Family Feels Residential Care 2

Type of visit: POC

Licensing Program Analyst (LPA) Maria (Mita) Partoza, conducted an unannounced case management to clear the citations for the deficiencies that was cited during annual inspection conducted on 06/19/2026. The following deficiencies are being cleared during today's visit 08/13/2026. 87303 Maintenance and Operation (e) Water supplies and plumbing fixtures shall be maintained as follows: (2)Faucets used by residents for personal care such as shaving and grooming shall deliver hot water. Hot water temperature controls shall be maintained to automatically regulate the temperature of hot water used by residents ...of not less than 105 degree F (41 degree C) and not more than 120 degree F (49 degree C). Based on inspection and record review the water temperature is being maintained at 118 degree F, the facility is keeping track of their water temperature on a daily basis. Health and Safety Code §1569.695 Emergency Plans (c) A facility shall conduct a drill at least quarterly for each shift. The type of emergency covered in a drill shall vary from quarter to quarter... Based on record review the facility conducted a fire and drill training on 06/20/2026. 87465 Incidental Medical and Dental Care (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. Based on record review the facility corrected and updated the centrally stored medication record logs according to the dates and time it was received and started. No deficiencies were cited during today's visit. Cleared POC letter and copy of the report was provided to DADM Philipp Perez.the state’s words, verbatim · CDSS document, Aug 13, 2026

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Maria (Mita) Partoza conducted an unannounced annual required inspection and met with Designated Administrator Philipp Perez and stated the purpose of the visit. The facility is licensed to serve adults 60 and over, capacity is 6. All may be non-ambulatory and a hospice waiver for 6. LPA observed 4 residents and 3 staff present, 2 out of 6 residents were not at the facility and 4 out of 6 were at the facility. LPA interviewed 2 Out of 6 residents. 2 Out of 6 was resting. LPA toured the facility, including common areas, resident rooms, kitchen, bathrooms, driveway, and outdoor spaces and storage areas. Indoor temperature was within acceptable range of 70°F. The kitchen was sanitary and organized; knives and chemicals were locked. Food supply met requirements (2 days perishable, 7 days non-perishable). LPA measured the hot water temperature with a digital thermometer in kitchen and bathrooms, water temperature measured at 128.8°F to 133.3°F which exceeded the requirement based on California Code of Regulations (CCR) Title 22 87303 (e)(2) of 105°F to 120°F. Bathrooms had grab bars and non-skid mats; resident rooms had adequate storage. Medications were locked and not accessible to residents; first aid kit was complete. Outdoor areas were free of hazards; laundry appliances were functional, and cleaning supplies were secured. Fire, smoke, and carbon monoxide systems were operational; hallways were clear from tripping hazards and well-lit. page 1 of 2 LPA reviewed resident and staff records, including medication logs, admission agreements, care plans, personal and incidentals, health screenings, and training. All staff have required clearances and certifications. LPA reviewed 3 out of 6 resident files and observed that 2 Out of the 3 files reviewed, the centrally stored medication record and destruction record (CSMDR) was not accurate and are missing entries. The medications were not recorded based on California Code of Regulation (CCR) 87465 Incidental Medical and Dental Care (6) The licensee shall be responsible for assuring that a record of centrally stored prescription medications for each resident is maintained. The (CSMDR) did not contain medication entry from February 4, 2026 to June of 2026 for 2 out of 3 resident record. The facility reviewed the emergency and disaster plan and observed that the plan was reviewed on 04/23/2026. Facility is equipped with fire extinguisher that was last inspected on 08/12/2025. Based on record review and based on DADM statement, quarterly drills are not conducted with staff for fire and earthquake under the Health and Safety Code (HCS) §1569.695(c). Deficiencies were cited during today's visit based on the California Code of Regulations (CCR) Title 22. An exit interview was conducted with DADM Philipp Perez and a copy of the report was provided. end of report page 2 of 2the state’s words, verbatim · CDSS document, Jun 19, 2026

