Casa Cambria Way

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Kristin Kontilis conducted an unannounced required Annual Inspection at the facility. LPA met with Asel Telman, Administrator and explained the purpose of the visit. Entrance Interview Conducted: The facility is a one-story Residential Care Facility for the Elderly (RCFE). The facility has been approved for six non-ambulatory residents of which two may be bedridden and maintains a hospice waiver for six residents. There are currently 6 residents residing in the facility. Upon arrival, there were five residents in care with one caregiver and one administrator on duty. Three (3) residents are currently on hospice. The facility consists of a living room, dining area, kitchen, and five bedrooms. Upon entrance, there is a walkway leading to the front door and garden areas. The front porch has a covered patio with available seating. The facility has a locked garage used for storage including the facility’s commercial generator. There are no fountains or bodies of water. The entrance into the residence leads into the common living area from a hallway. The kitchen consists of a refrigerator, microwave, sink, stove, oven, dishwasher, and a toaster. Trash and recycling bins are kept in a pullout drawer. All required CCL posters and signage are posted near the entrance and in the hallway. Personnel files, Residents’ files, and medications are kept in locked cabinets in the kitchen area. All files and medications are inaccessible to residents in care. Sharps are kept in a locked kitchen drawer and are inaccessible to residents in care. Perishable foods for 2 days and non-perishable foods for 7 days are kept on hand for the residents. The living room and dining area are furnished with adequate furnishings to sustain a capacity of six residents. First aid kits and a locked first aid supply cabinet are kept in the built-in locked cabinets located in the hallway. Please continue to 809-C, Pg 2 Bedroom 1 is a shared bedroom with a shared private bath. Bedrooms 2 and 3 are private bedrooms with private bathrooms. Bedrooms 4 and 5 are private bedrooms and share a bathroom off the hallway. Each bathroom has a sink, commode, and showers with grab bars. Bedrooms 1 and 5 have been designated as bedridden bedrooms. Each bedridden bedroom has an exit/entrance door leading to the outdoor areas. Each exit/entrance door has a functioning door alarm. Each resident’s bedroom has a bed, mattress, nightstand, chair, dresser, closet, and a motion detector for movement. Overhead lighting and lamps on the nightstands provide sufficient lighting in each bedroom. Hallways have night lights and ample lighting. The laundry area and storage area for cleaning agents and chemicals is located in the locked garage. The backyard consists of an umbrella, fenced, patio area with chairs and tables. The patio has built-in garden planters and walkways. The trash, recycling, and green waste cans are standardized cans located outside the facility. There is a hard-wired dual carbon monoxide detector and smoke alarm system in every room and every hallway. There are three fire extinguishers that were serviced on 2/18/2025. The fire extinguishers are located near the common area close to the bedrooms, kitchen, hallway, and in the garage. LPA observed the facility’s comfortable room temperature upon arrival. Residents’ records, personnel documents and records of confidentiality are kept in a locked closet located in the kitchen area. Residents records were reviewed. Admission agreements, needs and services plans, health screenings, and emergency contact information was on file and up to date for each resident. Medications are administered per Doctor’s orders. Residents participate at will in various activities based on their individual interests and preferences, including bird watching, musical activities, joyful movement, and games (Dominoes, Bingo, and many others). Exercise classes on the premises are provided for the residents that include physical therapy, music, and singing. Residents participate at will in outdoor activities such as spiritual/worship, socializing with family and friends, leisure drives and walks, and outside exercise. Volunteers from community organizations will assist residents in reading, arts and crafts activities, games, and seasonal celebrations. Please continue to 809-C, Pg 3. Administrator’s certificate is current. Staff records reviewed with all trainings, health screenings, and personnel documents are current. All staff have received a criminal background clearance and are associated to the facility. Exit interview conducted. No deficiencies noted; no citations issued. Copy of report issued at the time of the visit.the state’s words, verbatim · CDSS document, Oct 15, 2025

Type of visit: Required - 1 Year

On 10/15/2024, Licensing Program Analyst (LPA) Brian Phillips conducted a unannounced annual facility site inspection visit to the facility above. During this visit, LPA met with administrator Asel Telman and explained the reason for the visit. The LPA toured the physical plant areas inside and outside to ensure there are no health and safety hazards and facility is in compliance with Title 22 Regulations. This is a Residential Care Facility for the Elderly (RCFE) approved for six (6) non-ambulatory residents of which two (2) may be bedridden. The facility has an approved Hospice Care Request Waiver for six (6) residents. The LPA inspected the food service area and observed that knives/sharp instruments are stored in drawers inaccessible to residents. All appliances were in operable condition and looked clean/in good repair. Appliances such as microwaves, refrigerators, stoves, etc. are