Casa Costello

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Sandra Urena arrived at the facility unannounced to conduct the required annual inspection. The LPA was greeted by the Administrator Maria Elena Shinn and informed them of the reason for the visit. The facility is vendored by North Los Angeles Regional Center as a level three (3) home. The LPA and the Administrator toured the physical plant areas inside and outside to ensure there are no health and safety hazards and that the facility is in compliance with Title 22 Regulations. COMMON SPACES: At the time of the visit, living room and dining room furniture was observed to be in good condition. The LPA observed the fire extinguisher to be fully charged and last serviced on 12/19/2025. All required posting were observed throughout the facility. At 11:15 a.m., smoke alarms and carbon monoxide detectors were tested and functioned properly. KITCHEN: The sharp objects are stored in a locked kitchen drawer. Kitchen appliances are in operable condition. The facility has a sufficient supply of perishable and non-perishable food. At 12:15 p.m., hot water measured at 115.1-degree Fahrenheit. The laundry units are located inside the kitchen. Cleaning solutions, toxins, chemicals and hazardous items were inaccessible and locked away inside the locked storage cabinets. BEDROOMS: The facility is a single-story residential home with four (4) bedrooms, three (3) for resident use and one (1) for staff use and three (3) bathrooms. Two bedrooms are private rooms and one is a shared bedroom. One bedroom has a private bathroom. The staff’s bedroom was observed to be locked and inaccessible to residents in care at the time of the visit. The bedrooms were observed to be furnished appropriately with clean linens, appropriate furnishings and sufficient lighting. Inside temperature was maintained at a comfortable level. Continued on LIC 809-C… RESTROOMS: Residents’ restrooms are clean and sanitary and in operating condition with grab bars and non-skid surfaces. The hot water temperature tested at 115.1-degree Fahrenheit. OUTDOOR SPACE: The patio was observed to be equipped with a table and chairs and shade for residents’ use. RECORDS: Records review began at 12:03 p.m. Residents’ records were reviewed for, but not limited to care plans, medical records, admissions agreement, consent forms. All records were in order. Personnel records were reviewed for, but not limited to health assessments, criminal record clearances, first aid/CPR training, and the appropriate training. All files were in order. MEDICATIONS: Medications are centrally stored and locked in a cabinet in the kitchen; medications are labeled and were checked for expiration dates. Medications are properly documented on the centrally stored medications and destruction record. No errors observed during the medication review. The LPA reviewed the following documents: - LIC500 Personnel Roster (Administrator will email an updated form to LPA). - LIC9020 Client Roster - Certificate of Liability Insurance - Emergency Drills No deficiencies were observed at this time. Exit interview conducted. A copy of the report was issued.the state’s words, verbatim · CDSS document, Feb 4, 2026

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Sandra Urena arrived at the facility unannounced to conduct a required annual inspection. The LPA was greeted by the Administrator Maria Elena Shinn and informed them of the reason for the visit. The facility is vendored by North Los Angeles Regional Center as a level three (3) home. The LPA and the Administrator toured the physical plant areas inside and outside to ensure there are no health and safety hazards and that the facility is in compliance with Title 22 Regulations. COMMON SPACES: At the time of the visit, living room and dining room furniture was observed to be in good condition. The LPA observed the fire extinguisher to be fully charged and last serviced on 12/24/2024. All required posting were observed throughout the facility. At 4:03 p.m., smoke alarms and carbon monoxide detectors were tested and functioning properly. KITCHEN: The LPA observed the kitchen and dining area. Knives are stored in a locked kitchen drawer. Kitchen appliances are in operable condition. The facility has a sufficient supply of perishable and non-perishable food. At 12:15 p.m., hot water measured at 105.2-degree Fahrenheit. The laundry units are located inside the kitchen. Cleaning solutions, toxins, chemicals and hazardous items were inaccessible and locked away inside the locked storage cabinets. BEDROOMS: The facility is a single-story residential home with four (4) bedrooms, three (3) for resident use and one (1) for staff use and three (3) bathrooms. Two bedrooms are private rooms and one is a shared bedroom. One bedroom has a private bathroom. The staff’s bedroom was observed to be locked and inaccessible to residents in care at the time of the visit. The bedrooms were observed to be furnished appropriately with clean linens, appropriate furnishings and sufficient lighting. Inside temperature was maintained at a comfortable level. Continued on LIC 809-C… RESTROOMS: Residents’ restrooms are clean and sanitary and in operating condition with grab bars and non-skid surfaces. The hot water temperature tested at 105.0-degree Fahrenheit. OUTDOOR SPACE: The patio was observed to be equipped with a table and chairs and shade for residents’ use. RECORDS: Records review began at 1:03 p.m. Residents’ records were reviewed for, but not limited to care plans, medical records, admissions agreement, consent forms. All records were in order. Personnel records were reviewed for, but not limited to health assessments, criminal record clearances, first aid/CPR training, and the appropriate training. All files were in order. The Administrator was reminded that the 20-hour annual trainings must be dated as the date when the trainings took place. The Surety Bond is for $5000 and expires on 01/31/2026. Currently the facility staff is conducting drills every six (6) months. The LPA reminded the Administrator that Emergency Drill must be conducted on a quarterly basis. MEDICATIONS: Medications review began at 3:15 p.m.; medications are centrally stored and locked in a cabinet in the kitchen; medications are labeled and checked for expiration dates. Medications are properly documented on the centrally stored medications and destruction record. No errors observed during the medication review. The LPA reviewed the following documents: - LIC500 Personnel Roster (Administrator will email an updated form to LPA). - LIC9020 Client Roster - Certificate of Liability Insurance - Emergency Drills No deficiencies were observed at this time. Exit interview conducted. A copy of the report was issued.the state’s words, verbatim · CDSS document, Feb 19, 2025