Type of visit: Required - 1 Year

On 06/24/2024, Licensing Program Analyst (LPA) Jaime Vado conducted an unannounced annual inspection. LPA met with administrator Noralee Reyes and explained the purpose of today's visit. There is 3 staff present and 5 residents present. This facility is licensed for ages 60 years and over. All may be non-ambulatory. Hospice waiver for 6. 3 residents are on hospice at time of inspections. LPA was allowed entry into the facility. This is a single level facility. Annual fees are current. The physical plant was toured inside and outside to ensure the safety of the residents. The backyard is shared with their sister facility Family Feels 2 located at 781 Terrazo Drive. LPA observed the facility kitchen which is clean and observed appliances are in good repair. Knives are stored and locked in the kitchen cabinet below the sink along with cleaning supplies. Medications are locked in a file cabinet in the main living room area. Perishable and non-perishable food items are observed as in place. There is an additional freezer and refrigeartor, along with ccanned food supplies in the garage. First aid kits are observed as complete with required items. LPA observed fire extinguisher in the dining room with an inspection tag dated 08/09/24. The fire extinguisher is charged and within operable range, smoke detector/carbon monoxide detectors are observed in place through out the facility, and central heating/cooling system. PPE and additional food supplies are observed as in place. Continued on next page. Page 2 Laundry area is also observed as fully operational located beneath the facility. Emergency exit routes are observed inside and outside to be free and clear of obstructions. Last emergency/disaster drill was conducted in January 2025. Water temperature was measured at 110F in a common bathroom in the main hallway. Shower floor is observed to have non-skid mat. LPA observed rooms at random and all appeared clean, free of odors, and contained all the required furniture per regulatory recommendations. Resident linen supplies are observed as in place. Rooms 1 and 2 have residents using oxygen and signs are in place indicating. LPA reviewed 6 resident files and also reviewed 2 staff files on this day. Per resident files reviewed they are current with orders for bed rails. Per staff files reviewed all files. Staff have current first aid but no training records showing ongoing or continuing training. Client medications are inspected and are current including facility medication administration records. Administrator certificates are observed as current expiring on 01/05/2026. The following updated forms are requested to be submitted to CCLD by 07/01/2025: • Copy of updated Administrator Certificates • LIC308 Designation of responsible staff person • LIC610E Emergency Disaster Plan • LIC500 Staff Schedule • Copy of liability insurance Technical violations are given on this day on the attached LIC9102TV pages. Report is reviewed with Rita Garcia and a copy is provided.the state’s words, verbatim · CDSS document, Jun 24, 2025

Type of visit: Required - 1 Year

On 6/07/2024 at 2:45 p,m. Licensing Program Analyst (LPA) Maria (Mita) Partoza conducted an unannounced Required annual inspection and was met by Designated Administrator (DADM) Rita Garcia. The Administrator(ADM) Yiwen (NIcole) Shih was not present at the time of the visit. DADM called ADM and asked if LIC/ADM can come to the facility. LIC/ADM stated he/she is not available due to prior commitment. The facility is a Residential Care Facility for the Elderly (RCFE) licensed to serve ages 60 and over, capacity for 6 ambulatory of which 6 may be non-ambulatory and 6 hospice waiver. The facility has 3 residents that are neurocognitive impaired. 1 out of 2 staff were present at the time of the visit. 3 residents were present at the facility. 2 out of 3 are under the age of 60, 1 out 3 is non-ambulatory, 2 out of 3 are ambulatory, 3 out 3 have neurocognitive impairment. LPA and DADM toured the facility inside and outside, including but not limited to the following: Kitchen, dining, laundry, garage, 4 resident room, 1 staff room, 2 bathrooms, backyard and the exterior walkways. LPA observed the Personal Rights disclosure, Long Term Care Ombudsman (LTCO) and Centralized Complaint and Information Bureau (CCIB) of the CA Department of Social Services (CDSS) prominently posted on the wall, visible to visitors, resident and staff. The temperature inside the home was at 69 to 71.1 degrees F. LPA observed the kitchen to be organized, and sanitary with working appliances. Knives were kept in a secure locked area and not easily accessible to residents. The laundry area is located in the garage, cleaning supplies and laundry detergents are kept in a secure locked place not easily accessible to residents in care. The facility has 2 days of perishable food and 7 days of non-perishable food. page 1 of 2 LPA inspected the residents' bedrooms and found that 4 out of 4 rooms have furniture and closet space for resident's personal belongings, bed frames with mattress and bed linens. 4 Out of 4 resident room is sanitary, organized and are free from debris. LPA observed that the 1 Out of 2 bathrooms have rust on the floor of the shower and tub combination, stains on the toilet bowls, sink, faucet, trash bins and the floor. LPA with ADM tested the water temperature for kitchen and bathrooms, water temperature was measured at 105.6 degrees F to 113 degree F. LPA with DADM inspected the laundry area and observed washer and dryer are in good working condition. LPA observed that the medication is in a locked cabinet. The facility has a first aid cabinet with first aid supplies and accessible to staff. The side door and sliding door to access the backyard opens easily and are free from obstruction. LPA observed ramps and walkways are free from obstruction. LPA observed the backyard area to be free from debris and is maintained. The facility is in a compound with two other facility under the same ownership. LPA reviewed facility record and 2 out of 2 staff record, and 3 out of 3 resident records. The disaster training has not been conducted since the facility got licensed on 6/16/2023. 2 out of 2 does not have a CPR training, 2 out of 2 staff does not have on boarding training, 1 out 2 recently started with employment. Residents files were reviewed to be complete. Residents' medications are labeled and current. LPA discussed with DADM the importance of fire and earthquake training and the required training for the staff that was recently hired. page 2 of 3 During document review and observation, LPA observed that 2 out of 3 of the resident (R1 and R2) were under the age of 60 and facility did not submit an exception request and notify licensing to admit and retain residents under the age of 60. LPA requested documents from DADM such as, LIC 500, lease agreement, updated liability insurance and LIC 308 to update the facility record. LPA discussed with DADM the Summer Wellness Preparedness Readiness that is available online for the DADM and LIC/ADM to discuss and train staff. Deficiencies are cited during today's visit based on the California Code of Regulations (CCR) Title 22, see LIC 809D. An exit interview was conducted with designated administrator (DADM) Rita A Garcia. A copy of the report and appeals rights were provided.the state’s words, verbatim · CDSS document, Jun 7, 2024