Family Hands Senior Care Living

Type of visit: Required - 1 Year

On 07/10/26, the department conducted an unannounced annual inspection visit to the above facility. The department met with the Licensee Tina Scruggs-Tate, and the purpose of the visit was explained. The department was granted entry to the facility. Administrator, Doria Soria, met with the department shortly after. The Facility is licensed to serve, four (4) ambulatory adults ages 60 years and over, where two (2) can be non-ambulatory in room #3. Facility has a waiver for hospice care for two (2) residents. There are currently two (2) residents in the facility. The facility is a single story house located in a residential neighborhood and consists of the following: three (3) bedrooms, two (2) bathrooms, living room, dining are, kitchen, laundry area, and an outside shaded area. All bedrooms were checked, mattresses and box springs were in good condition, adequate lighting, plenty of dresser and closet space was observed. Bathroom toilets and water faucets worked properly, shower was free of mold/mildew, and there are sufficient toiletries accessible to residents. The water temperature properly measured between 105-120 F. A supply of perishable and non-perishable food was observed, toxins and knifes were stored and inaccessible to residents, no weapons nor bodies of water on the premises, exits and walkways are free of debris/hazards. Continued on LIC9099-C The department conducted a review of two (2) residents records, two (2) resident Medication Administration Records (MAR) and three (3) staff records and observed to be complete and in order. First aid kit observed along with manual, fire extinguishers were fully charged, carbon monoxide and smoke detectors were operational, and the last fire/emergency drill was completed on 03/24/26. Facility fees are current, liability insurance is active (Brookhurst Insurance Services, LLC. Policy #H26HPG21267-03 exp. 03/15/27), and Administrator certificate is active (exp. 01/26/28). Annual fees are current. There were no deficiencies cited during this inspection. An exit interview was conducted, and a copy of the report was provided to Dori Soria.the state’s words, verbatim · CDSS document, Jul 10, 2026

Type of visit: Case Management - Incident

On December 2, 2025, at approximately 9:30 am, Licensing Program Analyst- LPA Alfonso Iniguez conducted an unannounced Case Management/Incident visit at the facility. LPA Iniguez met with Dori Soria, Assistant Administrator, and explained the purpose of the visit. On November 22, 2025, the Regional Office received a Special Incident Report from the facility. The report stated that on that day, at approximately 4:49 AM, client 1 (C#1) exited the facility without being seen by the staff. It wasn't until around 7:00 AM, during the staff shift change, that the facility staff noticed (C#1) was absent from their room. The staff promptly conducted a search of the grounds but were unable to locate (C#1). The facility administrator reviewed the security camera footage and confirmed the time that (C#1) left the facility. Following this, the administrator alerted the police department. On December 2, 2025, LPA Iniguez conducted the following interviews: staff interview (S#1) and Assistant Administrator Interview (A#1). Continues on LIC 809C... On December 2, 2025, LPA Iniguez reviewed and gathered the following documents: (C#1)’s psychological assessment, LIC 602, hospitalization records, IPP, face sheet and Admissions Agreements. According to the California Code of Regulations (Title 22, Division 6, Chapter 8), LPA did not observe deficiencies during this visit; therefore, no citations were issued. An exit interview was conducted, and a copy of the Facility Evaluation Report was provided to Dori Soria/ Assistant Administrator.the state’s words, verbatim · CDSS document, Dec 2, 2025

Type of visit: Case Management - Other

On 07/18/2024, the California Department of Social Services (CDSS) – Community Care Licensing Division (CCLD) Licensing Program Analyst (LPA) Socorro Leandro conducted an unannounced case management visit and explained the purpose of the visit to Administrator, John Tate. LPA was allowed entrance to the facility. A total of 3 residents are currently residing in this facility. A facility tour was conducted. No deficiencies were cited. An exit interview was conducted, and a copy of this report was left with the Administrator, John Tate.the state’s words, verbatim · CDSS document, Jul 18, 2025

