Brompton Residential Care

Type of visit: Required - 1 Year

On 03/24/2026, Licensing Program Analyst (LPA) Jaime Vado conducted an unannounced required annual 1 year inspection visit. LPA met with the Administrator Ying Wang and explained the purpose of today's visit. During today's visit there are 5 residents present and 1 is in the hospital due to medical condition. There are 2 staff present including the administrator. This is a single level facility. This facility is licensed for 6 residents, 60 and over, whom all may be non-ambulatory. Hospice waiver on file for 2 residents. During today's visit there is 1 resident on hospice. LPA inspected the kitchen and found it clean, with breakfast preparation and cooking in progress at the time. Lunch was also being prepared for cooking. The appliances were checked and observed to be in working order. LPA inspected a locked drawer that contained knives and sharp objects are stored. Below the kitchen sink cleaning supplies are observed to be locked and not accessible to residents. Resident medications are locked as well in an upper cabinet in the kitchen. The refrigerator and pantry cabinets are inspected as sufficient in supplies of fresh perishable food for (2) days and nonperishable staples for (7) days were observed. No expired food or stored medications were noted in the refrigerator. The living room area is observed as clean, with all furniture in good repair. There is a sofa set, television, fireplace, and piano in the living room. LPA observed a fire extinguisher mounted on the wall in the living room with a purchase date of 01/24/2026. Facility has a hard wired combination smoke and carbon monoxide detectors as well as fire sprinklers through out. There is a fire pull station observed in the living room as well. Continued on LIC809-C Page 2 There are 6 bedrooms for residents, and one staff room. There are 2 common full bathrooms for resident use. All 6 resident rooms are single occupancy and are found to be clean, well-lit, and equipped with the required furniture outlined in Title 22. In the hallway connecting to to all resident rooms, there are closets designated for resident supplies such as incontinence care, linens, and incidental supplies. LPA inspected bathrooms and found them clean, sanitary, and in good working condition. The bathrooms contained soap, grab bars, paper towels, a trash can, a shower chair, and non-slip flooring. Water temperature is tested in two resident restrooms at 118F. The garage contains the washer, dryer, a refrigerator, a freezer containing additional food supplies. Cleaning supplies are observed as well located in the garage which is locked. A walk around of the outside perimeter and the backyard is conducted, and is observed as safe with fencing in place, no hazardous items or materials, and emergency exit routes are free and clear of any obstructions. There are two storage sheds observed as locked and housing gardening supplies and other items. LPA reviewed resident and staff records and found both to be current and complete. Staff training is in place and first aid cards are present. Last fire drill conducted was on 01/07/2026 per records observed, which was a fire drill that took place. LPA inspected the first aid kit and found it fully stocked as well during today's visit. Medications and its records are observed to be current and logged accurately. LIC500 Personnel Report LIC308 Designation of Facility Responsibility Certificate of Liability Insurance Copy of Administrator Certificate. No citations issued on this day. Technical Assistance is provided and can be foundon the the attached LIC9102TA. Report is reviewed with administrator Ying Wag and a copy is provided.the state’s words, verbatim · CDSS document, Mar 24, 2026

