Diamond Care

Type of visit: Case Management - Incident

Licensing Program Analyst (LPA) arrived unannounced to conduct a case management visit regarding a report received by Community Care Licensing (CCL) alleging non‑consensual sexual contact between Resident 1 (R1) and Resident 2 (R2). LPA met with the Administrator and explained the purpose of the visit. The visit was conducted to determine whether the facility provided adequate supervision and protected residents’ personal rights as required under Title 22. Based on interviews, documentation reviewed, and observations, the following was determined: R1 engaged in oral sexual contact (fellatio) with R2. R2 is a conserved individual with a diagnosis that does not support the capacity to consent to sexual activity. Because R2 is unable to provide informed consent, the contact is classified as non‑consensual under Title 22 personal rights standards. Following the incident, R2 began exhibiting changes in condition, including behavioral and emotional distress. Due to these changes, R2 was transported to a medical facility for assessment. As of the time of the visit, R2 has not returned to the facility. Continued The Administrator reported that staff will conduct a full assessment upon R2’s return to determine whether the facility can safely continue to meet R2’s needs. The facility did implement and document preventive measures, increased supervision, and safety planning. R1 has a diagnosis of major neurocognitive disorder (Dementia). Advisory given for updating the license to reflect Dementia as a part of the service delivery. Deficiencies were cited on today's date. Exit interview conducted.the state’s words, verbatim · CDSS document, May 22, 2026

From the deficiency page — Deficiency type: Type A · Section cited: CCR 87468.2a(8) · Plan of correction due date: May 25, 2026

Additional Personal Rights of Residents in Privately Operated Facilities To be free from neglect, financial exploitation, involuntary seclusion, punishment, humiliation, intimidation, and verbal, mental, physical, or sexual abuse. This requirement is not met as evidenced by: R2 is a conserved individual with a diagnosis that does not support the capacity to consent to sexual activity. This violation poses an immediate health, and safety risk to residents in care.the state’s words, verbatim · CDSS document, May 22, 2026

Plan of correction: The Licensee/Administrator shall provide Personal Rights training for all staff which shall be submitted by POC due date by 5/25/2026.

Type of visit: POC

LPA Albert Johnson made an unannounced POC visit to the facility to verify correction of citations issued during the Plan of correction visit on 3/10/2026. The following deficiencies, initially cited during a visit on 03/10/2026, have been cleared:the state’s words, verbatim · CDSS document, Apr 20, 2026

Type of visit: Case Management - Deficiencies

LPA Johnson arrived at the care facility and met with Amber to conduct a case management visit into incident reports received on 02/23/2026 and 02/27/2026. Later joined by Jenna Silva Administrator. R-1 AWOL'd from the facility on 2/23/2026 at approximately 7:15 am, Staff members noticed while breakfast preparation and shift change, staff observed that the resident was not present in the common areas as expected. Contact was made to the Licensee/owner by staff members on duty after being unable to locate R-1. R-1 was located by SJC Sheriff on 2/24/2026 and taken to mental health. Staff member returned R-1 back to the facility on 2/24/2026 that morning. According to R-1's Physicians report, R-1 is not allowed to leave the facility unassisted due to poor judgement and the lack of ability to make safe sound decisions. LPA spoke with Staff about the facilities care plan for R-1 going forward. LPA obtained copies of resident's service plan and other pertinent information. Additionally, On 02/27/2026 at approximately 11:30 p.m., staff member S-1, assigned to the NOC shift, reported that R-2 was exhibiting increased agitation and restlessness. The resident was reported to be removing clothing, pulling at his brief, and handling bowel movement contents. Staff reported that the resident was not willing to remain in bed. The behavior was reported to CEO Gloria Murphy at approximately the same time. Hospice of San Joaquin was contacted to assist with medication administration and to assess for any change in the resident’s mental condition. Hospice nurse arrived at approximately 6:30 a.m. on 02/28/2026. This was seven hours after the initial call, upon arrival, the hospice nurse observed the resident (R-2) undressed and on the floor with a floor mat in place. The hospice nurse reported that the resident was assessed for possible trauma or injury, including hip injury. Per hospice nurse assessment, no signs of fracture or acute injury were identified; however, redness was noted on the resident’s right hip and buttock area. At approximately 7:00 a.m., S-2 began their shift and assisted the hospice nurse with cleaning and repositioning the resident. It should be noted that S-1 did assist R-2 during and through out the evening, however, R-2 was aggressive and did not let S-1 completely clean R-2 during multiple changing of R-2's briefs. As a reminder: For emergencies NOT directly related to the expected course of the resident’s terminal illness, the facility staff is required to call 911. Deficiencies were cited on today's date. Exit interview conducted.the state’s words, verbatim · CDSS document, Mar 10, 2026

From the deficiency page — Deficiency type: Type A · Section cited: CCR 87411(a) · Plan of correction due date: Mar 11, 2026

87411(a)- Personnel Requirements - General-Facility personnel shall at all times be sufficient in numbers, and competent to provide the services necessary to meet resident needs.-This requirement is not met by observation and records review R-1 AWOL'd from the facility. The LIC 602 states the resident was not allowed to leave the facility unassisted. This presents an immediate health and safety risk to the resident in care.the state’s words, verbatim · CDSS document, Mar 10, 2026

Plan of correction: The facility shall conduct an in-service training with staff to go over what and how staff shall ensure that residents do not AWOL. Executive Director shall send the in-service training materials, plan on how staff will ensure residents do not AWOL and a signature sheet of all staff who attended. Executive Director shall email the date of the in-service training to LPA by 03/11/26 to meet the 24 hour POC requirement.

From the deficiency page — Deficiency type: Type B · Section cited: CCR87464(f)(1) · Plan of correction due date: Mar 24, 2026

(f) Basic services shall at a minimum include:(1)Care and supervision as defined in Section 87101(c)(3) and Health and Safety Code section 1569.2(c). This requirement was not met as evidenced by records reviewed and interviews conducted S-1 did not provide R-2 with assistance in the morning when hospice arrived. This is a potential health risk to resident in care.the state’s words, verbatim · CDSS document, Mar 10, 2026

Plan of correction: The facility shall conduct an in-service training with staff to review the regulation 87464 in it's entirety. Executive Director shall send the signature sheet of all staff who attended. Executive Director shall email the information by the POC date 3/24/2026.

