Folsom Senior Care

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Cassandra Mikkelson arrived unannounced and met with Administrator Brandon Lepadat to conduct an annual inspection utilizing the inspection tool. LPA conducted an inspection of the care home to ensure compliance with Title 22 regulations. LPA observed resident rooms, common area bathrooms, kitchen, common areas and perimeter of care home. Care home has a pool which is locked and inaccessible to residents in care. LPA observed rooms to be properly furnished, with appropriate bedding and lighting. The bathrooms were in sanitary condition and properly maintained. LPA checked the kitchen area for the ability to prepare and store food. Care home has required (2) two day perishable and (7) seven day non-perishable food supply on hand. Smoke detectors and carbon monoxide detectors are operational in the care home. Fire extinguishers and first aid kit are maintained and ready for emergency use. LPA checked medication storage and found medications to be locked away and inaccessible to the residents. LPA reviewed three (3) resident files, two (2) staff files and resident medications. Facility has a current copy of certificate of liability insurance and LPA obtained a copy. As a result of this visit, no deficiencies were cited pursuant to California Code of Regulations, Title 22, Division 6, Chapter 8. Exit interview was conducted with Administrator.the state’s words, verbatim · CDSS document, Aug 25, 2026

Type of visit: Post Licensing

Licensing Program Analyst (LPA) Angela Hood arrived at the care home today and met with the caregivers to conduct an annual required and post licensing visit. For more information on the post licensing visit, please see LIC 809 for Required - 1 Year dated 8/1/2025. No deficiencies cited for the post licensing visit.the state’s words, verbatim · CDSS document, Aug 1, 2025

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Angela Hood arrived at the facility unannounced and met with the caregivers to conduct a Required-1 Year Inspection. LPA conducted an inspection of the care home to ensure compliance with Title 22 regulations. There are five (5) bedrooms and two (2) bathrooms for resident use. LPA observed bedrooms to be properly furnished, with appropriate bedding and lighting. The bathrooms were in sanitary condition, properly maintained, and the hot water temperature was observed to be 117.7 degrees F. LPA checked the kitchen area for the ability to prepare and store food. Care home has required (2) two-day perishable and (7) seven-day non-perishable food supply on hand. LPA observed knives, cleaning products and other toxins to be locked away and inaccessible to residents. LPA observed the outdoor area and perimeter of the care home to be free of clutter and debris and there appeared to be no potential safety hazards to the residents in care. Smoke detectors and carbon monoxide detector are operational. First aid kit is maintained and ready for emergency use. LPA checked medication storage and found medications to be locked away and inaccessible to the residents. LPA reviewed four (4) resident files and also reviewed two (2) staff files. As a result of this visit, no deficiencies were cited per California Code of Regulations, Title 22. Exit interview conducted.the state’s words, verbatim · CDSS document, Aug 1, 2025

Type of visit: Prelicensing

On 08/08/24 Licensing Program Analyst (LPA) Cheyenne Ratajczak arrived at the facility announced to conduct a Pre- Licensing visit. LPA met with Administrator, Brandon Lepadat to conduct Pre- Licensing visit. This application is a change in ownership (CHOW). This address is currently licensed as Adina Home Care, #347002721. Administrator holds a current administrator certificate (#6060807740 with expiration date 01/07/25). The facility currently has five (5) resident during today's inspection. Facility has a fire clearance for six (6) non-ambulatory residents. Administrator and LPA conducted a tour of the interior and exterior of the facility. Areas toured include but not limited to resident bedrooms, bathrooms, kitchen, laundry room, garage, common areas and backyard. Resident bedrooms were properly furnished and maintained. Bathrooms were observed to be clean and sanitary. There is a pool in the backyard which is surrounded by a fence which is locked, the pool is inaccessible to residents. Facility food supply is in compliance with two (2) days of perishable and seven (7) days of non-perishable food items. Smoke and carbon monoxide detectors are operational. The Fire extinguisher was serviced on 04/15/24. Grab bars were present at the toilet and in the shower. All exits were unobstructed. All toxins, medications, and sharps were locked and stored away. Hot water temperature was observed to be 108.5 degrees Fahrenheit, which is within the required range of 105-120 degree. First aid kit found to be complete. Required Licensing posters are posted throughout the facility. LPA reviewed one (1) resident file and one (1) staff. LPA provided administrator with a copy of LIC311F, records to be maintained at the facility. Pre-licensing passed and Component III was completed. Applicant has satisfied all requirements in accordance to Title 22, California Code of Regulations. Application is pending and LPA will forward findings to the Centralized Application Bureau (CAB) for final review and approval. CAB will further contact applicant on final status of application. Exit interview conducted and a copy of this report was left at the facility.the state’s words, verbatim · CDSS document, Aug 8, 2024

Type of visit: Office

COMP II by CAB successfully completed Facility Type: RCFE Application Type: CHOW Capacity: 6 Census (if any clients in care): 5 Method: Telephone call with CAB COMP II Participants: Brandon Lepadat, Administrator/Owner; Shannon Betker, analyst. Applicant/administrator participated in COMP II at CAB via telephone call with analyst at CAB. Identification of the applicant and administrator was verified by confirming driver’s license number. During COMP II, applicant and administrator confirmed the understanding of Title 22. Component II was successfully completed. Applicant and administrator were advised to email/fax signed LIC 809 with copy of photo ID to CAB. During COMP II, CAB analyst confirmed Applicant/Administrator’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 readinessthe state’s words, verbatim · CDSS document, Jul 29, 2024