Type of visit: Case Management - Annual Continuation

Licensing Program Analyst (LPA) Emily Peraldi conducted an unannounced Case Management - Annual Continuation at the facility today continuing the inspection that began on 02/24/2024. At 10:30 a.m., the LPA met with the Licensee and explained the reason for the visit. RECORD REVIEWS: Between 10:36 a.m. and 11:51 a.m., the LPA conducted a file review for all four (4) residents and observed the following: appraisals, care plans, medical records, admissions agreement, consent forms. All resident records were up to date. At 12:10 p.m., P&I money was reviewed. Starting at 11:52 a.m., the LPA conducted a review of medication and medication documentation with staff for all four (4) residents and observed that all medications were properly documented and assisted with as prescribed. At 12:12 p.m., the LPA, along with staff, toured the physical plant areas inside and outside to ensure there are no health and safety hazards and that the facility is in compliance with Title 22 Regulations. KITCHEN: The LPA observed the kitchen and dining area. Knives are stored in a locked kitchen drawer. Kitchen appliances are in operable condition. The facility has a sufficient supply of perishable and non-perishable food. At 12:15 p.m., hot water measured at 105.2-degree Fahrenheit. Medications are centrally stored and located inside a locked cabinet in the kitchen. The laundry units are located inside the kitchen. BEDROOMS: The facility is a single-story residential home with four (4) bedrooms, three (3) for resident use and one (1) for staff use and three (3) bathrooms. The LPA observed resident bedrooms, which were furnished appropriately with clean linens, appropriate furnishings and sufficient lighting. Inside temperature was maintained at a comfortable level. Continued on LIC 809-C. RESTROOM: Resident restrooms are clean and sanitary and in operating condition with grab bars and non-skid surfaces. At 12:17 p.m., the hot water temperature tested at 105.0-degree Fahrenheit. OUTDOOR SPACE: At 12:20 p.m., the LPA observed the back patio. Cleaning solutions, toxins, chemicals and hazardous items were inaccessible and locked away inside the locked storage rooms. COMMON SPACES: At the time of the visit, living room and dining room furniture was observed to be in good condition. The LPA observed the fire extinguishers to be fully charged and last serviced on 12/21/2023. Signs are posted throughout the facility to promote handwashing, and cough/sneeze etiquette. At 12:23 p.m., smoke alarms and carbon monoxide detectors were tested and functioning properly. No deficiencies cited at this time. Exit interview conducted. A copy of the report was issued.the state’s words, verbatim · CDSS document, Feb 25, 2024

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Emily Peraldi arrived at the facility unannounced to conduct a required annual visit. At 11:30 a.m., the LPA met with the Licensee, Maria Shinn and explained the reason for the visit. The facility is vendored by North Los Angeles Regional Center as a level three (3) home. Starting at 11:41 a.m., the LPA conducted interviews with four residents (4) and one (1) staff. At 12:00 p.m., staff and two (2) residents returned from their outing. RECORD REVIEWS: Between 11:46 a.m. and 12:45 p.m., the LPA conducted a file review for all staff regularly scheduled and observed the following: personnel records, health assessments, criminal record clearances, first aid/CPR and the appropriate training. All personnel files were in order. The Administrator’s certificate for Maria Shinn is active and expires on 08/06/2024. The LPA also reviewed and obtained copies of the following: surety bond, valid liability insurance, Infection Control Plan and Emergency and Disaster Plan. The most recent emergency disaster drill was conducted on 01/02/2024. At 1:05 p.m., the LPA, along with staff, conducted a brief physical plant tour inside and outside to ensure there are no health and safety hazards. Due to time constraints the LPA will return to complete the annual at a later date. No deficiencies were observed at this time. Exit interview conducted. A copy of the report was issued.the state’s words, verbatim · CDSS document, Feb 24, 2024