Comfort Care Home IV

Type of visit: Required - 1 Year

On 04/13/26, Licensing Program Analyst (LPA) M. Yang arrived unannounced to conduct an annual visit. LPA introduce self, stated the purpose of the visit and requested to meet with the Administrator. LPA met staff Fely Reyes. Licensee/ Administrator (L1) Amardeep “Amy” Dhillon was called and arrived shortly. LPA toured facility with L1. All six residents were present during inspection. The facility was observed to be at a comfortable temperature, clean, in good repair, and no passageway obstructions or fire hazards were observed inside or outside. Sharps observed locked under kitchen counter. Fire extinguisher was observed with serviced date of: 03/11/26. An adequate supply of perishable and non-perishable food was observed. Refrigerator temperature observed maintains at 30 degrees F and freezer temperature maintains at -4 degrees F. Medications were observed locked in laundry cabinet. MARs were reviewed and medications were checked. Chemicals were observed locked in laundry shelves and under kitchen sink. All bedrooms were observed to have the required furnishings and adequate lighting. Extra linens were observed. The bathrooms were toured and observed operational during inspection. Non-skid mats and grabbed bars were observed. Hot water temperature was tested at 105.8 degrees F in shared master bathroom and at 107 degrees F in hall bathroom. Outside of facility toured and observed to be free of debris. Side gate observed self-closing. Adequate outdoor seating observed available for residents. Sample of staff and half of the residents’ files were reviewed. Carbon monoxide and smoke detector tested operational during inspection. A deficiency is being cited on the attached Lic 809D in accordance to California Code of Regulations, Title 22, Division 6. Exit Interview conducted. The requested documents are to be submitted to the department by 04/20/26: Lic 308, Lic 500, Lic 610E, and current liability insurance. A copy of this report and appeal rights was provided to Licensee, whose signature on this form confirms receipt of this report.the state’s words, verbatim · CDSS document, Apr 13, 2026

Allegation investigated: Resident sustained an injury while in care Staff did not address residents care needs in a timely manner

On 06/03/25, Licensing Program Analyst (LPA) M. Yang arrived unannounced to deliver complaint findings. LPA introduced self, stated the purpose of the visit, and met with caregiver Felyn Reyes. Licensee Amy Dhillion was called and unable to attend meeting. Findings was discuss with Licensee via telephone. Licensee authorized caregiver to receive and sign report. During the course of the investigation, the Department conducted interviews, records were reviewed and toured the facility. R1 had gone outside in the front yard. Staff was present with the resident when the resident refused to go inside the facility and slid the resident self onto the ground. Based on interviews conducted, allegation alleging resident sustained an injury while in care and staff did not address the resident’s needs in a timely manner, the preponderance of evidence standard has been met, therefore the above allegations are found to be UNSUBSTANTIATED. An exit interview was conducted, and a copy of this report was provided to the caregiver, whose signature confirms received of this report. Unsubstantiatedthe state’s words, verbatim · CDSS document, Jun 3, 2025 · control 24-AS-20250415161650

Type of visit: Required - 1 Year

On 04/21/25, Licensing Program Analyst (LPA) M. Yang arrived unannounced to conduct an annual visit. LPA introduce self, stated the purpose of the visit and requested to meet with the Administrator. LPA met staff Fely Reyes. Licensee/ Administrator (L1) Amardeep “Amy” Dhillon was called and arrived shortly. LPA toured facility with L1. Five residents were present during inspection. The facility was observed to be at a comfortable temperature, clean, in good repair, and no passageway obstructions or fire hazards were observed inside or outside. Sharps observed locked under kitchen counter. Fire extinguisher was observed with serviced date of: 03/06/25. An adequate supply of perishable and non-perishable food was observed. Refrigerator temperature observed maintained at 40 degrees F and freezer temperature maintained at 0 degrees F. Medications were observed locked under kitchen and laundry shelves. MARs were reviewed and medications were checked. Chemicals were observed locked in laundry shelves. All bedrooms were observed to have the required furnishings and with adequate lightening. Extra linens were observed. The bathrooms were toured and observed operational during inspection. Non-skid mat and grabbed bars were observed. Hot water temperature was tested at 106.2 and 106.7 degrees F in shared master bathroom and at 106.3 degrees F in bathroom. Outside of facility toured and observed to be free of debris. Side gate observed self-closing. Adequate outdoor seatings available for residents. Sample of staff and all of the residents’ files were reviewed and observed to have the required documents. Carbon monoxide and smoke detector tested operational during inspection. A deficiency is being cited on the attached Lic 809D in accordance to California Code of Regulations, Title 22, Division 6.Exit Interview conducted. The requested documents are to be submitted to the department by 04/28/25: Lic 308, Lic 500, Lic 610E, current liability insurance, and current Administrator Certificate. A copy of this report and appeal rights was provided to Licensee, whose signature on this form confirms receipt of this report.the state’s words, verbatim · CDSS document, Apr 21, 2025

Type of visit: Required - 1 Year

On 05/22/24, Licensing Program Analyst (LPA) M. Yang arrived unannounced to conduct an Annual Inspection. LPA arrived, greeted, and allowed entry by Licensee Amy Dhillon. LPA conducted tour with Licensee. All five residents were present during inspection. The facility was observed to be at a comfortable temperature, clean, in good repair, and no passageway obstructions or fire hazards were observed inside. An adequate supply of perishable and non-perishable food was observed. Refrigerator temperature maintained at 34.9 degrees F and freezer temperature at -2 degree F. Fire extinguisher was observed with a service date of: 03/07/24. Medications were checked and observed kept locked in laundry room cabinet. Residents’ MARS was reviewed. Knives and medication cups observed in kitchen drawers accessible to residents. Residents' bedrooms were toured and observed to be adequately furnished with bed, dresser, and adequate lighting. Bathrooms were properly equipped, and the hot water temperature was tested range between 107.2 and 107.5 degrees F in shared bedroom and 108.1 in bathroom. Carbon monoxide and smoke detectors were tested and observed to be operational. Outside of facility toured. Side gate was self-closing and self-latching. All residents’ and a sample of staff files were reviewed to have all the required documents. A deficiency is being cited on the attached 809D in accordance to California Code of Regulations, Title 22, Division 6. Exit Interview conducted. LPA received copies of Lic 308, Lic 500, Lic 610E, current liability insurance, and current Administrator Certificate. A copy of this report and appeal rights was provided to Licensee, whose signature on this form confirms receipt of these report.the state’s words, verbatim · CDSS document, May 22, 2024