Ck Homes / Cypress II

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Jerome Haley conducted an unannounced visit for the purpose of conducting a required one-year annual inspection. LPA was greeted, granted entry by staff and explained the reason for the visit. Structure: The facility is a single level structure and licensed for six ambulatory residents, As of today, the facility has three residents admitted. All residents were present upon LPA’s arrival and then left for their day program. There’s a total of 6 bedrooms of which 4 bedrooms are for the residents and two bedrooms have been converted into activity areas. There are two restrooms available. There’s a living room space, a dining space and an attached garage. Bedrooms: All bedrooms have the required furnishings: bed, lamp, chair, and storage space. Bathroom(s): Bathrooms are equipped with a working toilet, wash basin, and shower. Hot water measured in between 116.2 – 116.6 degrees F. Kitchen: All burners and the warmer were operational on the gas stove. Sharps are kept locked cabinet near the stove. Dish soaps and cleaning chemicals are stored below the sink. Food Service: A supply of perishable and non-perishable food items that meet regulation requirements was observed. Resident & Staff Files: Resident and staff files stored in the main office. . File Review: 3 of 3 resident files were reviewed during the visit, and three staff files were reviewed. Medications/First-Aid Kit: Resident medications are stored in a medication cabinet in the main hallway. Medication Review: 3 of 3 resident medications were reviewed during the visit. Continued on LIC809C Linens & Hygiene Supplies: Hygiene items were observed in a locked cabinet in the bathroom area. Garage Area: The garage is clean and well organized. The walkways were free of obstruction. Cleaning supplies are stored in cabinets. Incontinent care supplies were observed, and there’s an extra refrigerator with a supply of nonperishable items. Backyard/Exterior: The backyard is clean and very well organized. Walkways are free of obstruction. A table and chairs were observed under a shaded patio area. Bodies of Water: None Smoke/Carbon Monoxide Detectors: Smoke and carbon monoxide detectors tested operational. Fire Extinguisher: Fire extinguisher was observed mounted on a wall in the kitchen. An emergency evacuation drill: Was conducted June 5, 2025. Evacuation drills are conducted monthly. Emergency Phone Numbers, House Rules, Exit Plan & Menu: Several facility postings are posted are available for review on the main postings board in the main hallway. Additional Comments: Licensing fees are current. Resident P&I funds were counted. Emergency food and water was observed in a cabinet in the kitchen. Facility contact information was reviewed during the visit, and the facility number will be updated. No deficiencies are being cited during today’s visit. An exit interview conducted, and a copy of the report was provided.the state’s words, verbatim · CDSS document, Jun 9, 2026

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Samer Haddadin conducted an unannounced annual visit. Upon arrival, LPA was granted entry and met with Care Staff Nora De Leon. The purpose of the visit was explained. The facility is a one-story home consisting of six bedrooms and two bathrooms, with an attached garage currently used for storage. LPA toured the facility and inspected all client bedrooms, each of which contained the required furnishings and elements. Both bathrooms were inspected and found to be clean, functional, and equipped with all required supplies. No mold or mildew was observed. Hot water was tested and measured within the regulatory range. At the time of the visit, three clients were in care. Knives, sharps, and cleaning chemicals were stored securely and were inaccessible to clients. Fire extinguishers were observed on site with the last inspection date of October 24, 2024. A review of two client files and two staff files revealed that all required documentation was present. Records showed the last emergency drill was conducted on September 5, 2025. The facility maintained sufficient food supplies, including a two-day supply of perishable items and a seven-day supply of nonperishable items, in accordance with regulations. The outdoor area included a shaded seating space with one table and four chairs available for client use. All emergency exits were clear and free from obstruction. No deficiencies were observed during the inspection. An exit interview was conducted, and a copy of this report was provided to the care staff at the conclusion of the visit.the state’s words, verbatim · CDSS document, Sep 20, 2025

Type of visit: Required - 1 Year

This unannounced inspection is being conducted by Licensing Program Analyst (LPA) Sean Haddad for the purpose of conducting a Required – 1 Year Inspection. LPA met with Staff #1 (S1) Nora De Leon and discussed the purpose of the inspection. Administrator (AD) Maxine Kniazeff arrived during the inspection. LPA reviewed Infection Control requirements. At about 9:00AM, LPA and S1 conducted a tour of the inside and outside of the facility, common areas, resident rooms, kitchen, and garage and observed the following: Structure: this is a one-story home. Facility is a 6-bedroom, 2-bathroom, one-story house with attached garage that is being used for storage. LPA observed 2 staff and 2 residents present at the facility. Resident Bedrooms: the 6 resident bedrooms are spacious and will easily accommodate the residents’ furnishings. Furniture for each resident bedroom inspected. Staff Bedrooms: there are no staff bedrooms. Bathrooms: the bathrooms were clean, faucets and toilets were operational. Water temperature: tested at 114 degrees F in the front client bathroom and 115 in the rear client bathroom. LPA inspected all rooms in the facility. Linens & Hygiene Supplies: new linens and fully stocked linen closets were observed. Emergency Phone Numbers, Exit Plan & Menu: reviewed. Food Service: LPA observed the facility has a 2-day supply of perishables and a 7-day supply of non-perishable food is available as required by regulations. Carbon Monoxide, Smoke Detectors, Fire Extinguisher: observed and tested, including the wired smoke detectors/carbon monoxide detectors. Appliances: stove burners, microwave, washer, and dryer inspected. Knives: observed locked in the kitchen. Toxins: observed locked in the kitchen and laundry room. Medication cabinet: observed to be locked. First-Aid Kit and Activity Supplies: observed and available. LPA discussed licensing fees with AD. At about 10:00AM, LPA reviewed 4 resident files and 4 staff files, interviewed 2 residents and 2 staff, inspected medications for 2 residents, and inspected resident money and ledgers for 4 residents. CONTINUED. During the inspection, LPA and AD observed the following. Per their most recent Physician’s Reports, Resident #1 (R1) and Resident #2 (R1) are non-ambulatory but the facility does not have a fire clearance for non-ambulatory residents. Based on the observations made during today’s inspection, deficiencies are being cited per Title 22 Division 6 of the California Code of Regulations. See LIC809D. Immediate civil penalties are being assessed. See LIC421IM. An exit interview was conducted and a copy of this report and appeal rights was discussed with and provided to facility representative.the state’s words, verbatim · CDSS document, Oct 25, 2023

The state marks this report as 5 pages; the online copy we transcribed has 3. You can request the full file from the county licensing office.