed the facility to be clean and clutter free. Facility is licensed for 6 residents and has a current census of 0. Water temperature was checked in the kitchen which read at 129.9 degrees Fahrenheit. Administrator was informed to correct water temperature before residents move in. Fire Extinguisher was purchased November 17, 2025 and has current charge. Smoke and carbon monoxide detectors were tested and are in working order. Jaswant Bajwa's Administrator Certificate expires on July 17, 2027. There is currently no staff or resident files to review at this time. LPA observed first aid kit on site. Facility has locked storage for toxins and cleaning supplies. Facility has a locked storage for medications and knives. LPA inspected the interior and the exterior of the facility including the common living spaces, resident bedrooms, bathrooms, medication storage, kitchen, garage and outdoor areas. Bedrooms were clean, properly furnished, with adequate lighting, and in good repair. Food supply is adequate for 7-day nonperishable. Currently there is no perishable food items since there are no residents. No citations were issued today due to facility having no residents. Exit interview conducted and a copy of this report LIC809 was provided to Administrator Jaswant Bajwa.the state’s words, verbatim · CDSS document, Jan 29, 2026

Type of visit: Required - 1 Year

On 1/20/2026 Licensing Program Analyst (LPA) arrived at the facility unannounced. It appeared no one was available. LPA attempted to call the facility and there was no answer. LPA called the Administrator Jaswant Bajwa who stated there are currently 0 residents and no one is available at the facility. LPA explained as long as there is a current license the Dept will still have to conduct annual inspections. Jaswant stated the facility is in the process of becoming an ARF. LPA informed Jaswant that will be under a new license but currently an annual inspection needs to be completed. LPA informed Jaswant a follow-up visit is warranted in order to conduct the annual inspection, Jaswant understood and no other action was taken at this time.the state’s words, verbatim · CDSS document, Jan 20, 2026

Type of visit: Required - 1 Year

On January 29, 2025, Licensing Program Analyst (LPA) Rachel Bruce arrived for an unannounced annual inspection of this facility. No body was present at the home, LPA spoke with Administrator/ Licensee on the phone and she arrived shortly to the facility. There are currently no residents living in the facility, although Administrator/ Licensee is actively recruiting and hopes to have residents shortly. A pre licensing inspection was successfully completed back in January of 2024. During this visit, LPA conducted the annual inspection utilizing the CARE tools, with Licensee, Jaswant (Rubie). Common areas have adequate furnishings and lighting. All 4 client bedrooms have the required furnishings, bed linens, proper lighting and smoke detectors. LPA observed a supply of extra bed linens, towels, and personal hygiene and grooming products. Non-Skid mats are available, soap, paper towels present along with storage available for client personal items. Kitchen observed to have supply of dishes, plates, utensils, pots and pans. Food storage and preparation areas are clear and appropriate for food preparation. Cleaning supplies and chemicals are locked in the lower kitchen cabinet and in locked cabinet in garage. Sharps/knives in a lock drawer in the kitchen. Appliances observed to be in working order. LPA observed there was not enough food per regulation but with no residents there will be no citation. Licensee understands regulatory requirements and will ensure compliance once residents are received. Garage is clean and free of obstruction. There is locked storage space available for chemicals and storage for additional food. First aid kit, located where medications will be locked and stored, contains all the required items. Washer and Dryer observed in the laundry room with additional storage space available. Doors and passageways are unobstructed throughout the home. Exit interview conducted with Administrator. A copy of this report will be provided via emailthe state’s words, verbatim · CDSS document, Jan 29, 2025

