Fairview Comfort 3

Type of visit: Required - 1 Year

On 08/25/2026, at approximately 9:30 a.m., Licensing Program Analyst (LPA) Ali Deniz arrived unannounced to conduct a one-year required inspection of this licensed Residential Care Facility for the Elderly (RCFE). The LPA was greeted by Staff Member, Dandy Abesamis. Licensee/Administrator Patricia Harland arrived shortly after. The facility has an approved fire clearance for a capacity of six (6) non-ambulatory residents, and approved hospice waiver for three (3) residents. At the time of the visit, there were three (3) residents in care and one (1) staff member on duty. The facility is a two-story home consisting of three (3) resident bedrooms, two (2) bathrooms, and common living areas. The LPA reviewed the facility's staff roster and verified that all staff present during the inspection were fingerprint cleared and associated with the facility as required by regulation. At approximately 10:30 AM, LPA and Administrator toured the building and grounds which was found to be clean and in good repair. LPA observed all walkways and exits to be unobstructed. All notices that are required to be posted have been posted and are in a highly visible area. LPA observed activity supplies for resident use. The amount of fresh and nonperishable foods is within regulation. Facility kitchen, refrigerators and freezers were clean, and food was stored properly. LPA observed toxins are stored inaccessible to residents. Water temperature measured 106.2 degrees F which is within regulation between 105- and 120-degrees F at faucets accessible to residents. Fire Extinguishers found to be last charged in December 2025 at the time of visit. Carbon Monoxide and smoke detectors were present and in order. There was enough lighting in all common areas, resident rooms, and hallways. Medication is centrally stored and secure in hallway closet. Continued on LIC809-C... Continued from LIC809… LPA reviewed three (3) resident records and found all residents have care plans, admission agreements, and physician's report on file. Resident medication records are thorough and contains doctor’s order. LPA also reviewed the personnel records of two (2) staff members. All staff members had completed the required initial training and had required documentation. The Administrator Certificate for Patricia Harland (Certificate No. 7003252740) expires on 01/08/2028. Facility has supplies enough to operate for more than 72 hours in an emergency. Facility conducted and documented a disaster drill on 06/05/2026. Updated copies of the following documents were requested for facility file and are to be submitted to CCL by due date of 09/06/2026: -LIC 308 Designation of Facility Responsibilities -LIC 500 Personnel Summary -LIC 9020 Register of Facility Client’s/Resident’s -Copy/Proof of Updated Certificate of Liability Insurance No deficiencies were observed in the areas inspected, No citations were issued during today’s visit. Exit interview conducted. Copy of report provided to Administrator. Signature on form confirms receipt of documents.the state’s words, verbatim · CDSS document, Aug 25, 2026

Type of visit: Required - 1 Year

At approximately 12:25 PM, Licensing Program Analyst (LPA) Magdaleno arrived unannounced to conduct a required 1-year annual inspection and was greeted by Administrator Patricia Harland. Facility is a Residential Care Facility for the Elderly (RCFE) with three (3) residents in care. Facility has a Dementia Care Plan, a Hospice waiver for three (3), with one (1) Hospice resident currently in care, and is approved for all non-ambulatory residents. At approximately 12:45 PM, LPA initiated a tour of the facility with Administrator and observed the following: Facility is a two (2) story home, was a comfortable temperature, and passageways were free from obstructions. Facilities second story is used solely by staff and is not accessible for residents. Fire extinguishers were last inspected 12/24. Smoke and Carbon Monoxide detectors are hardwired and serviced by the Fire Marshall, last inspection was 12/24. Water temperature measured 107.2 degrees F and 109.4 degrees F, which is within the allowable range of 105 to 120 degrees F per Title 22 regulations. LPA observed a supply of clean linens, hygiene, incontinent care, and paper products available for residents. Residents' bedrooms were inspected and observed to have all the appropriate furnishings as outlined in Title 22 regulations. Cabinets containing cleaning supplies and other items that could pose a risk were locked. LPA observed at least a two (2) day supply of perishable and seven (7) day supply of non-perishable food, as well as an emergency water supply. Food was found to be stored in a safe manner with open items covered. There is a shaded seating area in the backyard with outdoor space for activities. Facility has an internet access devise and internet available to clients in care, and the phone was tested and operational during today's inspection. Continued LIC809C... Continued from LIC809... Facility conducts quarterly disaster drills, and the most recent drill was conducted 6/25. LPA observed facility's infection control plan and emergency disaster plan which was last updated 7/25. LPA observed a supply of PPE, emergency supplies, a first aid kit, and flashlights. At approximately 1:20 PM LPA conducted a review of three (3) resident records. All required documentation present. At approximately 1:40 PM LPA conducted review of one (1) staff records. All required documentation present. At approximately 2:00 PM LPA and Administrator conducted a spot check of medication and medication records. Medication is centrally stored and locked. Patricia Harland Administrator Certificate 7003252740 expires 1/8/2026. All fees are current as of this time. Updated copies of the following documents were gathered during this visit: LIC610E: Emergency Disaster Plan Liability Insurance Updated copies of the following documents shall be submitted to CCL within 30 days of this visit: LIC500 - Personnel Report LIC308 - Designation of Responsibility LIC400 - Affidavit Regarding Client Cash Resources No deficiencies cited. Exit interview conducted with Administrator, whose signature on form confirms receipt.the state’s words, verbatim · CDSS document, Aug 5, 2025