Type of visit: Office

A Noncompliance Conference (NCC) was conducted today, February 13th, 2026, via Microsoft Teams. The purpose of the NCC was to discuss the facilities substantiated non compliance. Present at today’s NCC were the Regional Office Manager Stephenie Doub, Licensing Program Managers (LPMs) Liza King and Lisa Rios, Licensing Program Analysts (LPA) Noel Wolf Petersen, and Licensee Diamond Care Inc. CEO Gloria Murphy, Administrator Zachary Murphy, Administrator Jenna Silva. The administrative process was explained during this meeting and Licensee was informed that further citations may result in Administrative Action. Participating in the non-compliance conference does not deprive the Department of its authority to take appropriate formal legal action under the Health and Safety Codes if such action is deemed necessary by the Regional Manager. Citations for the past 3 years - Ten (10) A type citations in areas of Basic Care and Supervision, Reporting Requirements, Prohibited Health conditions, Administrator Qualifications, Inspection Authority, Basic Care, Storage Space and Access, Incidental Medical and Dental Care, Staff Records. B citations in the past 3 years six (6), in the areas of Maintenance and Operation, Personal Rights, Insurance Requirements. During inspections over the past year the department learned two clients with prohibited conditions were admitted to the facility without submitting an exception review to the department, presenting unnecessary risk to the health and safety of the clients. Both were hospitalized within a short period of being admitted to the facility. Additionally, the department experienced lengthy delays in facility documents requested or required by the department, to include unreported significant events and a resident file missing from the facility Continued on C Page: Issues discussed related to the above include: 1. Facility basic understanding and plans regarding Restricted and Prohibited Conditions and Exception Requests 2. Outstanding POCs 3. Facility plans regarding Unavailability/excessive lateness with files requested by the department 4. Reporting Requirements 5. Plan of Operation 6. HCO status During the meeting, the facility agreed to the following: 1. Submission of LIC 500 Personnel Summary for supervisory changes facility to include Administrator presence with no less than 40 hours per week, and tenative schedules of TO BE HIRED positions required by licensure as a 16 person facility, 03/6/26 2. Provide an LIC308 for each facility by 03/6/26 3. Provide an updated LIC309by 03/6/26 4. Provide an updated Organizational Chart by 03/6/26 5. Conduct Staff training/submit training logs for the following topics within 30 days then quarterly thereafter for one year: Restricted Health Conditions accepted by the facility Prohibited Health Conditions Inspection Authority Reporting Requirements 6. Participate in TSP 7. Provide Exception requests for: no current clients unless the client with the pending 602 change regarding thier ability to dial and administer their own insulin meets the critera for needing a restricted care exemption. 8. updated Needs and services plans for the clients entering hospice, hospice care plans for the three current hospice residents, updated 602's and needs and services plans for the insulin dependant person who will perhaps become independantly able to manage thier care themselves by 3/6/26 9. provide proof of insurance for liability and workers comp by 3/6/26 Licensee has been advised that failure to complete the above agreed upon actions by the dates will result in this Department taking the appropriate enforcement actions. Additional information provided by the licensee during the meeting included: A separate meeting will review updates to the plan of op, regarding the use of the volunteers, different requirements including staffing requirements for facilities with 16 or more clients, and the use of the gate. CCL will Conduct unannounced quarterly visits to monitor the overall compliance. During the quarterly visits, the Department will focus its review on the following areas: Medical Assessment of residents Preplacement Assessments Individualized Needs and services plans Staff knowledge regarding reporting requirements, restricted and prohibited care conditions In the event that the Department determines that the licensee has violated the law/regulations or is inadequately implementing the approved plans, the Department, in its discretion, may seek formal legal action or other appropriate administrative action. An exit interview was conducted via telephone and a copy of this report was sent electronically for signature.the state’s words, verbatim · CDSS document, Feb 27, 2026

Type of visit: Office

On 2/20/26 at 10:00 am, an office meeting was called regarding the Plan of Op at Diamond Care Inc. Attending the meeting was LPM Liza King, LPA Noel Wolf Petersen, Facility Administrator Jenna Silva. Discussion of the items began at 9:58 after introductions. The department has concerns about the plan of op missing/incomplete policies and procedures: Accepting residents with dementia and also mental health diagnosis 1 RN on call versus on multiple RN's on staff versus contracted 3rd party RN Services Restricted/prohibited conditions are mixed together. it will be copied over from the admission agreement Needs and services plan, the preplacement appraisals. It was fine, just out of order. Special equipment needs procedures for the specific needs. resident records checklist was provided to the administrator Personal rights, add all the codes, add a line that says this is not all inclusive of the codes, or make reference to an attached document Like an appendix A where you enumerate the rights. Continued on C page. The emergency plan is missing some components regarding evacuation sites. hospital does not do temporary shelter, transportation will be provided in an emergency, Neither hospice or home health is going to step up and should be excluded from an emergency shelter plan. church, or any environment without bedding, you need to provide a plan for meeting the clients continuing needs including bedding, should to be included in the evacuation plan. Dementia training has required training topics that should be listed with hours in the plan of op. Staff required training topics and hours should be listed. TSP service referral. If home health falls through with their responsibilities, the facility is responsible to react to that. if there is care outside the scope of a care giver that needs to be done, the facility has to make arrangements for it to happen. Home health and hospice agencies have care plans maintained with the facility to describe the division of labor. Facility is going to arrange for transportation under incidental and medical and dental. The cost like charge for an escort or a transportation has to be outlined into the admission agreement if the responsible party is going to be charged for that as a service. Transport services for someone unconscious/can't do advance in writing requests? Plan of op should describe what the policy for the how the scheduling/transport will work in that scenario. Medical care is going to be scheduled by the facility. Theft and loss policy should specifically address thefts more than 100$, an inventory for safegaurded resident property should be completed soon. Restraints/seclusion are not permitted for use in the facility. Secured perimeter waiver will be dicussed in the ncc, usually its delayed egress. Topline is the department has not made a wavier and the department is aware the fire department is willing to allow it. No citations issued at this time. A copy of the report was read and provided to the administrator via email, and will be filed as signed when returned. exit interview was conducted.the state’s words, verbatim · CDSS document, Feb 20, 2026