clean and operating properly. Food utensils, dishes, glasses, etc. are clean and in good repair with no cracks or chips. Furniture is room/resident appropriate, clean and in good repair. All rooms are appropriately furnished for their intended use such as bedrooms, dining rooms, kitchens, living rooms, etc. Hot water temperature is maintained at an appropriate temperature Fahrenheit as per Community Care Licensing (CCL) Title 22 regulations. Outdoor activity spaces have shaded areas and furnished for outdoor use. Each resident has an adult bed with a mattress, pad, bedsprings, and pillow, which are clean and in good repair. Each bed is fitted with sheets, pillowcase, blankets, and bedspread that are clean and in good repair. Each resident has adequate dresser and closet space for clothing and other belongings that includes at least two drawers or adequate dresser space. The facility has a sufficient supply of linens to permit weekly changing or more often to always insure clean linens for residents. Equipment and supplies for resident personal hygiene is available and on site. Activity supplies are available for residents. As the facility has an approved fire clearance for a maximum of six (6) residents, there is no signal system required or observed by LPA. Refrigerators and freezers are maintained at an appropriate temperature Fahrenheit as per Community Care Licensing (CCL) regulations. Food storage and preparation areas, including pantries, cupboards, counters, etc., are clean and appropriate for food preparation. Continued on 809-C The food service area was clean and sanitary, with covered trashcans and operating ventilation systems. No toxic substances are stored in any food preparation or storage area, and all cleaning supplies for the kitchen are kept in a separate area than the food supplies. There is enough tableware and utensils for all residents living in the facility, and enough equipment for the storage, preparation, and service of food. A locked storage area for central storage of medications is available. Cleaning supplies are kept in areas separate from where food supplies are stored. Walls, ceilings, floors, carpeting, window screens, and areas around the facility are clean, painted and/or in good repair. There are locked storage area(s) for poisons, toxic, cleaning solutions, disinfectants, etc. Fire extinguishers are serviced by the fire department annually and smoke detectors/carbon monoxide detectors operate properly. Doors and passageways are unobstructed. There are no pools/bodies of water on the physical plant of the facility as observed by LPA. During the inspection, LPA did not observe any firearms that would require trigger locks, locked and inaccessible, or firing pins removed. At the time of the visit, all common areas/interior rooms of the facility were observed to be appropriately furnished, with all furniture in good condition. There are activity materials in the common areas of the facility in good repair and operating condition. The facility maintained a comfortable temperature in all areas inspected. There is one (1) fireplace in the facility that is adequately screened and inaccessible to residents. There is appropriate lighting in all the common areas of the facility. All passageways through the common areas of the facility were free of obstruction, with no changes in incline requiring ramps and/or sturdy hand railings/stair chair accessibility devices. The facility maintains an auditory alert system/delayed egress system on all exits from the interior of the facility. There are ramps in place on all exits out of the facility with changes in incline. This facility is one (1) story throughout and therefore there are no stairways for residents to utilize. There are no bodies of water as observed by LPA in the outdoor area of the facility. LPA did not observe any noticeable outdoor hazards. The outdoor activity space is completely enclosed by fencing/walls and latching gates. The front outdoor area of the facility consists of a front courtyard area and the garage contains storage of emergency supplies. The designated laundry area is in a locked addendum/closet area in a hallway of the facility, with the storage of cleaning products locked and inaccessible to residents, away from food products. There was emergency food and water in cabinets in the living room/dining room area of the facility, which was observed to be in good condition. Cleaning supplies, disinfectants, and other items that could pose a danger to residents are kept in areas inaccessible to residents. The facility restrooms were sanitized and in operating condition while the LPA toured the facility. All resident restrooms in the facility that included soap, paper towels, required postings, and clean trashcans with closed lids. Continued on 809-C All restrooms were sufficiently stocked with soap, paper towels, and additional supplies; towels and washcloths are not shared. The hot water temperature was measured in the restrooms at the appropriate degrees Fahrenheit as per Title 22 regulations. An emergency exiting plan and emergency phone numbers are posted in an appropriate place. A current disaster and mass casualty plan maintained at the facility. First-aid supplies, which include sterile first-aid dressings, bandages, adhesive tapes, scissors, tweezers, thermometer, antiseptic solution, and a current first-aid manual, are maintained. Administrator’s records, employees and resident records are maintained at the facility and available for review by the LPA as employees are hired and residents accepted into the facility. The facility complies with CCL standards for health screening, TB clearance, staff training, criminal background