Cottages at the Colony of Sherman Oaks #2

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Quoc Huynh arrived at the facility unannounced to conduct a required annual visit at 9:42AM. The LPA met with the Administrator Anna Lee and informed them of the reason for the visit. Entrance interview conducted. Beginning at 9:58AM, the LPA and Administrator 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. The following was observed: OUTDOOR AREA: The rear yard had a shaded patio area equipped with furniture in good condition for resident and visitor use. There was a shed that contained emergency water and general storage. Exits and passageways were free of obstructions. There was two (2) emergency side exits with a self-latching gate. The facility had a secured garage that was utilized as an office. COMMON AREAS: At the time of the visit, living room and dining room furniture was observed to be in good condition. A fireplace was observed in the living room that was screened and inoperable. Required postings were observed in the entryway. Facility hallway closets contained extra linens and emergency supplies. The facility maintained a comfortable temperature throughout the visit and nightlights were observed throughout the hallways. There was a laundry room attached to the kitchen with operating machines. The laundry room also had cabinets with non-perishables and emergency food, secured medications, and secured cleaning supplies. Report Continued on LIC 809-C BEDROOMS/RESTROOMS: There were seven (7) total bedrooms: six (6) private resident rooms and one (1) secured staff room. The facility was approved for six (6) bedridden residents. Bedrooms were furnished appropriately with clean linens, appropriate furnishings and sufficient lighting. There were five (5) total restrooms in the facility: three (3) private and two (2) shared. Restrooms were clean and sanitary and in operating condition with grab bars and non-slip surfaces. All restrooms were sufficiently stocked with soap, paper products, and displayed hand washing signs. Hot water was tested and measured between 107.6 degrees F and 115.7 degrees F which is within the required range per regulation. KITCHEN: The LPA observed knives and cleaning supplies stored inaccessible. Kitchen appliances were clean and in operable condition. The facility had a sufficient supply of perishable and non-perishable food. Food in the refrigerator and freezer were observed to be properly stored with labels and dates. RECORDS: Record review began at 10:23AM. Resident records were reviewed for, but not limited to care plans, physician's report, admissions agreement, and 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 records were in order. INFECTION CONTROL/EMERGENCY DISASTER PLAN: During today's visit, LPA reviewed the facility's infection control plan and emergency disaster plan. Both documents were observed to be complete and reviewed annually as required. Fire extinguishers were observed and last serviced on 10/07/2025. Emergency disaster drills are conducted quarterly, with the last documented drill on 12/01/2025. Smoke and carbon monoxide detectors and fire door were tested at 11:11AM and were operational. Report Continued on LIC 809-C MEDICATIONS: Medication review began at 11:13AM. Medications were centrally stored and kept inaccessible in the laundry area. Medications were observed for two (2) residents. Medications were labeled and checked for expiration dates and were properly documented on the centrally stored medications and destruction record. No errors observed during the medication review. No deficiency cited. Exit interview conducted. A copy of the report was reviewed and provided.the state’s words, verbatim · CDSS document, Feb 25, 2026

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Trevor Byrne arrived at the facility unannounced to conduct a required annual visit at 10:00 AM. LPA met with facility staff who contacted the facility Administrator Anna Lee. The Administrator arrived to the facility at approximately 10:15 AM. Entrance interview conducted and the reason for the visit was explained. Beginning at approximately 10:15 AM the LPA, along with facility Administrator toured the physical plant areas inside and outside to ensure there are no health and safety hazards and that facility is in compliance with Title 22 Regulations. The following was observed: OUTDOOR SPACE: The facility has two (2) emergency exit gates located on either side of the facility; LPA observed clear passageways for emergency exit use. The facility has adequate shaded seating outdoors for resident use. LPA observed the facility’s outdoor areas to contain cameras. LPA observed the backyard to contain one (1) shed which contained the facility’s emergency water supplies. KITCHEN: The LPA observed the kitchen area to be clean. Kitchen appliances appeared to be in operable condition. The facility has a sufficient supply of two (2) days perishable and seven (7) days non-perishable food. LPA observed a secured drawer to contain knives and other sharp objects. All foods observed were labeled properly and were within their expiration dates. Continued on LIC 809C. COMMON AREAS: This includes the living room, hallway, laundry room, and dining area. LPA observed the living room to be clean and properly furnished at the time of the visit. The living room contains a fireplace, it is appropriately screened and contains no tools. Cameras were observed throughout the facility’s hallways and common areas. The hallway was observed to contain a storage closet which contained extra linens for resident use. LPA observed the laundry room to be attached to the facility’s kitchen. The laundry room was observed to contain a pantry, adequate emergency food supplies, and a locked cabinet which contained cleaning supplies and resident medications. The dining area was observed to be equipped with adequate seating for resident use. All furniture throughout the facility was observed to be clean and in good repair. The facility’s combination fire and carbon monoxide alarms were tested at 11:48 AM and were functional at the time of the visit. All exits in the facility were observed to contain functioning auditory alarms. BEDROOMS: There are seven (7) bedrooms in the facility; six (6) are single occupancy resident rooms and one (1) is designated as a staff bedroom. LPA and facility administrator toured all six (6) resident bedrooms. All resident rooms were observed to be furnished appropriately with clean linens, appropriate furnishings, and sufficient lighting. LPA observed fall detection devices to be installed in resident rooms. The staff bedroom was observed to be locked and inaccessible to clients in care. BATHROOMS: There are five (5) bathrooms at the facility. three (3) are attached to resident rooms and are designated as private resident bathrooms, and two (2) are designated as a shared/common resident bathrooms. All resident bathrooms were observed to be clean and in good repair and were equipped with nonskid surfaces. Grab bars were observed in all resident showers and near all resident toilets, all were properly secured. The water temperature was measured between 106.5 and 113.0 degrees Fahrenheit, which is in compliance with regulation. GARAGE: LPA observed the garage to be locked and inaccessible to clients in care. The garage is utilized by facility staff as an office space. Continued on LIC 809C. RECORD REVIEW: Record review began at 10:40 AM. Staff and resident records were reviewed for documents including, but not limited to: health screening, TB test, staff training records, fingerprint clearance, resident physician's report, needs and service appraisal, consent forms, and personal rights. Three (3) staff files were reviewed. All staff files contained all required documents and trainings. Five (5) resident files were reviewed. All resident files contained all required documentation and signatures. No deficiencies were observed during record review. MEDICATION REVIEW: Medication review began at 11:50 AM. Medications for two (2) of five (5) residents were observed. All medications were stored properly and were appropriately documented on their respective centrally stored medication and destruction record sheets. No deficiencies were observed during medication review. INFECTION CONTROL/EMERGENCY DISASTER PLANNING: During today’s visit, the LPA reviewed the facility's infection control practices and the facility's emergency disaster plan. The facility’s policies and procedures as it pertains to infection control are adequate. Emergency disaster drills are conducted quarterly; the facility’s last emergency disaster drill was conducted on 03/03/2025. The facility’s emergency disaster plan is up to date and is adequate. Both the infection control plan and the emergency disaster plan are reviewed/updated annually by the facility’s administrator. INTERVIEWS: LPA interviewed three (3) residents. All residents interviewed stated that the staff treat them well and are attentive to their needs. No residents had concerns with the facility. LPA interviewed two (2) staff members. Both staff members interviewed were knowledgeable on their roles and responsibilities, the resident’s rights, the forms of abuse, and the appropriate reporting procedures for suspected abuse. During today’s visit LPA obtained a copy of the facility’s LIC 500, resident roster, and current liability insurance. No deficiencies were observed during today’s inspection. Exit interview conducted and copy of the report was issued.the state’s words, verbatim · CDSS document, Mar 25, 2025