Type of visit: Post Licensing

On August 04, 2025, the Licensing Program Analyst (LPA) Kiran Jain arrived unannounced at the facility to conduct a Post Licensing inspection. The LPA met with the Licensee, Ying Wang, and disclosed the purpose of the inspection. The Licensee informed the LPA that the facility had four (4) residents in care and one (1) additional staff member present at the time. LPA initiated a walk-through of the facility, accompanied by the Licensee. The indoor temperature reading of 68°F on a thermostat was observed in the hallway at the time of the visit. LPA inspected the kitchen and observed lunch preparation and cooking in progress at the time. The appliances were checked and observed to be in working order. The LPA inspected a magnetic locked cabinet containing knives and sharp objects. LPA inspected another magnetic locked cabinet under the sink with detergents, disinfectants, and cleaning supplies. The refrigerator and pantry cabinets were inspected, and sufficient supplies of fresh perishable food for (2) days and nonperishable staples for (7) days were observed. No expired food or stored medications were noted. LPA observed the refrigerator temperature at 37°F and freezer temperature at 0°F. LPA inspected the dining area adjacent to the kitchen. The dining table and chairs were observed to accommodate the residents, and all the furniture was in good repair. LPA inspected the living room and observed a sofa set, chairs, a fireplace, and a television in the living room. One (1) resident was observed sitting in the living room watching TV. LPA observed three (3) hallway closets, one linen closet with bedsheets, blankets, and towels, second closet containing incontinent supplies, and the third closet with toiletries. Continued on LIC809-C There were six (6) bedrooms, three (3) full bathrooms, and one (1) half bathroom designated for residents' use. All (6) resident rooms were single occupancy. LPA inspected all (6) resident rooms and found them clean, well-lit, equipped with the required furniture. Four (4) rooms had a sliding door exit to the outside deck/backyard access. The bathrooms contained soap, grab bars, towels, a trash can, a shower chair, and non-slip mats/flooring. The hot water temperature at the sink faucet measured between 115.8°F to 117.5°F in all bathrooms. The LPA inspected the laundry area and observed a washer and a dryer. LPA observed a locked cabinet in the laundry area containing detergents, disinfectants, and cleaning supplies. LPA inspected a locked staff break room in the garage and observed sofa, table, and chairs preset in the break room. LPA inspected the fire extinguisher mounted on the wall in the hallway and found it fully charged, with the last service tag dated 10/13/2024. The Licensee tested the carbon monoxide detector located in the hallway in the LPA's presence, and it was found to be functional. Additional smoke detectors were observed in all bedrooms and common areas of the facility during the visit. LPA toured the backyard area and found ramps and passageways in good condition, clear of obstructions, with no blocking or tripping hazards. No accessible bodies of water were found. The backyard had a table, chairs, and shaded areas for resident use. LPA observed a magnetic locked centrally stored medication cabinet located inside in the dining area. Medications were organized separately for each resident. All medication bottles were properly labeled. Centrally Stored Medication Records were reviewed and found to be complete. Medication count was found to be accurate. LPA inspected the first aid kit and found it fully stocked. LPA reviewed Emergency Drill Logs and observed Emergency Disaster Drills were conducted quarterly, with the most recent drill completed on 06/23/2025. LPA reviewed three (3) staff personnel records and four (4) resident records. The LPA observed that 4 of 4 residents had the Admission Agreement, Physician's Report, Appraisal Needs and Services Plan, Consent forms, Safeguard personal property and valuables, and Personal rights forms. LPA observed that 3 of 3 staff members had LIC 508 Criminal Record Statements and LIC 503 Health Screening. Continued on LIC809-C The following updated forms are requested to be submitted to CCLD by 08/11/2025: LIC 500: Personnel Report LIC 308: Designation of Facility Responsibility No deficiencies were cited during today's visit. An exit interview was conducted with the Licensee. A copy of this report was provided to the Licensee, Ying Wang, whose signature on this form confirms receipt of the report.the state’s words, verbatim · CDSS document, Aug 4, 2025

Type of visit: Prelicensing

On April 10, 2025, at 09:00 AM, the Licensing Program Analyst (LPA) Kiran Jain arrived announced at the facility to conduct a Pre-licensing visit to follow up on the deficiencies that were observed on March 06, 2025, during previous Pre-licensing inspection. The LPA met with the Administrator, Ying Wang, and disclosed the purpose of the inspection. There were no residents present at the facility at the time. The facility has an approved fire clearance for (6) non-ambulatory residents. The facility is a single-story building with 6 bedrooms, 4 bathrooms, a living room, kitchen with dining area, a laundry area, and a garage. On March 06, 2024, deficiencies were observed and documented in the Pre-licensing visit report. During today's (04/10/2025) visit, LPA observed beds, mattresses, bedsheets, pillows, chairs, nightstands, and chest of drawers in all residents’ rooms. There were grab bars in shower and toilet, paper towels, soap, and trash cans in all four (4) bathrooms. A sturdier TV stand was observed in the living room. Scissors and tweezers were found in the first aid kit. Cleaner blinds and shades, paint chip offs and scratches were fixed throughout the facility. A patio table, chairs, and umbrella along with a side yard fence door were observed in the backyard. COMP III was reviewed and completed with the Licensee. No issues were noted during the Pre-licensing inspection prior to the licensure. LPA observed the facility is ready to be licensed. However, this report will be submitted to the Central Application Bureau (CAB) and a final review of the application will be conducted. This facility is not yet licensed and is subject to final approval by CAB. Additional requirements may still be required. Continued on LIC809-C No deficiencies were cited during today's visit. An exit interview was conducted with the Licensee. A copy of this report was provided to the Licensee, Ying Wang, whose signature on this form confirms receipt of the report.the state’s words, verbatim · CDSS document, Apr 10, 2025