Type of visit: Case Management - Annual Continuation

Licensing Program Analyst, LPA, Noel Wolf Petersen arrived unannounced to continue the annual inspection which was cut short due to time constraints. LPA met with administrator Carie Snodgrass to explain the purpose of the visit. Physical plant inspection and client file review were completed on the original visit 1/30/26. Fire extinguishers are dated 1/27/26, water temperature was measured within range 105-120*F, CO/smoke alarm is functional in both buildings. Only note was related to a cracked door in a residents room that opens to the outside. there are other doors that lead outside in that room. Administrator provided a work order would be made for the door, pictures of the completed repair should be sent to the LPA by 3/4/25. Staff files were reviewed, including but not limted to background checks for doj/fbi, conitnuing and inital trainings, first aid certification, and health screening, files are present and up to date. LPA gave guidance that there are a lot of diabetic folks in the facility, more training time could be devoted to topics in diabetic care. Administrator files were reviewed. including but not limited to the facility posters; license, facility sketch, ombudsman reporting number, licensing reporting number, evacuation plan, client rights, residential council, family council, and administrators certificate(has a pending renewal). and Infection control plan. up to date and present. control of property, should be established on a lease agreement available for review by the department. The landlord(also the owner of the corporation) should write a letter adknowleging that a buisness is renting the property and lengthy notice would be given if the property was to no longer rent to the buisness to afford time for the clients of the buisness to go through the eviction procedure. Continued on c page. The surety bond is very high, and the facility is not holding cash for the clients. LPA gave guidance ccld only requires 1000 above whatever the facility is holding and not at all if the facility is not holding cash. The liability insurance is low, only 250k per occurance and 750k in aggrigate. By regulation 1m, 3m are the correct values. The facility is reporting not to have workers compensation insurance. Files otherwise are up to date and present. During the previous annual inspection, LPA Wolf Petersen became aware of a client who experinced an incident(pneumonia) and transfered to the hospital, which should have been reported to licensing. LPA gave guidance that any clients unexpected visit to the hospital/acute psychiatric care should trigger a written report to notify licensing within 7 days. The LIC 624 is the appropriate form for notifying licensing of a significant event, it should go to the regional office email and the LPA's email. cclascpsacramentosouthro@dss.ca.gov and noel.wolfpetersen@dss.ca.gov Citations are issued, a copy of the report was read and given to staff. appeal rights were provided. an exit interview was conducted.the state’s words, verbatim · CDSS document, Feb 4, 2026

From the deficiency page — Deficiency type: Type A · Section cited: CCR 87211(a)(1)(D) · Plan of correction due date: Feb 5, 2026

87211 Reporting Requirements (a) Each licensee shall furnish to the licensing agency such reports as the Department may require, including, but not limited to, the following: (1) A written report shall be submitted to the licensing agency and to the person responsible for the resident within seven days of the occurrence of any of the events specified in (A) through (D) below. This report shall include the resident's name, age, sex and date of admission; date and nature of event; attending physician's name, findings, and treatment, if any; and disposition of the case.(D) Any incident which threatens the welfare, safety or health of any resident, such as psychological abuse of a resident by staff or other residents, or unexplained absence of any resident. This requirement was not met as evidenced by: per record review where licensing had not recived a report regarding the client with pneumonia hospitalization. This presents an immediate risk to the health, safety, or personal rights of clients in care.the state’s words, verbatim · CDSS document, Feb 4, 2026

Plan of correction: Licensee will send the LPA a strategy for correcting the violation, by the poc date 2/5/26, noel.wolfpetersen@dss.ca.gov LPA is suggesting a training be held for staff, covering the topic of what is a reportable event to licensing.

From the deficiency page — Deficiency type: Type B · Section cited: HSC 1569.605 · Plan of correction due date: Feb 11, 2026

§1569.605 Liability insurance; coverage requirements On and after July 1, 2015, all residential care facilities for the elderly, except those facilities that are an integral part of a continuing care retirement community, shall maintain liability insurance covering injury to residents and guests in the amount of at least one million dollars ($1,000,000) per occurrence and three million dollars ($3,000,000) in the total annual aggregate, caused by the negligent acts or omissions to act of, or neglect by, the licensee or its employees. This requirement was not met as evidenced by: record review where Liability insurance is stated to be 250k per occurance and 750k in total aggrigate. This presents a potential risk to the health and saftey and personal rights of clients in carethe state’s words, verbatim · CDSS document, Feb 4, 2026

Plan of correction: Provide proof of insurance by the date, noel.wolfpetersen@dss.ca.gov

From the deficiency page — Deficiency type: Type B · Section cited: CCR80063(a)(1) · Plan of correction due date: Feb 11, 2026

80063 Accountability (a) The licensee, whether an individual or other entity, is accountable for the general supervision of the licensed facility, and for the establishment of policies concerning its operation. (1) If the licensee is a corporation or an association, the governing body shall be active and functioning in order to ensure such accountability. This requirement was not met as evidenced by: staff interview and record review where the workers comp insurance was not provided due to not being purchased. This presents a potential risk to the health and saftey and personal rights to clients in care.the state’s words, verbatim · CDSS document, Feb 4, 2026

Plan of correction: Provide proof of insurance by the poc date, noel.wolfpetersen@dss.ca.gov Licensee should review Califonia Labor Code 3700, requiring that workers compensation insurance for california employers.

Type of visit: Required - 1 Year

Licensing Program Analysts, LPAs, Noel Wolf Petersen and Michael Bilger arrived unannounced to conduct a annual inspection. LPAs met with administrator Carie snodgrass to explain the purpose of the visit. LPA toured physical plant with office administrator inside and outside to ensure the safety of the residents. LPA observed two facilities on two properties housing residents. LPA observed kitchen, garage, restrooms, bedrooms, and common living areas to be clean and in good repair. The temperature inside the facility was measured at 70*F which is within the required range of 68*F and 85*F, or in areas of extreme heat the maximum shall be 30*F less than the outside temperature. The hot water was measured at 117*F and 110.5*F within regulatory range of is not less than 105*F and not more than 120*F. LPA observed the centrally stored medications, toxins, and knives stored in the locked garage office to be locked inaccessible to residents. LPA observed food supplies of staple nonperishable foods for a minimum of one week and fresh perishable foods for a minimum of two days which shall be maintained on the premises at all times. LPA observed signs posted, restrooms stocked with paper towels, hand soap and touchless covered trash cans. LPA observed bacterial analysis of private water supply is being conducted annually. the last analysis was completed on 2/18/2025. LPA ran out of time will need to complete the inspection at a later date. A copy of the report was read and given to the staff, and exit interview was conducted. no citations were issued as part of this inspection.the state’s words, verbatim · CDSS document, Jan 30, 2026

