Compassionate Residential Care Home

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Maria (Mita) Partoza conducted an unannounced annual required inspection and met with administrator Belinda Devano and stated the purpose of the visit. The facility is licensed for adults 60+; 6 non-ambulatory, 1 maybe bedridden, and hospice waiver for 5. LPA observed 6 residents and 2 staff present 6 out 6 residents present at the facility 3 out of 5 were in their bedroom and 3 out of 6 were in the living room watching TV. 5 out of 6 resident was interviewed by LPA. LPA toured the facility, including common areas, resident rooms, dining, kitchen, 3 bathrooms, outdoor area and storage area. Indoor temperature was within acceptable range of 70°F. The kitchen was sanitary and organized; knives and chemicals were locked. Food supply met requirements (2 days perishable, 7 days non-perishable). Kitchen water temperature measured at 107.9°F. Bathroom water temperature ranged from 109.9°F to 111.0°F. Bathrooms had grab bars and non-skid mats; resident rooms had adequate storage. Medications were locked and inaccessible to residents; first aid kit was complete. Outdoor areas were free of hazards; laundry appliances were functional, and cleaning supplies were secured. Fire, smoke, and carbon monoxide systems were operational; hallways were clear and well-lit. The facility has motion sensors to alert any movements in the hallways at night time. LPA observed a storage shed at the back of the property that is used to store dry goods and a portion was converted as a activity place for residents to use. page 1 of 2 see LIC 809C LPA reviewed 5 resident and 3 staff records, including medication logs, admission agreements, care plans, personal and incidentals, health screenings, and training. All staff have required clearances, certifications and training required for residents that are in the facility. The facility conducts fire and earthquake drill quarterly for each shift. Last drill practice training was on 01/02/2026. The facility is equipped with fire pull alarm system and 1 fire extinguisher were inspected on 05/29/2025. No deficiencies were cited during today's visit based on the California Code of Regulations (CCR) Title 22. An exit interview was conducted with administrator Belinda Devano and a copy of the report was provided. end of report page 2 of 2the state’s words, verbatim · CDSS document, Jan 14, 2026

Type of visit: Required - 1 Year

Licensing Program Analysts (LPAs) Christine (Dolores) Kabariti and Marcela Yanez arrived unannounced to conduct the facility's annual required - 1 year inspection. LPAs met with Administrator (ADM), Belinda Devano. During visit, LPAs toured the facility with ADM to include the living room, resident bedrooms, staff bedroom, bathrooms, kitchen, garage, and backyard. There are 5 residents under hospice care. All fire exit routes were free and clear of obstruction. 4 staff present are fingerprint cleared. 3 out of 4 staff are associated to the facility. 1 out of 4 staff present was fingerprint cleared but was not associated to the facility. During visit, the ADM associated the staff to the facility using Guardian. ADM was advised to ensure all staff are associated to the facility prior to work. Facility temperature maintained at 72 degrees F. Fire extinguisher last serviced on 06/04/2024. Carbon monoxide detector observed present and operable in the hallway next to the kitchen. Smoke detectors observed throughout the facility. First aid kit observed complete. LPA observed Personal Protective Equipment (PPE) supplies. Emergency lighting such as lanterns and flashlights observed in the facility. Facility is conducting fire drills quarterly and the last drill was completed on 01/03/2025. 5 out of 5 resident bedrooms observed equipped with proper furniture and lighting to include a bed, linens, night stand, and dresser. 4 out of 5 resident's who are under hospice observed with full bed rails. Based on record review, 4 out of 5 residents hospice care plan included the physician order for full bed rails. 2 residents used oxygen. Oxygen in use sign observed posted outside the resident bedrooms. See LIC809-C. Around 11:20AM, the hot water temperature was measured in the bathroom next to bedroom #1 to be maintained at 102 degrees F. ADM states the hot water temperature is low because in the morning they use a lot of hot water. ADM states the hot water should raise in the afternoon. At 1:30PM, the hot water temperature was measured at 121.8 degrees F. Bathroom showers are equipped with grab bars and non-slip mats. Sharp objects, chemicals/toxins, and medications observed locked. Facility has at least 2 days worth of perishables and 7 days worth of non-perishable foods. Refrigerator temperature in the kitchen measured at 34 degrees F. Freezer temperature in the kitchen measured at 0 degrees F. There are 2 additional refrigerators in the garage which stores more food for the residents. The refrigerator in the garage temperatures measured at 40 degrees F and freezer measured at 0 degrees F. 3 resident files were reviewed. 1 out of 3 resident files did not contain an appraisal/needs and services plan. ADM was unable to produce the appraisal/needs and services plan for the 1 resident. 2 out of 3 resident files contained an appraisal/needs and services plan. 3 resident files reviewed were up to date and maintained. 3 residents centrally stored medications and records were reviewed and all medications were accounted for. 2 residents were interviewed. 3 staff records were reviewed and observed complete and maintained. 3 out of 3 staff annual training were complete to include at least 20 hours of annual training. Posters observed to include but not limited to the ombudsman, complaint poster, theft and loss policy, admission agreement, and house rules. Documents were obtained to update the facility's file to include: LIC500, LIC308. LIC400, Liability insurance, proof of administrator certificate renewal, and page 9 of the emergency disaster plan. A deficiency was cited per California Code of Regulations, Title 22. See LIC809-D. Advisory note provided. This report was reviewed with Administrator, Belinda Devano and a copy of the report and appeal rights were provided.the state’s words, verbatim · CDSS document, Jan 16, 2025

The state marks this report as 4 pages; the online copy we transcribed has 3. You can request the full file from the county licensing office.

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Mita Partoza conducted an unannounced annual required inspection to the facility. LPA met with administrator (ADM) Belinda Devano and 1 staff. 4 out of 4 residents are under hospice care. During visit, LPA toured the facility to include the living room, dining room, kitchen, bedrooms, bathroom, garage, and backyard. Staff room was inspected, 2.5 bathroom were inspected. The bathroom hot water temperature was measured at 105F to 115F. The room temperature in the facility was at 68-75F. LPA randomly reviewed resident and staff records including residents medications. Perishable and non-perishable food supply are within required regulation. Toiletries such toilet paper, paper towels, toothpaste are inspected and found to be in ample supply. Toxic materials such as laundry detergent, disinfectant are inaccessible to residents (locked in a cabinet). LPA tested the smoke/carbon monoxide and found to be in good working condition. Night lights are also observed and are in good working condition. All designated emergency exits and passage ways are clear from obstructions. Staff and Administrator were interviewed and reminded about infection control plan. LPA reviewed training for emergency disaster was last administered on 7/4/2023. A deficiency was cited per California Code of Regulations, Title 22 during today's visit. This report was reviewed with administrator Belinda Devano and a copy of the report was provided.the state’s words, verbatim · CDSS document, Jan 24, 2024