Garnsey Garden

Type of visit: Required - 1 Year

Licensing Program Analysts (LPA) J. Duarte arrived at the facility unannounced to conduct the Required Annual Inspection. LPA met with Administrator Jethronel Lazaga. LPA disclosed the purpose of the inspection and was granted entry into the facility.A tour of the facility was conducted with the Administrator. The facility was observed to be at a temperature of 72 degrees F, clean and no passageway obstructions were observed. The living room has sufficient seating for residents. Living room has a fireplace with a cover. The kitchen was toured and LPA observed an adequate supply of perishable and non-perishable food. The facility stores kitchen knives in a locked cabinet. All bedrooms were toured and observed to have the required furniture and adequate lighting. Bathrooms were observed operational, with non-skid strips and grabbed bars observed for the showers and toilets. The hallway restroom hot water measured at 109 degrees F and the hot water to the restroom connected to the room measured at 108 degrees F. The garage and outside of the facility was toured. The facility has a dryer and washer in the garage. The facility has an additional refrigerator and freezer in the garage with an additional food supply. LPA observed disinfectants, chemicals, tools, and paint unlocked. The facility has a pool that is gated and locked. The facility has seating and tables under the patio. The carbon monoxide/smoke detector was observed operational during inspection. Medications observed kept locked in hallway closet. Medications were reviewed along with MARS and observed medication for a resident was not logged on the centrally stored log to indicate a start date or how many pills were received to verify if the resident was receiving medication as prescribed. A first aid kit is stored with the medication and was complete. A sample of resident files and staff files were also reviewed and observed to have required documentation. Two fire extinguishers were observed with a service date of 01/19/26. Continued in LIC 809C. Continued from LIC 809. A repeat deficiency is being cited on the attached LIC 809D in accordance to California Code of Regulations, Title 22,Division 6. An exit Interview was conducted. A copy of this report and appeal rights were provided to AD, whose signature on this form confirms receipt of this report. LPA requested the following updated forms be faxed to CCL Department: Designation of Facility Responsibility (LIC308), Administrative Organization (LIC309), Personnel Report (LIC 500), Proof of current Liability Coverage. Please submit these documents by 02/13/26 .the state’s words, verbatim · CDSS document, Feb 6, 2026

Type of visit: Required - 1 Year

Licensing Program Analysts (LPA) Shawna Doucette arrived at the facility unannounced to conduct the Required Annual Inspection. LPA met with Administrator Jethronel Lazaga. LPA disclosed the purpose of the inspection and was granted entry into the facility by Staff. Staff contacted Administrator via telephone who responded to assist with the visit. A tour of the facility was conducted with the Administrator. Residents' rooms were toured and inspected and observed to be clean. Hot water temperature was measured from 133.9. Kitchen toured, supply of food observed and food stored properly for perishable and nonperishable. Medications were stored in a locked Medication closet. LPA observed medications on office desk. Office is not a locked room making medications accessible to residents. One of R1's medication was not logged on centrally stored log to indicate whether or not R1 is receiving medications as prescribed. Cleaning supplies were in a locked storage closet in the garage. Facility has a pull station fire alarm. Fire extinguishers were charged and had service dates of 1/06/25. Smoke detectors and carbon monoxide were operating. There was outdoor seating for the residents under a covered patio. Facility has a pool that is gated and locked, making it inaccessible to residents in care. Resident, medication and staff records were reviewed. Current first aid and CPR were on file for staff. Refer to 809D An exit interview was conducted with the Administrator. A copy of this report, plan of correction and appeal rights were provided.the state’s words, verbatim · CDSS document, Feb 13, 2025

The state marks this report as 5 pages; the online copy we transcribed has 3. You can request the full file from the county licensing office.

Type of visit: Prelicensing

Licensing Program Analyst (LPA) Darius Williams conducted an announced visit to conduct a Pre-Licensing inspection. Tour began on the front yard of the facility. Front yard and walk ways were free of obstruction. LPA observed required postings in the facility entrance and hallways. The living room and dining room were clean and free of obstruction. Seating was available to accommodate 6 residents. LPA observed 4 bedrooms. All bedrooms had mattresses, blankets, sheets, chair, dresser, lamp, and night stand. Rooms were clean and free of obstructions. LPA observed 3 bathrooms for residents and 1 bathroom for visitors. All rooms were clean and free obstruction. Grab bars were present in all bathrooms for residents use. Non skid mats or strips were not observed in 3 of 3 residents bathrooms. Pool is present in the backyard and secured. Dual smoke detector and carbon monoxide was present and operation. LPA observed fire extinguishers present and charged. First aid kit was present in the hallway and had all required items. Licensee identified separate locked locations for medications, sharps/knives, and chemicals. *Continued on 809-C* LPA requested the following items to be corrected: - Dementia and Bedridden care is required to be addressed in facilities emergency disaster plan. - Add non-skid mats or strips were in 3 of 3 bathroom showers/tubs Once LPA receives proof of correction, it will be forwarded to the Central Application Bureau for further review and processing. Component III was reviewed with Licensee's An exit interview was conducted and a copy of this report was provided to the Licensee.the state’s words, verbatim · CDSS document, Feb 14, 2024

Type of visit: Office

Facility Type: RCFE Application Type: Initial Capacity: 6 Census (if any clients in care): zero COMP II Participants: Cecilia and Jethronel Lazaga Interview Method: Telephone interview On February 2, 2024, applicant/administrator participated in COMP II. Identification of the applicant and administrator was verified through interview questions based on photo ID and other identifying personal information. During COMP II, applicant and administrator 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. Signed LIC 809 with copy of photo ID have been obtained. During COMP II, CAB analyst confirmed Applicant/Administrator’s understanding of following areas: 1. Facility operation: License type, client/resident populations, and program 2. General Provisions; program, unusual incidents, Medicine and pre licensing readinessthe state’s words, verbatim · CDSS document, Feb 2, 2024