Type of visit: Case Management - Other

Licensing Program Analysts, LPA, Noel Wolf Petersen and Michael Bilger arrived unannounced to conduct a case management for the exception process. LPAs met with administrator Carie Snodgrass to explain the purpose of the visit. LPAs reviewed 12 of 12 client preapprisals, needs and services plans, 602's, medication logs for restricted and prohibited conditions. 1 of 1 hospice care plan and 4 clients home health aid services contracts. 6 of 12 clients were met by the LPAs to physically inspect thier needs. 2 clients with catheter care, restricted 1 client with o2 administration, restricted 1 client with tracheometry tube, Prohibited 2 clients have insulin dependant diebetes, restricted 1 client has a g-tube, restricted, LPA provided guidance to facilitate alternate accomodations for the client with the Trach tube. Per administrator, the resident with o2 administration and the tracheometry tube is in the hospital with pneumonia, and the plan is to have that resident not come back to the facility. LPA gave guidance Needs and services plans will be updated for the remaining clients, describing what elements of care the facility is doing and what elements of care the 3rd party services are doing. Administrator provided 602's will be updated as necessary for clients who can take care of thier own needs. LPA provided guidance to formally request exceptions from the departement for any outstanding restricted care. LPA gave guidance for blood pressure medication distribution with variable distribution is to be evaluated by a nurse, not a caregiver. Citations issued on following d-page. A copy of the report was read and given to the staff, appeal rights were provided. An exit interview was conducted.the state’s words, verbatim · CDSS document, Jan 30, 2026

From the deficiency page — Deficiency type: Type A · Section cited: CCR 86615(a)(6) · Plan of correction due date: Jan 30, 2026

87615 Prohibited Health Conditions (a) Persons who require health services for or have a health condition including, but not limited to, those specified below shall not be admitted or retained in a residential care facility for the elderly: (6) Tracheostomies. This requirement was not met as evidenced by: administrator interview and record review where one client was admited with a tracheostmy tube. This presents an immediate health and saftey risk to clients in care.the state’s words, verbatim · CDSS document, Jan 30, 2026

Plan of correction: Facility will have a training related to prohibited health conditions, licensee will attend the training. submit a signed statement of attendees of the training to the lpa. noel.wolfpetersen@dss.ca.gov

From the deficiency page — Deficiency type: Type A · Section cited: CCR87405(d)(2) · Plan of correction due date: Jan 30, 2026

87405 Administrator - Qualifications and Duties (d) The administrator shall have the qualifications specified in Sections 87405(d)(1) through (7). If the licensee is also the administrator, all requirements for an administrator shall apply. (2)Knowledge of and ability to conform to the applicable laws, rules and regulations. This requirement was not met as evidenced by: administrator interview and record review where 5 restricted conditions amongst the clients admited into care without either an approved exception plan or needs and services filled out designating responsibilites carried out by the client and facility. This presents an immediate health and saftey risk to clients in care.the state’s words, verbatim · CDSS document, Jan 30, 2026

Plan of correction: Submit a signed statement of understanding of regulation 87209, begin/contine the process of aquiring exceptions or updating needs and services and 602's for the relevant clients. noel.wolfpetersen@dss.ca.gov

Type of visit: Case Management - Other

LPA Kesha Lewis arrived at the facility today and met with CARIE SNODGRASS to follow up on documents that were requested via email on 10/30/2025 and again on 12/09/2025 for R1 which include the following: · Staff schedules for the months of Nov and Dec 2024 and Jan 2025. Please ensure that the titles of staff are documented. · Current LIC500 · MARS for the for the months of Nov and Dec 2024 and Jan 2025 · Physicians Orders for the months of Nov and Dec 2024 and Jan 2025 for R1 · Any reassessment that was conducted for R1 · Any service notes for the months of Nov and Dec 2024 and Jan 2025 for R1 On this date, LPA attempted to collect the file R1 however it was not at the facility. Documentation as listed above is still needed at this time. The facility is being cited today inspection authority based on the failure to provide the requested documents (see 809D attached). LPA met with CARIE SNODGRASS, reviewed the report, provided a copy as well as the appeal rights.the state’s words, verbatim · CDSS document, Dec 12, 2025

From the deficiency page — Deficiency type: Type A · Section cited: CCR 87775(c) · Plan of correction due date: Dec 12, 2025

87755 - Inspection Authority of the Licensing Agency. (c) The licensing agency shall have the authority to inspect, audit, and copy resident or facility records upon demand during normal business hours. Records may be removed if necessary for copying. Removal of records shall be subject to the requirements in Sections 87412(f), 87506(d), and 87508(b). This requirement is not met as evidenced by: Based on interview with the adminstrator the file for R1 was not at the facility. Which poses a potential health, safety or personal rights risk to persons in care.the state’s words, verbatim · CDSS document, Dec 12, 2025

Plan of correction: Licensee will provide documents to the department by EOD on 12/12/2025.

Type of visit: Case Management - Legal/Non-compliance

Licensing Program Analyst, LPA, Noel Wolf Petersen arrived to the facility 3pm to conduct a case management follow up visit regarding R1 that was recently investigated by the Department. LPA met with administrator Carrie Snodgrass to explain the purpose of the visit. Record reviews of hospital discharge summaries, assessments and Needs and Services plan detail R1 having conditions that required skilled medical services and worsening signs of an infection. Additionally, the discharge summary, hospital records and facility notes document a period of two weeks where R1 was in need Home Health services which were not implemented. Having accepted R1 back into their care, Diamond Care Inc assumed responsibility for meeting R1’s needs. Based on information known to the licensee they should have scheduled a MD appointment or had the resident transported to the emergency room. Two citations are issued on following d Page. This incident is currently under review and a future civil penalty may apply based on § 1569.49H&S. Failure to correct the deficiencies may also result in civil penalties. a copy of the appeal rights were given, an exit interview was held, a copy of the report was read and given to the administrator.the state’s words, verbatim · CDSS document, Dec 2, 2025

From the deficiency page — Deficiency type: Type A · Section cited: CCR 87464(d) · Plan of correction due date: Dec 3, 2025

87464(d) Basic Care, A facility need not accept a particular resident for care. However, if a facility chooses to accept a particular resident for care, the facility shall be responsible for meeting the resident's needs as identified in the pre-admission appraisal specified in Section 87457, Pre-admission Appraisal and providing the other basic services specified below, either directly or through outside resources. – This requirement was not met as evidenced by: Based on the record review of discharge documentation that states resident requires skilled nursing services which were not implemented. Additionally based on documentation there were worsening signs of infection of prohibited health conditions which should require medical assessment. This poses an immediate risk to the health and safety to clients in carethe state’s words, verbatim · CDSS document, Dec 2, 2025

Plan of correction: review and sign indicating understanding of 87612, 87613, 87616, regarding the care of restricted healthcare clients by the poc date.