clearance and transfer requests. Admission agreements and needs and services (ANS) plan are maintained for each resident and/or their authorized representative. Resident records are maintained on the facility premises in a secured area. Centrally stored medications are locked and inaccessible to residents. LPA audited the medications for residents and noticed no irregularities or issues concerning the dispensing of medications or the logging of medications. The medications in the facility were labeled appropriately with no additional or prohibited markings by the facility. The facility administrator meets the qualifications as specified in Title 22 regulations. Administrator has a current Residential Care Facility for the Elderly (RCFE) administrators’ certificate that expires on 04/01/2026. The facility maintains documentation on site prominently posted in areas accessible to residents and their visitors. Provider Information Notices are available and able to be presented to Staff, residents, visitors, and accessible to LPA. Exit interview conducted by LPA. Copy of this report provided to the facility.the state’s words, verbatim · CDSS document, Oct 15, 2024

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Kristin Kontilis conducted an unannounced required Annual Inspection at the facility. LPA met with Asel Dzheentaeva. Entrance Interview Conducted: The facility is a one-story Residential Care Facility for the Elderly (RCFE). The facility has been approved for six non-ambulatory residents of which two may be bedridden and maintains a hospice waiver for six residents. There are currently 6 residents residing in the facility. Upon arrival, there were five residents in care with two caregivers and one administrator on duty. Four residents are currently on hospice. The facility consists of a living room, dining area, kitchen, and five bedrooms. Upon entrance, there is a walkway leading to the front door and garden areas. The front porch has a covered patio with available seating. The facility has a locked garage used for storage including the facility’s commercial generator. There are no fountains or bodies of water. The entrance into the residence leads into the common living area from a hallway. The kitchen consists of a refrigerator, microwave, sink, stove, oven, dishwasher, and a toaster. Trash and recycling bins are kept in a pullout drawer. All required CCL posters and signage are posted near the entrance and in the hallway. Personnel files, Residents’ files, and medications are kept in locked cabinets in the kitchen area. All files and medications are inaccessible to residents in care. Sharps are kept in a locked kitchen drawer and inaccessible to residents in care. Perishable foods for 2 days and non-perishable foods for 7 days are kept on hand for the residents. The living room and dining area are furnished with adequate furnishings to sustain a capacity of six residents. First aid kits and a locked first aid supply cabinet are kept in the built-in locked cabinets located in the hallway. Bedroom 1 is a shared bedroom with a shared private bath. Bedrooms 2 and 3 are private bedrooms with private bathrooms. Bedrooms 4 and 5 are private bedrooms and share a bathroom off the hallway. Each bathroom has a sink, commode, and showers with grab bars. Please continue to 809-C, Pg 2. Bedroom 1 is a shared bedroom with a shared private bath. Bedrooms 2 and 3 are private bedrooms with private bathrooms. Bedrooms 4 and 5 are private bedrooms and share a bathroom off the hallway. Each bathroom has a sink, commode, and showers with grab bars. Bedrooms 1 and 5 have been designated as bedridden bedrooms. Each bedridden bedroom has an exit/entrance door leading to the outdoor areas. Each exit/entrance door has a functioning door alarm. Each resident’s bedroom has a bed, mattress, night stand, chair, dresser, closet, and a motion detector for movement. Overhead lighting and lamps on the night stands provide sufficient lighting in each bedroom. Hallways have night lights and ample lighting. The laundry area and storage area for cleaning agents and chemicals is located in the locked garage. The backyard consists of an umbrella, fenced, patio area with chairs and tables. The patio has built-in garden planters and walkways. The trash, recycling, and green waste cans are standardized cans located outside the facility. There is a hard-wired dual carbon monoxide detector and smoke alarm system in every room and every hallway. There are three fire extinguishers that were serviced on 2/22/2023.The fire extinguishers are located near the common area close to the bedrooms, kitchen, hallway, and in the garage. LPA observed the facility’s comfortable room temperature at 12:45 pm. Residents’ records, personnel documents and records of confidentiality are kept in a locked closet located in the kitchen area. Residents participate at will in various activities based on their individual interests and preferences, including bird watching, musical activities, games (Dominoes, Bingo, and many others). Exercise classes on the premises are provided for the residents that include physical therapy, music, and singing. Outdoor activities, when permitted, include bird watching, socializing, leisure drives and walks, and outside exercise. Volunteers from community organizations will assist residents in reading, arts and crafts activities, games, and seasonal celebrations. Administrator’s certificate is current. All staff have received a criminal background clearance and are associated to the facility. Exit interview conducted. No deficiencies noted; no citations issued. Report issued at the time of the visit.the state’s words, verbatim · CDSS document, Oct 20, 2023