Type of visit: Required - 1 Year

At approximately 12:35PM, Licensing Program Analyst (LPA) Felias arrived unannounced to conduct a 1-Year Required Visit and met with Staff Member, Maribel Saldevar. Licensee/Administrator, Patricia Harland, arrived during visit at approximately 12:50PM. Facility serves residents with dementia and has a plan of operation for dementia care and programming on file. Facility has an approved fire clearance and capacity for 6 non-ambulatory residents. Facility has an approved hospice waiver for 3 individuals. Upon arrival, LPA was informed that there were 4 Residents in care and 1 staff member on-site. At approximately 12:40PM, LPA reviewed the Facility's Staff Roster and found that all staff on-site were background cleared and associated to the facility per regulation. At approximately 12:50PM, LPA conducted a walk-though of the facility with Staff Member. LPA observed the following: The facility was found to be clean and at a comfortable temperature with all exits free from obstruction. Facility had emergency lighting. Facility is a 2 story building with 4 Resident bedrooms,1 staff room, 2 bathrooms, and common spaces. Facility has an Infection Control plan on file. There was a sufficient supply of both perishable and nonperishable foods as required by Title 22 Regulations. There was an appropriate supply of cleaning products, linens, hygiene products and paper products available for Residents. Mattress pads were in place or available for Resident use. Toxins were observed to be stored inaccessible to Residents. Bathrooms were equipped with necessary grab bars, and non-slip floors/mats were present. Hot water temperatures for all sinks in facility were within Title 22 regulations of 105 to 120 degrees Fahrenheit. Fire extinguishers were last inspected December 2023. Smoke detectors and carbon monoxide detectors were tested and operational. Facility's last disaster drill was conducted August 2024. LPA observed that facility does not have an evacuation chair on-site per Health and Safety Code. Per discussion with Licensee, all residents live on the first floor and staff members live on the second floor (see technical advisory, LIC9102, H&S Code 1565(f)(1)). At approximately 1:00PM, LPA reviewed staff files, resident files and resident medication. All files were all found to be well organized, thorough and contained the required documentation. Staff files had current First Aid and CPR certification. Medication was observed to be centrally stored and secure. Continued on LIC809C Continued from LIC809 During medication review, LPA observed that PM medications were pre-poured. Per Licensee, PM medication was poured this morning. LPA informed Licensee that prepouring medications is out of compliance with regulation and that medications must be live-poured (see technical violation, LIC9102, regulation 87465(h)(5)). Administrator's Certificate for Patricia Harland (7003252740) was current with an expiration date of 01/08/2026. Per discussion with Licensee, facility does not do many activities apart from birthday parties and resident walks. LPA discussed activity ideas with Licensee (see technical advisory, LIC9102, regulation 87219(a)). LPA requested the following documents to update facility file: Designation of Facility Responsibility (LIC 308) Emergency Disaster Plan (LIC 610D) Updated Liability Insurance Active and Current Administrator Certificate Documents to be submitted to Community Care Licensing (CCL) by due date of 10/27/2024. No Deficiencies Cited during Visit. Exit interview conducted. Copy of report and LIC9102 (Technical Advisories/Violations) discussed and provided to Licensee/Administrator. Signature on form confirms receipt of documents.the state’s words, verbatim · CDSS document, Sep 27, 2024

The state marks this report as 5 pages; the online copy we transcribed has 2. You can request the full file from the county licensing office.