Type of visit: Required - 1 Year

On 06/13/2025 at 12:08 PM, Licensing Program Analyst (LPA) Antonine Richard conducted an unannounced visit to the above facility. The purpose of today’s visit was to conduct the one-year inspection visit. LPA met with the Licensee Tina Scruggs-Tate and the purpose of the visit was explained. The Facility is a residential facility for the Elderly, ages 60 years and older. There are currently three (3) individuals, of which two (2) non-ambulatory, and zero (0) bedridden. The home is three (3) bedrooms, two (2) bathrooms, one-story home situated in a residential neighborhood. The home includes a living, dining, kitchen, and laundry area. The living room had 6 chairs and coffee table. The activity room area with chase. The kitchen has a refrigerator and stove. The rear exterior is fenced throughout. The passageways, walkways, and steps are free from obstructions. LPA did not observe hazards, such as ladders, gardening tools. The patio contained one (1) table and four (4) chairs. The facility has three (3) bedrooms for residents. There is one (1) bedroom for non-ambulatory residents and two (2) of the bedrooms specific for the ambulatory. Evaluation Report Continues One room include two twin-size beds. The other two rooms include a full-size bed. one (1) chair, one (1) nightstand, one (1) trash ban with a lid, and one (1) table lamp. All bedrooms are equipped with a ceiling light. The home has two (2) bathrooms. Bathrooms are accessible in all rooms. All bathrooms have a working toilet, washbasin, and shower with grab bars and non-skid mats. Beds have the required linen supplies which include, pillowcases, mattress pads, fitted sheets, blankets, and bedspreads. An adequate supply of linen is stored in the hall closet inside the bedrooms. There is one (1) fire extinguisher located by the laundry area. A telephone line is available in the kitchen, living, and activity rooms. Emergency supplies and Personal Protective Equipment supplies are stored in the cabinet. Dishes, cups, and flatware are stored in the kitchen cabinets, inspected, and in good repair. Knives, cutlery, and other sharp kitchen utensils are stored in a locked drawer. Food supply is adequately stored in kitchen cabinets and consists of the can goods. Smoke and carbon monoxide detectors throughout the interior space. Hardwired smoke detectors in all three (3) bedrooms and hallways. Carbon monoxide is combined with smoke detectors a total four (4). The water temperature is 116.3F degrees throughout the kitchen and bathrooms. There were no deficiencies cited. A copy of the report was provided to Licensee Tina Scruggs-Tatethe state’s words, verbatim · CDSS document, Jun 13, 2025

Type of visit: Case Management - Other

On June 4, 2025, Licensing Program Analyst (LPA) Bernadette Allen conducted an unannounced visit to conduct a case management visit for Complaint Control Number: 11-AS-20250415095000. Upon arrival, LPA met with John Tate Administrator who was explained the purpose of the visit. At 2:30 PM, LPA observed Resident 1- Resident 3 (R1-R3) in the living room watching television and having snacks. LPA attempted to interview Resident 1 (R1) but was unable to have a clear conversation. LPA was able to obtain a document from Carson Foot Clinic dated 4/25/2025 which states podiatry services were provided. LPA also observed R1 with flips flops and R1 toenails appeared to have been trimmed. LPA also toured the facility and there were no health and safety concerns observed. A exit interview was conducted where this report was discussed and provided to John Tate-Administrator at the conclusion of the visit.the state’s words, verbatim · CDSS document, Jun 4, 2025