From the deficiency page — Deficiency type: Type A · Section cited: CCR80064(a)(2) · Plan of correction due date: Dec 3, 2025

80064(a)(2) Administrator - Qualifications and Duties (a) The administrator shall have the following qualifications: (2) Knowledge of the requirements for providing the type of care and supervision needed by clients, including ability to communicate with such clients This requirement was not me as evidenced by: Based on the record review of discharge paperwork, R1 had been admitted to the facility with both prohibited and restricted health conditions which were not appropriately addressed. The Administrator failed to seek an exception per 87616, ensure a plan was developed, implemented and approved by the Department if necessary. This poses an immediate risk to the health and safety of clients in care.the state’s words, verbatim · CDSS document, Dec 2, 2025

Plan of correction: Review and sign indicating understanding of 87615, regarding the care of prohibited healthcare clients by the poc date.

Type of visit: Case Management - Other

Licensing Program Analyst, LPA, Noel Wolf Petersen arrived to the facillity unannounced for a case management related to a recent IB investigation. LPA met with administrator Carie Snodgrass to explain the purpose of the visit. LPA inspected the physical plant of the facility. There are flies in different parts of the facility, administrator will have staff take measures to eliminate insects and pests. There is a broken door knob and missing lamp shade in one of the rooms, the repairs are to be scheduled. a test of the alert system sounds a tone in the office and kitchen, LPA waited 3 minutes before concluding the test without a response by the staff to the tone. The administrator will trouble shoot the system for changes that will make the alert system usable by the staff to have a reasonable response time. LPA asked for confirmation that the documents requested for the recent IB investigation were complete. Z. Murphy replied they were. No citations were given as part of the visit. A copy of the report was read and given to the administrator.the state’s words, verbatim · CDSS document, Nov 13, 2025

Allegation investigated: Staff did not issue a refund to resident's authorized representative Staff did not follow proper admission procedures

On 7/28 at 10:30am, Licensing Program Analysts(LPAs) Noel Wolf Petersen and Micheal Bilger arrived unannounced to deliver findings in regard to the allegations above, the LPAs met with Staff Cierrah Warren and Administrator Carie Snodgrass to inform them of the purpose of the visit. The allegation that the Staff did not issue a refund to resident’s authorized representative, was investigated via interview and record review with the staff. While a record was received detailing that a refund was offered to the residents next of kin after the death of the resident, the offered refund was determined by interview to not have been made with the calculation of amount as outlined in the regulation (5300 (prorated month)and 2400 (80% preadmission), 7733 total). Continued on C page Substantiated The allegation that the Staff did not follow proper admission procedures, was investigated via record review. In 1 of 2 admission agreements reviewed by the LPA the admission agreement that was missing a refund conditions section and contained prohibited terms: requiring advance notice of termination of the contract regardless to the death of the client. Based on LPAs observations and interviews which were conducted, the preponderance of evidence standard has been met, therefore the above allegation(s) is found to be SUBSTANTIATED. California Code of Regulations is being cited on the attached LIC 9099D. Per Title 22. An exit interview was conducted, the report was read and a copy given to the staff. Appeal rights were provided. The allegation that staff did not provide adequate food service to resident(s) in care, was investigated by a record review and interviews of clients, staff, and responsible parties to the clients. There is conflicted statements being made about the claim. The menu receives input from the clients, and is generally reflected In the available foods. The staff report to be responsive to requests for alternative choices in food and taking measures of supplementing special and requested diets, while some concerns were raised about the documentation of follow through on specific food service requests that were medically necessary. The LPA observed that residents do not have immediate food access, it is stored locked in a garage and requires staff to be intermediary to all meals and snacks. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation(s) did or did not occur, therefore the allegation is unsubstantiated. An exit interview was conducted, the report was read and a copy given to the administrator. Appeal rights were provided.the state’s words, verbatim · CDSS document, Jul 28, 2025 · control 27-AS-20250505145459

From the deficiency page — Deficiency type: Type B · Section cited: CCR 87507(g)(5)(A) · Plan of correction due date: Aug 28, 2025

87507 Admission Agreements (g) Admission agreements shall specify the following: (5) Refund conditions. (A)Facility policy concerning refunds, including the conditions under which a refund for advanced monthly fees will be returned in the event of a resident’s death, pursuant to Health and Safety Code section 1569.652. This requirement was not met as evidenced by: Record review and interview of the administror detailing a refund not being issued following procedures outlined in regulation. Which posed a potential risk to health saftey or violation of the clients rights of residents in care.the state’s words, verbatim · CDSS document, Jul 28, 2025

Plan of correction: Include refund terms in the admission agreement for the specific situations as described by the regulation 87507. provide a copy of the new admission agreement to the Responsible parties and clients, by the poc date.

From the deficiency page — Deficiency type: Type B · Section cited: CCR 87507(h)(1) · Plan of correction due date: Aug 28, 2025

87507 Admission Agreements(h) The admission agreement shall not contain the following:(1) Any provision that is prohibited from being included in the admission agreement. This requirement was not met as evidenced by: Record review and interview of the administrator detailing specific terms: (87507 (i)The admission agreement shall not require advance notice for its termination upon the death of the resident.) Which posed a potential risk to health saftey or violation of the clients rights of residents in care.the state’s words, verbatim · CDSS document, Jul 28, 2025

Plan of correction: New admission agreement wont have any offensive terms described by the regulation 87507. provide a copy of the new admission agreement to the Responsible parties and clients, by the poc date.

Type of visit: Case Management - Other

On 7-28-25 at 1:15pm, Licensing Program Analysts (LPAs) Michael Bilger and Noel Wolf Petersen arrived unannounced to conduct a case management visit. LPAs met with lead medical assistant Cierrah Warren and explained the purpose of the visit. Administrator Carie Snodgrass arrived and was present briefly before departing. Case management consisted of a physical plant tour and interviews with various residents and staff. LPAs toured various areas of facility including common areas, resident rooms, kitchen areas, office space area, and outside of the facility. During today’s case management, the following physical plant observations were noted: (1) Door leading to room storing chemicals on the side of site 100 was unlocked and accessible to residents in care, (2) Facility is a residential care facility for the elderly licensed for 16-bed capacity, and required to maintain a working signal system for residents in care. Based on observation and interview, it was revealed that residents occupying room #E did not have access to the call system and did not have an alternative way to signal for assistance. (3) LPAs observed a ramp at the entry way of room #5 to be steep. {Cont. on LIC 809C} An interview conducted with resident1 (R1) who occupies this room revealed that attempting to leave the room presents with difficulty due to the nature of the steep ramp, (4) LPAs observed resident rights poster and non-discrimination notice not posted for resident viewing in site 100. Based on observations and interviews conducted, citations are issued and noted on LIC 809D. An exit interview was conducted with lead medical assistant and a copy of this report was provided. Appeal rights provided.the state’s words, verbatim · CDSS document, Jul 28, 2025