Type of visit: Prelicensing

On March 06, 2025, at 09:00 AM, the Licensing Program Analyst (LPA) Kiran Jain arrived announced at the facility to conduct a Pre-licensing inspection. The LPA met with the Administrator, Ying Wang, and disclosed the purpose of the inspection. There were no residents present at the facility at the time. The facility has an approved fire clearance for (6) non-ambulatory residents. The facility is a single-story building with 6 bedrooms, 3½ bathrooms, a living room, laundry area, and a garage. At 9:24 AM, the LPA initiated a walk-through of the facility, accompanied by the Administrator. LPA inspected the kitchen and found it in good repair. The appliances were checked and observed to be in working order. The LPA observed a locked cabinet containing knives and sharp objects, and a locked cabinet under the sink with detergents, disinfectants, and cleaning supplies. The refrigerator and freezer were inspected and observed to be in working condition. The Administrator stated they will be storing resident’s medications in a locked cabinet in the kitchen. LPA inspected the dining area adjacent to the kitchen and found it clean. Dining table and chairs were in good repair. LPA inspected the living area. LPA observed a TV placed on a glass top and two pedestal stands, which were not sturdy. LPA inspected the fire extinguisher mounted on the wall in the living room and found it fully charged, with the purchase tag dated 10/13/2024. There were (6) bedrooms and (3½) bathrooms designated for residents' use. LPA inspected all (6) private resident rooms. There was no furniture in five (5) bedrooms. LPA observed chipped paint on the walls and ceilings in the bedrooms. LPA inspected (3½) bathrooms and found them sanitary, and in good working condition. LPA observed the bathrooms didn’t contain soap, grab bars, paper towels, and trash cans. The hot water temperature at the sink faucet in all bathrooms measured between the range of 115.2°F to 118.8°F. Continued on LIC809-C The LPA inspected the laundry area and observed a washer and a dryer. LPA observed a locked cabinet in the laundry area containing detergents, disinfectants, and cleaning supplies. The Administrator tested the smoke and carbon monoxide detector located in the hallway in the LPA's presence, and it was found to be functional. Additional smoke and carbon monoxide detectors were observed in all bedrooms and common areas of the facility during the visit. LPA toured the backyard area and found ramps and passageways in good condition and clear of obstructions. No bodies of water were noted. LPA observed tripping hazards on one of the side yards. There was no outdoor patio furniture for resident’s use. LPA inspected the first aid kit and observed it was missing scissors and tweezers. Following issues needs to be addressed prior to the licensure - Clean blinds and shades throughout the facility Beds, mattresses, bedsheets, pillows in all residents’ rooms Chair, night stand, and chest of drawers in all residents’ rooms Grab bars in shower and toilet in the bathrooms Paper towels, soap, and trash cans in bathrooms TV stand in the living room Scissors and tweezers in the first aid kit Add gate or side yard fence door Set of a backyard patio table, chairs, and umbrella Fix walls and ceiling paint chip offs and scratches throughout the facility Setup the house in move in condition for the residents The Administrator stated they would need 30 days to fix above mentioned issues. The LPA will return on a follow up inspection visit to verify above mentioned issues. An exit interview was conducted with the Administrator. A copy of this report was left with the Administrator, Ying Wang, whose signature on this form confirms receipt of the report.the state’s words, verbatim · CDSS document, Mar 6, 2025

Type of visit: Office

Facility Type: RCFE Application Type: Initial Capacity: 6 Census (if any clients in care): 0 COMP II Participants: Ying Wang (Managing Member/Administrator) Interview Method: Virtual interview via Microsoft Teams On February 11, 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, Feb 11, 2025