Type of visit: Required - 1 Year

Licensing Program Analysts (LPAs) Emily Peraldi and Martha Arroyo arrived at the facility unannounced to conduct a required annual visit. At 1:35 p.m., the LPAs met with the Administrators, Anna Bernice D Lee and Claudette Marasigan and explained the reason for the visit. Entrance interview. At 1:40 p.m., the LPA along with 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. The facility is a single-story residential home with seven (7) bedrooms, six (6) for resident use and one (1) for staff use and five (5) bathrooms. The property has a garage which is used for an office. Resident do not have access to the garage. BEDROOMS: 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. RESTROOMS: Restrooms are relatively clean and sanitary and in operating condition with grab bars and non-skid mats. Starting at 1:47 p.m., the hot water temperature was measured and it was in compliance between 107.6 and 115.8 degrees Fahrenheit. The sinks had sufficient liquid soap, and paper towels. Signs are posted throughout the facility restrooms to promote handwashing. KITCHEN: The LPAs 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. Food labels were observed for expiration dates. At 2:00 p.m., the kitchen faucet was measured at 110.9 degrees Fahrenheit. Medications are located in a locked cabinet in the laundry room/area. A first aid kit is located near the kitchen. Cleaning solutions, chemicals and hazardous items were inaccessible and locked away inside locked cabinets in the laundry room/area. Laundry units are located next to the kitchen in the laundry room/area. Continued on LIC-809-C. OUTDOOR SPACE: At 1:40 p.m., LPA Arroyo observed the back patio which has a covered outdoor area for resident use. There are two gates on each side of the house designated for an emergency exits. The property is gated. Passageways were free and clear from obstruction. There are no bodies of water on the premises. COMMON AREAS: The LPAs observed common areas to be relatively clean and properly furnished. The LPAs observed the fire extinguisher to be fully charged and last serviced on 10/12/2023. At 2:23 p.m., fire alarms/carbon monoxide detectors were tested and functioned properly. All exits have functioning auditory devices and were operational at the time of the visit. Facility telephone was observed during the time of the visit. LPAs observed cameras in the common areas, and throughout the exterior perimeter of the facility. Night lights were present in the hallways. During the time of the visit, the LPAs conducted interviews with two (2) out of six (6) residents and one (1) staff. RECORD REVIEWS: Starting at 1:40 p.m., the LPAs conducted a file review for all residents and staff regularly scheduled and observed the following: Staff have current first aid and training documentation showing required training completed. Resident records were reviewed for, but not limited to care plans, medical records, admissions agreement, consent forms. All files were in order. The Administrator’s certificate is active and expires on 01/11/2025. Copy of valid liability insurance and Facility Emergency Plan was provided to the LPAs during the visit. Starting at 2:33 p.m., LPA Arroyo conducted a review of medication and medication documentation with Administrator for five (5) residents and observed that all medications were properly documented. No deficiencies cited at this time. Exit interview conducted. A copy of the report was issued.the state’s words, verbatim · CDSS document, Feb 10, 2024

The state marks this report as 3 pages; the online copy we transcribed has 2. You can request the full file from the county licensing office.