From the deficiency page — Deficiency type: Type A · Section cited: CCR 87309(a) · Plan of correction due date: Jul 29, 2025

87309(a) Storage Space and Access. (a) Except as specified in subsection (b), the licensee shall ensure that disinfectants, cleaning solutions, poisonous substances, knives, matches, tools, sharp objects, and other similar items which could pose a danger to residents are in locked storage and are not left unattended if outside the locked storage. This requirement was not met as evidenced by: Based on observation, side door leading to storage area for chemicals was unlocked with no supervision within area present, this posed an immediate health and safety risk to residents in care.the state’s words, verbatim · CDSS document, Jul 28, 2025

Plan of correction: Licensee will ensure completed staff training on regulation 87309(a) emphasizing importance of storing chemicals and other dangerous items. Training date to be submitted to LPA by POC due date. Proof of completed training to be sent to LPA no later than 8-11-2025. Licensee will read regulation 87309 and submit a signed declaration of understanding to LPA by POC due date.

From the deficiency page — Deficiency type: Type A · Section cited: CCR87303(I) · Plan of correction due date: Jul 29, 2025

87303(I) Maintenance and Operation (i) Facilities shall have signal systems which shall meet the following criteria: (A) Operate from each resident's living unit. This requirement was not met as evidenced by: Based on observation and interview, Licensee did not ensure a working call system operating in room #E. This posed an immediate health and safety risk to residents in care.the state’s words, verbatim · CDSS document, Jul 28, 2025

Plan of correction: Facility staff provided emergency pendants in room #E during today’s visit. Signal system tested by LPAs ensured operation. Licensee to read regulation 87303(I) and submit a signed declaration of understanding to LPA by POC due date.

From the deficiency page — Deficiency type: Type B · Section cited: CCR 87468.1(a)(2) · Plan of correction due date: Aug 4, 2025

87468.1(a)(2) Personal Rights of Residents in All Facilities (a) Residents in all residential care facilities for the elderly shall have all of the following personal rights: (2)To be accorded safe, healthful and comfortable accommodations, furnishings and equipment. This requirement was not met as evidenced by: Based on observation and interview, wheelchair ramp at entry of room #5 is steep and presents a challenge when exiting room for R1. This poses a potential health, safety, and resident rights risk to residents in care.the state’s words, verbatim · CDSS document, Jul 28, 2025

Plan of correction: Licensee to modify ramp for easy and safe access. Licensee to send photo proof to LPA by POC due date.

From the deficiency page — Deficiency type: Type B · Section cited: CCR87468(c) · Plan of correction due date: Aug 4, 2025

87468(c) Personal Rights. (c) Licensees shall prominently post personal rights, nondiscrimination notice, and complaint information in areas accessible to residents, representatives, and the public. This requirement was not met as evidenced by: Based on observation, Licensee did not ensure resident rights and non-discrimination notice posted for resident and visitor viewing. This poses a potential health, safety, and resident rights risk to residents in care.the state’s words, verbatim · CDSS document, Jul 28, 2025

Plan of correction: Licensee will post resident rights and non-discrimination notice in an area visible and easily accessible to residents in care. Licensee to send photo proof of postings to LPA by POC due date.

Type of visit: Case Management - Deficiencies

On 05/09/25 at 12:00pm, Licensing Program Manager (LPM) Liza King and Licensing Program Analyst(LPA) NoelWolf Petersen arrived unannounced to conduct a complaint investigation and facility observations. They met with Carie Snodgrass, staff member and explained todays visit. A facility walk through occured, including but not limited to the resident bedrooms, bathrooms, exterior, hallways, common areas, and evacuation routes. The facility was found to have traffic areas unobstructed and well lit, with required furniture and furnishings present. The fire extinguisher was last serviced the facility 01/10/2025 as noted on the fire extinguisher, resident washroom water was measured at 117, air temperature was measured comfortable. The physical plant has the required posters(client rights, ombudsmans information, evacuation routes, administration credential, and federal workers rights) are of appropriate dimension and location. DIAMOND CARE INC, is a 16 bed facility. Total hospice 1 resident. 4 are receiving home health care services. The following areas were observed and citations will be issued spiders and spider webs located throughout facility observed on office and 2 exterior units Broken cabinets in kitchen. sink and tolet nonfunctional in exterior unit. Dish soap on counter in kitchen Medications being prepoured; observed during medication pass at lunch and confirmed during interview to be poured and set up by "management" staff acknowledged not knowing what the medication was being provided to the resident. Personal Care supplies were readily accessible in all bedrooms. Cont on pg c Discussions between LPM and Zachary Murphy-Duncan, General Manager regarding the findings during the walk through. In regards to personal care supplies, TA will be provided as Zachary states all clients can have access to personal supplies. A pad lock was observed on the front gate, Zachary reported that this is included in the plan of operation and a secured perimeter has been approved and proof will be provided. A follow up visit may be necessary. LPA was informed during inspection that the facility has resident records electronic.up date the plan of op regarding those personal supplies Citations are issued on the attached D page attached, appeal rights provided and exit interview will occur. a copy of the report was read and given to staff.the state’s words, verbatim · CDSS document, May 9, 2025

From the deficiency page — Deficiency type: Type A · Section cited: CCR 87465(h)(5) · Plan of correction due date: May 12, 2025

87465 Incidental Medical and Dental Care (h)(5) Each resident's medication shall be stored in its originally received container. No medications shall be transferred between containers. The licensee failed to do so as observed by observation of preporued medication and interview with staff and General Manager. This is an immediate risk to health and saftey for clients in care.the state’s words, verbatim · CDSS document, May 9, 2025

Plan of correction: The Administrator will submit a plan to address meeting this regulation by 05/12/2025.