Type of visit: Prelicensing

Licensing Program Analyst (LPA) L. Padgett arrived or announced reinspection of this facility. LPA met with Licensee, Jaswant (Rubie) and Balwinder Kaur and toured the facility. Common areas have adequate furnishings and lighting. All 4 client bedrooms have the required furnishings, bed linens, proper lighting and smoke detectors. LPA observed a supply of extra bed linens, towels, and personal hygiene and grooming products. Non-Skid mats are available, soap, paper towels present along with storage available for client personal items. Kitchen observed to have supply of dishes, plates, utensils, pots and pans. Food storage and preparation areas are clear and appropriate for food preparation. Cleaning supplies and chemicals are locked in the lower kitchen cabinet and in locked cabinet in garage. Sharps/knives in a lock drawer in the kitchen. Appliances observed to be in working order. LPA observed a 7 day of non-perishable food stored in a pantry. Licensee has designated a locked cabinet in the laundry room. First aid kit contains all the required items. Washer and Dryer observed in the laundry room with additional storage space available. Doors and passageways are unobstructed throughout the home. AD has addressed the following: Utensils sufficient for 6 residents Proof of Fire Extinguisher purchased on 1/11/2024. Posting of Fire Clearance, PUB 475, Resident rights, Visiting Policy Lock sharps/knives in locked cabinet or box Provide paper towels for bathrooms Purchase adequate food supply for 7 days Install grab bars in shower Install night lights in hallway Purchase personal hygiene products, sufficient for 6 residents. continued on 809C In regards to the elevated floor planks in bedroom 5, licensee has decided to use this room as a staff rooom and will place rug over planks until they are replaced. Licensee will submit updated facility sketch to LPA by tomorrow. The applicant has met all pre-licensing requirements. LPA will submit documentation to CAB in Sacramento for final review prior to license being issued. An exit interview was conducted and a copy of this report was left with AD, whose signature confirms receipt of these documents.the state’s words, verbatim · CDSS document, Jan 18, 2024

Type of visit: Prelicensing

Licensing Program Analyst (LPA) Lissett Padgett arrived at the facility to conduct the Pre-Licensing Inspection. LPA met with Administrator (AD) Jaswant “Ruby” Bajwa. LPA began the tour by entering through the front door of the 5 bedroom/2 bathroom/1 story home. Interior common areas have adequate furnishings and lighting. All 5 client bedrooms have the required beds, night stands with drawers and closet space. All bedrooms lacked chest of drawers for each resident. LPA was unable to determine if there are adequate bed linens as items were in bags and in various locations in the facility. Smoke and Carbon Monoxide detectors were tested and observed to be in working order. LPA observed a adequate supply of towels. There was an inadequate supply of personal hygiene and grooming products. There were no paper towels in the bathrooms. Hot water temperature in bathroom measured at 120 degrees F. Non-Skid mats present in the showers. AD states she has purchased grab bars for the shower. AD will inform LPA when these have been installed. Kitchen observed to have supply of dishes, plates, pots and pans. LPA observed utensils serving for 4, AD will purchase utensils sufficient for 6 residents. Food storage and preparation areas are clear and appropriate for food preparation. Cleaning supplies and chemicals are locked in the garage cabinet. Sharps/knives do not yet have a designated locked location. AD will address this issue. Appliances observed to be in working order. LPA observed did not observed a 7 day supply of non-perishable food. AD plans to store medications in locked cabinet in the laundry room. First aid kit contains all the required items. A fire extinguisher is present but did not have a purchase or expiration date. Washer and Dryer observed in the laundry room with additional storage space available in upper cabinets. See Lic.809-C for continuation of report. Doors and passageways are unobstructed throughout the home. Outside of the facility toured. There is a covered gazebo seating area and a self-latching gate found to be working properly. The home does not have a pool. LPA called and confirmed the facility phone number by calling (559) 515-6726 The following observed will need to be brought into compliance: Chest of drawers for each resident Utensils sufficient for 6 residents Proof of Fire Extinguisher in compliance Posting of Fire Clearance, PUB 475, Resident rights, Visiting Policy Repair broken tile in bathroom Lock sharps/knives in locked cabinet or box Repair elevated floor planks in home Provide paper towels for bathrooms Purchase adequate food supply for 7 days Replace mattress for 1 bed in bedroom 4 Install grab bars in showers Install night lights in hallway Purchase personal hygiene products, sufficient for 6 residents An exit interview was conducted and a copy of this report was left with AD, whose signature confirms receipt of these documents.the state’s words, verbatim · CDSS document, Jan 8, 2024

Type of visit: Office

COMP II by CAB successfully completed Facility Type: RCFE Application Type: Initial Capacity: 6 Census (if any clients in care): 0 Method: Telephone call with CAB COMP II Participants: Jaswant Bajwa, Administrator; Balwinder Kaur, Owner; Shannon Betker, analyst. Applicant/administrator participated in COMP II at CAB via telephone call with analyst at CAB. Identification of the applicant and administrator was verified by confirming driver’s license number. 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. 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, Oct 24, 2023