Type of visit: Prelicensing

On 06/03/2024, Licensing Program Analyst (LPA) Antonine Richard conducted an announced visit to the facility for the purpose of a pre licensing evaluation. LPA was greeted by applicant Tina Scruggs-Tate and explained the purpose of today’s pre-licensing inspection visit. An application was submitted to CCLD on 04/24/23 in the initial license application for a Residential Facility for the Elderly, ages 60 years and older. The applicant requested a capacity of four (4) individuals, of which two (2) non-ambulatory, and zero (0) bedridden. Structure: The home is three (3) bedrooms, two (2) bathrooms, one-story home situated in a residential neighborhood. The home includes a living, dining, kitchen, and laundry area. The living room had 6 chairs and coffee table. The activity room area with chase. The kitchen has a refrigerator and stove. The rear exterior is fenced throughout. The passageways, walkways, and steps are free from obstructions. LPA did not observe hazards, such as ladders, gardening tools. The patio contained one (1) table and four (4) chairs. Bedrooms Residents: The facility has three (3) bedrooms for residents. There is one (1) bedroom for non-ambulatory residents and two (2) of the bedrooms specific for the ambulatory. One room include two twin-size beds. The other two rooms include a full-size bed. one (1) chair, one (1) nightstand, one (1) trash ban with a lid, and one (1) table lamp. All bedrooms are equipped with a ceiling light. All rooms had a dresser, which complies with the requirement of 8 cubic feet of space. All rooms had closets for ample storage. Evaluation Report Continues Bedrooms Staff: There is no bedroom designated for live-in staff. Bathrooms: The home has two (2) bathrooms. Bathrooms are accessible in all rooms. All bathrooms have a working toilet, washbasin, and shower with grab bars and non-skid mats. Linens & Hygiene Supplies: Beds have the required linen supplies which include, pillowcases, mattress pads, fitted sheets, blankets, and bedspreads. An adequate supply of linen is stored in the hall closet inside the bedrooms. Emergency Phone Numbers, Exit Plan & Menu: Emergency phone numbers. The exit plan and menu are posted and readily available for review throughout the home. There is one (1) fire extinguisher located by the laundry area. A telephone line is available in the kitchen, living, and activity rooms. Emergency supplies and Personal Protective Equipment supplies are stored in the cabinet. The applicant submitted a Mitigation Plan on 03/19/2024. Food Service: Dishes, cups, and flatware are stored in the kitchen cabinets, inspected, and in good repair. Knives, cutlery, and other sharp kitchen utensils are stored in a locked drawer. Food supply is adequately stored in kitchen cabinets and consists of the can goods. The kitchen counters also had small appliances. Smoke Detectors: Smoke and carbon monoxide detectors throughout the interior space. Hardwired smoke detectors in all three (3) bedrooms and hallways. Carbon monoxide is combined with smoke detectors a total four (4). Toxins: All toxins are locked and stored in the hallway in locked cabinets. Evaluation Report Continues Stove burners, oven, microwave, washer, and dryer are working. The kitchen counters also had small appliances which include toaster, and microwave. There is one (1) refrigerator in the home. The refrigerator measured a temperature of at least 45 degrees Fahrenheit for appropriate food storage. The home is equipped with central heaters and air conditioning systems. Water Temperature: The water temperature is 116.3F degrees throughout the kitchen and bathrooms. Medications, First-Aid Kit & Book: A first aid kit is stored in the living room cabinet inspected which has at least the following: thermometer, tweezers, scissors, antiseptic, bandages, gauze, and current first aid manual locked and inaccessible to residents. The resident's medications will be stored in the medication cabinet locked in the hallway and inaccessible. Resident & Staff Files: The applicant is handling the cash resources for residents. Records of staff and residents will be stored in the licensee office. Reading Material, Games, Equipment & Materials: The facility has board games, books, magazines, and other recreational materials for the resident's use all stored in the activity room. Pool/Jacuzzi & Pets: There are no pets, jacuzzi, or pool in the fenced area. Evaluation Report Continues Fire clearance: A Fire Clearance inspection was conducted on 08/22/23 approved for a capacity for four (4) ambulatories and two (2) can be non-ambulatory, and zero (0) for bedridden. Pre-licensing Checklist: Completed by licensee and reviewed by LPA. Component III: LPA Richard Conducted the Pre-Licensing visit, along with the information provided about how to operate the facility within substantial compliance with Component III Power Point. No corrections observed. A copy of the report was provided to Licensee Tina Scruggs-Tate END OF REPORTthe state’s words, verbatim · CDSS document, Jun 3, 2024

Type of visit: Office

Component II completion: Successful Facility Type: Residential Care Facility for Elderly (RCFE) Application Type: Initial Capacity: 4 Census (if any clients in care): none COMP II Participants: Tina Scruggs-Tate, Applicant Interview Method: Telephone interview On April 26, 2024 at 10:00 AM applicant participated in COMP II. Identification of the applicant was verified through interview questions based on photo ID and other identifying personal information. During COMP II, applicant confirmed that they have read and understand community care facility licensing laws included in the Health and Safety Codes and the California Code of Regulations Title 22. During COMP II, CAB analyst confirmed Applicant's understanding of following areas: 1. Facility Operation: License type, client/resident populations, and program 2. Admission Policies 3. Staffing requirements & Training 4. Restrictive/Prohibited Health Conditions 5. General Provisions 6. Emergency Preparedness 7. Complaints & Reporting 8. Pre-licensing Readiness Exit interview conducted with applicant. Report sent via email and request to return sign copy to CAB by end of business day today.the state’s words, verbatim · CDSS document, Apr 26, 2024