From the deficiency page — Deficiency type: Type B · Section cited: CCR87303(a,e)(6) · Plan of correction due date: May 1, 1987

87303 (a) The facility shall be clean, safe, sanitary and in good repair at all times. Maintenance shall include provision of maintenance services and procedures for the safety and well-being of residents, employees and visitors. (e)(6)(6) Toilet, handwashing and bathing facilities shall be maintained in operating condition. Additional equipment shall be provided in facilities accommodating physically handicapped and/or nonambulatory residents, based on the residents' needs. This was not met as evidenced by: LPA observed spiders and spider webs located throughout facility observed on office and 2 exterior units Broken cabinets in kitchen. sink and tolet nonfunctional in exterior unit. This is an immediate risk to health and safety of clients in carethe state’s words, verbatim · CDSS document, May 9, 2025

Plan of correction: The Licensee shall furnish the LPA with proof of correction; photo evidence showing repairs/cleanliness of the proscribed areas by 5/19/25

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Albert Johnson arrived unannounced to conduct a required annual inspection. LPA met with Office Administrator. Four of four staff observed on site with criminal record clearance in Licensing Information System. LPA toured physical plant with office administrator inside and outside to ensure the safety of the residents. LPA observed two facilities on two properties housing residents. LPA observed kitchen, garage, restrooms, bedrooms, and common living areas to be clean and in good repair. The temperature inside the facility was measured at 74*F which is within the required range of 68*F and 85*F, or in areas of extreme heat the maximum shall be 30*F less than the outside temperature. The hot water was measured at 119.8*F and 110.5*F within regulatory range of is not less than 105*F and not more than 120*F. LPA observed the centrally stored medications, toxins, and knives stored in the locked garage office to be locked inaccessible to residents. The first aid kit was found in compliance. LPA observed fire extinguishers which were last inspected on 1/2025. Smoke and carbon monoxide detectors, central heating and air in the facility. LPA observed food supplies of staple nonperishable foods for a minimum of one week and fresh perishable foods for a minimum of two days which shall be maintained on the premises at all times. LPA observed signs posted, restrooms stocked with paper towels, hand soap and touchless covered trash cans. LPA observed bacterial analysis of private water supply is not being conducted annually. the last analysis was completed on 9/21/2021. The facility has an approved Mitigation Plan. LPA reviewed seven resident and four staff files, including criminal record clearances. All staff are fingerprint cleared and associated to the facility. During the resident file review LPA observed and outdated physician report for R1, no orders for half rails for R2 and R3. During the medication review, the department discovered that the facility is per pouring medication 24 hours in advance, no PRN letters for any resident in care, observed missing medications for R4 and half pill for R5 with no record of destruction or purpose for splitting the pill and medication not being given according to doctor's orders for R6. Per California Code of Regulations, Title 22 there were deficiencies cited during today's inspection. An exit interview was conducted with administrator. A copy of this report was left at the facility.the state’s words, verbatim · CDSS document, Feb 4, 2025

From the deficiency page — Deficiency type: Type A · Section cited: CCR 87465(a)4(b-d)(h)5 · Plan of correction due date: Feb 5, 2025

87465 Incidental Medical and Dental Care (a) A plan for incidental medical and dental care shall be developed by each facility. The plan shall encourage routine medical and dental care and provide for assistance in obtaining such care, by compliance with the following:(4) The licensee shall assist residents with self administered medications as needed.(b) If the resident's physician has stated in writing that the resident is able to determine and communicate his/her need for a prescription or nonprescription PRN medication, facility staff shall be permitted to assist the resident with self-administration of his/her PRN medication. The following requirements shall apply to medications which are centrally stored:(5) Each resident's medication shall be stored in its originally received container. No medications shall be transferred between containers. This requirement is not met as evidenced by the department discovered that the facility is per pouring medication 24 hours in advance, no PRN letters for any resident in care, observed missing medications for R4 and half pill for R5 with no record of destruction or purpose for splitting the pill and medication not being given according to doctor's orders for R6.the state’s words, verbatim · CDSS document, Feb 4, 2025

Plan of correction: Licensee/Administrator shall submit a plan of action and conducted in-service training to all those staff responsible for medication administration, including the staff members responsible for the medications errors. POC due 2/5/2025

From the deficiency page — Deficiency type: Type B · Section cited: CCR87303(e)1(A&B) · Plan of correction due date: Feb 18, 2025

(e) Water supplies and plumbing fixtures shall be maintained as follows: (1) All residential care facilities for the elderly where water for human consumption is from a private source shall: (A) As a condition of initial licensure, provide evidence of an on-site inspection of the source of the water and a bacteriological analysis by a local or state health department or other qualified public or private laboratory which establishes the safety of the water. (B) Following licensure, provide a bacteriological analysis of the private water supply as frequently as is necessary to assure the safety of the residents, but no less frequently than the time intervals shown in the table below. However, facilities licensed for six or fewer residents shall be required to have a bacteriological analysis subsequent to initial licensure only if evidence supports the need for such an analysis to protect residents. This requirement was not met as evidenced by LPA observed bacterial analysis of private water supply is not being conducted annually. the last analysis was completed on 9/21/2021.the state’s words, verbatim · CDSS document, Feb 4, 2025

Plan of correction: The licensee will have the well head tested by POC date and will send the results to the department with the findings of the analysis

Type of visit: POC

LPA Albert Johnson made an unannounced POC visit to the facility to verify correction of citations issued during the Plan of correction visit on 8/30 2024. LPA toured the facility, reviewed records and observed that the deficiency that was cited on 08/30/2024 has been cleared. Deficiency cited under Title 22 Regulations has been cleared. Licensee complied with the terms of the POC by POC due date. Citation given for criminal record clearance and health screening. During the tour of the facility the department discovered that the facility is using two student volunteers from the two agencies, these student volunteers are not cleared or associated to the facility and do not have a health screening or TB test. See 809D page attached to this report. Civil penalty assessed. Exit interview conducted, copy of report and appeal rights provided.the state’s words, verbatim · CDSS document, Dec 6, 2024

From the deficiency page — Deficiency type: Type A · Section cited: CCR 87355(e1-3) · Plan of correction due date: Dec 7, 2024

(e) All individuals subject to a criminal record review pursuant to Health and Safety Code Section 1569.17(b) shall prior to working, residing or volunteering in a licensed facility: (1) Obtain a California clearance or a criminal record exemption as required by the Department or (2) Request a transfer of a criminal record clearance as specified in Section 87355(c) or (3) Request and be approved for a transfer of a criminal record exemption, as specified in Section 87356(r), unless, upon request for a transfer, the Department permits the individual to be employed, reside or be present at the facility. Based on record review the licensee did not comply with the section cited above which poses an immediate health, safety or personal rights risk to persons in care.the state’s words, verbatim · CDSS document, Dec 6, 2024

Plan of correction: S1 and S2 will be associated to this facility by POC date 12/7/24

From the deficiency page — Deficiency type: Type A · Section cited: CCR87411(f) · Plan of correction due date: Dec 7, 2024

General. Good physical health of personnel shall be verified by a health screening, including a T.B. test, performed and signed by a physician not more than six months prior to or seven days after employment. LPA observed two volunteers/staff did not have a health screening and TB test results in her file. Based on record review the licensee did not comply with the section cited above which poses an immediate health, safety or personal rights risk to persons in care.the state’s words, verbatim · CDSS document, Dec 6, 2024

