Everett Forest

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Beena Singh made an unannounced visit to the facility to conduct a required annual inspection. LPA met with Administrator Angelo Galasinao and Staff Linda and discussed the purpose of the visit. The facility is a Residential Care Facility for the Elderly (RCFE) with a license capacity of (6), a current census of five(5). LPA Singh conducted an overall inspection of the facility, which included, but was not limited to, the following: Physical Plant/Environment: Indoor and outdoor passageways are free of obstruction. The facility has no swimming pool or similar bodies of water. The facility has sufficient lighting and is maintained at a comfortable temperature. The facility has sufficient indoor and outdoor space for resident activities The facility is equipped with operating smoke detectors/carbon monoxide alarms, laundry equipment, and telephone service. Resident’s showers, toilets, and hand washing areas were operating properly with non-skid mats and grab bars, night-lights. The hot water temperature in two (2) residents bathrooms measured between 110 and 112 degrees F. Four (4) resident’s bedrooms had beds, bed linen, chairs, dresser, storage space and sufficient lighting. The facility has sufficient linens, towels, and personal hygiene items for residents. The facility has posted in a common area, Ombudsman poster, facility license, emergency disaster plan, personal rights, CCLD complaint poster, facility sketch, incontinent care plan, and Administrator certificate. Food Service: Facility kitchen and dining areas are maintained clean. The facility has sufficient non-perishable and perishable food supply for residents in care. Sharps and chemicals were kept locked and inaccessible to residents in care. Care & Supervision: Facility has 24-hour/7days a week care staff. Facility staff have current CPR/first aid training. Medical Related Services: Resident’s medications are labeled and centrally stored in a locked cabinet. Record Review: Two (2) Staff files reviewed were observed to be complete. All staff files reviewed had first aid certifications, fingerprint clearances/exemptions, health screenings, training, and personnel records. Two (2) Resident files reviewed were observed to be complete. All residents files reviewed had admissions agreements, physician's reports, pre-admission assessments, needs and services plan and emergency contacts. Fire/earthquake/emergency drill was not conducted quarterly, deficiency will be issued. Liability Insurance is valid through 05/01/2025 to 05/01/2026. Based on observations and record review no deficiency was cited per Title 22, Division 6, of the California Code of Regulations. An exit interview was conducted, and this report with LIC 809, 809C, LIC809D and Appeal Rights discussed and provided to Administrator Angelo Galasinao.the state’s words, verbatim · CDSS document, Nov 13, 2025

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Sarina Ramirez made an unannounced visit to the facility to conduct a required annual inspection. LPA met with Administrator Angelo Galasinao, and discussed the purpose of the visit. The facility is a Residential Care Facility for the Elderly (RCFE) with a license capacity of (6), a current census of (6). LPA Ramirez conducted an overall inspection of the facility, which included, but was not limited to, the following: Physical Plant/Environment: Indoor and outdoor passageways are free of obstruction. The facility has no swimming pool or similar bodies of water. The facility has sufficient lighting and is maintained at a comfortable temperature. The facility has sufficient indoor and outdoor space for resident activities The facility is equipped with operating smoke detectors/carbon monoxide alarms, laundry equipment, and telephone service. Resident’s showers, toilets, and hand washing areas were operating properly. The hot water temperature in two (2) residents bathrooms measured between 106 and 112 degrees F. Four (4) resident’s bedrooms had beds, bed linen, chairs, dresser, storage space and sufficient lighting. The facility has sufficient linens, towels, and personal hygiene items for residents. The facility has posted in a common area, Ombudsman poster, facility license, emergency disaster plan, personal rights, CCLD complaint poster, facility sketch, incontinent care plan, and Administrator certificate. Food Service: Facility kitchen and dining areas are maintained clean. The facility has sufficient non-perishable and perishable food supply for residents in care. Sharps and chemicals were kept locked and inaccessible to residents in care. Continuation on LIC – 809C: Care & Supervision: Facility has 24-hour/7days a week care staff. Facility staff have current CPR/first aid training. Medical Related Services: Resident’s medications are labeled and centrally stored in a locked cabinet. Record Review: Two (2) Staff files reviewed were observed to be complete. Two (2) Resident files reviewed were observed to be complete. Based on observations and record review a deficiency was cited per Title 22, Division 6, of the California Code of Regulations. An exit interview was conducted, and this report with LIC 809D and Appeal Rights was discussed and provided to Administrator Angelo Galasinao.the state’s words, verbatim · CDSS document, Oct 15, 2024

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Magda Malcore made an unannounced visit to the facility to conduct a required annual inspection. LPA met with Angelo Galasinao, Administrator, and discussed the purpose of the visit. The facility is a Residential Care Facility for the Elderly (RCFE). License capacity of (6) with a current census of (6) residents. LPA conducted an overall inspection of the facility, which included, but was not limited to, the following: LPA inspected the facility inside and out. Indoor and outdoor passageways are free of obstruction. The facility has sufficient lighting and is maintained at a comfortable temperature. Facility has no outdoor bodies of water. Facility backyard is enclosed with self-latching gates and covered patio is sufficient for outdoor resident activities. LPA inspected the kitchen. The refrigerator and freezer are operating in a healthful manner. Hot water temperature is maintained at 105 degrees F. Facility has sufficient non-perishable and perishable food supply for residents in care. Facility has sufficient cups, plates, and utensils for residents use. Facility food is stored in a safe and healthful manner. LPA inspected resident bedrooms. Bedrooms are equipped with beds, bed linen, nightstands, chairs, storage space, and sufficient lighting. LPA inspected resident bathrooms. Bathrooms are equipment with non-skid mats and grab rails. The hot water temperature in bathrooms tested between 106 and 107 degrees F. LPA observed the facility is equipped with operating carbon monoxide alarms and telephone service. LPA observed the following posted in a common area: Licensing complaint contact, Ombudsman contact, disaster and evacuation plan. A fire drill was conducted on 9/4/23. Facility has a complete first aid kit. Facility has sufficient linen, emergency supplies, and personal hygiene products for clients. Sharps, disinfectants, cleaning solutions, and toxins are kept in a locked cabinet. LPA observed resident medications are kept in a locked cabinet inaccessible to residents in care. All medications are labeled and administered as prescribed. All staff files reviewed had first aid certifications, fingerprint clearances/exemptions, health screenings, training, and personnel records. All residents files reviewed had admissions agreements, physician's reports, preadmission assessments, and emergency contacts. An exit interview was conducted, where this report was discussed and a copy of report with appeal rights was provided to the Administrator at the conclusion of the visit.the state’s words, verbatim · CDSS document, Oct 5, 2023