Plan of correction: Administrator to provide a health screening/TB results for S1 and S2 by POC date 12/7/24

Type of visit: POC

LPA Albert Johnson made an unannounced POC visit to the facility to verify correction of citations issued during the complaint visit conducted on 6/14/2024. LPA toured the facility, reviewed records and observed that the deficiency that was cited on 06/14/2024 ( 87465(c)(2) ) have been cleared. Deficiency cited under Title 22 Regulations have been cleared. Licensee complied with the terms of the POC by POC due date. Citation given for infection control (87470 Infection Control Requirements). During the medication POC review the department discovered that the facility is cleaning and reusing PRN syringes for administration of control medications. Advisories were given during today's POC visit. 87465 Incidental Medical and Dental Care (h)The following requirements shall apply to medications which are centrally stored:(3) Each container shall carry all of the information specified in (6)(A) through (E) below plus expiration date and number of refills. (5) Each resident's medication shall be stored in its originally received container. No medications shall be transferred between containers. Continued (6) The licensee shall be responsible for assuring that a record of centrally stored prescription medications for each resident is maintained for at least one year and includes: (A) The name of the resident for whom prescribed. (B) The name of the prescribing physician. (C) The drug name, strength and quantity. (D) The date filled. (E) The prescription number and the name of the issuing pharmacy. (F) Instructions, if any, regarding control and custody of the medication. Exit interview conducted and a copy of this report was left at the facility.the state’s words, verbatim · CDSS document, Aug 30, 2024

From the deficiency page — Deficiency type: Type A · Section cited: CCR 87470(a)(3)(B) · Plan of correction due date: Aug 31, 2024

(a) A licensee shall ensure that infection control practices are maintained as follows:(3) In addition to Section 87629, Injections, all staff who are assigned to assist residents with the self-administration of injectable medication shall observe the following procedures:(B) A syringe and needle shall only be used once per injection on one resident and then properly disposed of in accordance with the California Code of Regulations, Title 8, Section 5193. This requirement was not met as evidenced by observation and interview conducted. The facility is cleaning and reusing syringes to administer controlled medication for hospice residents.the state’s words, verbatim · CDSS document, Aug 30, 2024

Plan of correction: The facility will use syringes one time for any medication administration. The Licensee will develop a plan to maintain compliance with this regulation and will submit a plan to the department by the POC date. If additional time is needed the licensee will request time to develop a plan by submitting a request by email to the department by the POC date.

Allegation investigated: Staff gave authorized representative other residents medication upon discharge.

Licensing Program Analyst (LPA) Lewis made an unannounced visit to the facility to deliver findings for the above allegation. LPA spoke with Administrator and explained the purpose of the visit. Throughout the course of the investigation the Department interviewed staff and toured the physical plant, and reviewed documentation pertinant to the allegations listed above. Allegation: Staff gave authorized representative other residents medication upon discharge. Based on pictures provided by the reoprting party and interviews with the adminstrator and staff the allegation is SUBSTANTIATED. See 9099C page...... Substantiated Based on interviews with administrator and staff the facility provided documentation showing daily skin checks and oral hygiene. R1 liked to sit in a particular spot the facility was taking measures to increase movement and relive pressure. A finding that the complaint allegation(s) are UNSUBSTANTIATED means that although the allegation(s) may have happened or is valid, there is not a preponderance of the evidence to prove that the alleged violation(s) occurred, and the findings are unsubstantiated. Exit interview conducted, copy of report provided. Based on interviews with administrator and staff that confirm the wrong residents medication was given at discharge of R1 and records reviewed the Department finds the allegations to be Substantiated, meaning there was/is a preponderance of evidence that the event occurred. Deficiencies are being cited as a result of today's visit. See 9099D page.... Exit interview conducted, copy of report and appeal rights provided.the state’s words, verbatim · CDSS document, Jun 14, 2024 · control 27-AS-20240220084349

From the deficiency page — Deficiency type: Type A · Section cited: CCR 87465(c)(2) · Plan of correction due date: Jun 17, 2024

87465(c)(2) Incidental Medical and Dental Care. Once ordered by the physician the medication is given according to the physician's directions. This requirement is not met as evidenced by: Based on interviews and records review, the Licensee did not ensure medications ordered for resident was given at discharge which poses an immediate health and safety risk to residents in care.the state’s words, verbatim · CDSS document, Jun 14, 2024

Plan of correction: The Administrator will developed a plan on how the facility will prevent medication being given to the wrong resident and hold a in service training for staff. Please send the agenda along with the sign-in sheet for the in-service. via email and fax to LPA Lewis by COB 06/17/2024. Kesha.lewis@dss.ca.gov

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Ruth Wallace arrived unannounced to conduct a required annual I year inspection visit. LPA met with Office Administrator and explained purpose of visit. LPA toured physical plant with office administrator inside and outside to ensure the safety of the residents. LPA observed two facilities on two properties housing residents. LPA observed kitchen, garage, restrooms, bedrooms, and common living areas to be clean and in good repair. The temperature inside the facility was measured at 74*F which is within the required range of 68*F and 85*F, or in areas of extreme heat the maximum shall be 30*F less than the outside temperature. The hot water was measured at 110.8*F and 110.5*F within regulatory range of is not less than 105*F and not more than 120*F. LPA observed the centrally stored medications, toxins, and knives stored in the locked garage office to be locked inaccessible to residents. The first aid kit was found in compliance. LPA observed fire extinguishers which were last inspected on 3/22/2023. Smoke and carbon monoxide detectors, central heating and air in the facility. LPA observed food supplies of staple nonperishable foods for a minimum of one week and fresh perishable foods for a minimum of two days which shall be maintained on the premises at all times. LPA observed COVID precautions signs posted, restrooms stocked with paper towels, hand soap and touchless covered trashcans. LPA observed bacterial analysis of private water supply is being conducted annually and logged by a maintenance person. The facility has an approved Mitigation Plan. Continued on 809-C Page Two Continued from 809 - Page Two LPA reviewed four resident and five staff files, including criminal record clearances. All staff are fingerprint cleared and associated to the facility. LPA requested the following documents for facility file to be sent via email by December 19, 2023: LIC 308 Designation of Facility Responsibility, LIC 500 personnel report, LIC 610-E Emergency Disaster Plan, Liability Insurance, and Current Administrator Certificate. ruth.wallace@dss.ca.gov Per California Code of Regulations, Title 22 there were no deficiencies cited during today's inspection. An exit interview was conducted with administrator. A copy of this report and (LIC 811 - Confidential Names) was left at the facility.the state’s words, verbatim · CDSS document, Dec 12, 2023