Grand Oaks Assisted Living

Type of visit: Required - 1 Year

Licensing Program Analysts (LPA) B. Miranda conducted an unannounced visit today August 11, 2026 for the facility’s annual inspection. LPA introduced themselves and was allowed entrance into the facility. LPA met with Administrator Alena Lema. Facility is licensed for 85 residents and has a current census of 73. There are 4 residents on hospice and 2 with home health. Facility is licensed for 1 bedridden resident and currently has 3 bedridden residents (not including a hospice resident). Each room has it's own exit. Water temperature was checked in 2 resident bathrooms which read at 120 degree Farhient. Fire Extinguisher was serviced April 7, 2026 and is within the safety regulation period. Sprinkler system was inspected on July 21, 2026 and passed with no issues. Carbon monoxide detectors are in every wings and a sample was tested and in working order. Alena Lema’s Administrator Certification expires July 3, 2028. Staff files were reviewed, are complete, and current. Resident files were reviewed, complete, and current. Facility provided a log for disaster drills that are conducted quarterly. First aid kit on site. Toxins and cleaning supplies are locked and inaccessible. There is a locked storage for medications. LPA inspected the interior of the facility including the common living spaces, resident bedrooms, bathrooms, medication storage, & kitchen. Bedrooms were clean, properly furnished, with adequate lighting, and in good repair. Food supply is adequate for 2-day perishable and 7-day nonperishable. Deficiencies observed were cited during today's inspection per California Code of Regulations, Title 22. LPA is requesting the following documents: LIC 500 Personnel Report, LIC 308 Designation of Administrative Responsibility, LIC 610-E the Emergency Disaster Plan and copy of current Administrator’s Certificate to update the facility file. Listed documents shall be sent to Licensing August 21, 2026. Exit interview conducted and a copy of this report LIC809, LIC809D, and appeal rights were provided to Administrator Alena Lema.the state’s words, verbatim · CDSS document, Aug 11, 2026

Type of visit: Case Management - Other

On May 4, 2026 Licensing Program Analyst (LPA) B. Miranda arrived at the facility unannounced to conduct a case management visit. The Dept received a notice indicating S1 needed an Exemption. Alena informed LPA she is the new administrator and provided necessary documents to the Dept. Alena was also able to provide a copy of the Exemption Approval for S1. No citations were issued at this time. Exit interview was conducted and a copy of this report will be emailed to Administrator Alena Lema by the end of the day.the state’s words, verbatim · CDSS document, May 4, 2026

Allegation investigated: Staff are not abiding to the admission agreement Staff do not provide adequate transportation services

Licensing Program Analyst (LPA) Shawna Doucette arrived at the facility unannounced to deliver findings. LPA met with Assistant Administrator Alena Lema. LPA interviewed staff and residents. LPA reviewed records. Based on records review and interviews, facility is charging a $35 dollar additional internet/wifi fee to residents. Facility does not have a list of optional services that show fees listed in the admissions agreement. Based on records review and interviews, the admissions agreement states Licensee will provide transportation to medical and dental appointments. Based on interviews, since on or about August 2025, facility is not assisting residents with transportation to doctor/dental appointments. Substantiated Based on the interviews and records review the preponderance of evidence standard has been met, therefore the above allegation is found to be SUBSTANTIATED. California Code of Regulations, Title 22, Division 6, Article 8, is being cited on the attached LIC 9099D. A copy of this report with appeal rights and plan of correction was provided.the state’s words, verbatim · CDSS document, Jan 26, 2026 · control 24-AS-20251105104638

From the deficiency page — Deficiency type: Type B · Section cited: CCR 87507(g)(2) · Plan of correction due date: Feb 26, 2026

87507 Admission Agreements (g) Admission agreements shall specify the following:(2) Additional items and services which are available. This requirement was not met as evidenced by: Licensee does not have an optional services list showing fees for optional services in the admissions agreement which poses a potential health safety and or personal rights risk to residents in care.the state’s words, verbatim · CDSS document, Jan 26, 2026

Plan of correction: Licensee agrees to include an optional services listing services and prices in admissions agreement by POC due date 02/26/26.

From the deficiency page — Deficiency type: Type B · Section cited: CCR 87507(f) · Plan of correction due date: Feb 26, 2026

87507 Admission Agreements (f) The licensee shall comply with all applicable terms and conditions set forth in the admission agreement, including all modifications and attachments. This requirement was not met as evidenced by: Licensee did not plan, arrange and/or provide for transportation to medical and dental appointments which poses a potential health safety and or personal rights risk to residents in care.the state’s words, verbatim · CDSS document, Jan 26, 2026

Plan of correction: Licensee agrees to submit a written plan on how this regulation will be met by POC due date 02/26/26.

Allegation investigated: Facility staff are not properly supervising resident who is a fall risk.

Licensing Program Analyst (LPA) Shawna Doucette arrived at the facility unannounced to deliver findings. LPA met with Assistant Administrator Alena Lema. LPA interviewed staff. LPA reviewed records. LPA observed photos. Based on interviews and photos and records review, facility staff were not properly supervising R1. Photos reveal R1 with half bedrails and another postural support/restraint near the bottom end of the bed with large pillows and a tv tray in between the bedrails and the additional postural support/restraint in attempt to prevent R1 from getting out of bed due to R1 being a high fall risk. Based on records review, there was no doctor perscription for R1 for restraints or postural supports. Facility has a plan for low/moderate fall risk residents, but does not have a plan for high risk fall residents. Substantiated Based on photos, interviews and records review the preponderance of evidence standard has been met, therefore the above allegation is found to be SUBSTANTIATED. California Code of Regulations, Title 22, Division 6, Article 8, is being cited on the attached LIC 9099D. A copy of this report with appeal rights and plan of correction was provided. Based on interviews and records review, it is undetermined if facility had enough staff to meet the needs of residents. Based on interviews, Administrator was holding staff over to work longer shifts to meet the needs of R1. Based on records review, Administrator did not have an accurate staff schedule available to review. Administrator provided daily time clock logs of all staff, where LPA was unable to determine which staff were care staff. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur, therefore the allegation is UNSUBSTANTIATED. A copy of this report was provided.the state’s words, verbatim · CDSS document, Jan 26, 2026 · control 24-AS-20251119202642

From the deficiency page — Deficiency type: Type A · Section cited: CCR 87464(f)(1) · Plan of correction due date: Jan 27, 2026

87464 Basic Services (f) Basic services shall at a minimum include:(1) Care and supervision as defined in Section 87101(c)(3) and Health and Safety Code section 1569.2(c). This requirement was not met as evidenced by: Licensee did not provide care and supervision for R1 who is a high fall risk, by using postural supports/restraints, which were not perscribed by a doctor to keep R1 in bed which poses an immediate health safety and or personal rights risk to residents in care.the state’s words, verbatim · CDSS document, Jan 26, 2026

Plan of correction: Licensee agrees to submit a date the plan will be completed and when training will be conducted by POC due date 01/27/26. Licensee agrees to submit the plan in writing for high risk fall residents and a copy of staff trained and training after training is conducted.

Type of visit: Case Management - Deficiencies

Licensing Program Analyst (LPA) Shawna Doucette arrived at the facility unannounced to deliver complaint findings on 24-AS-20251119202642. During the course of the investigation, LPA observed an additional deficiency. LPA met with Assistant Administrator Alena Lema. During the course of the investigation, LPA interviewed Administrator on January 10,2026. LPA did not observe any reports to Licensing regarding R1's falls. Administrator stated R1 had fallen approximately 5 times but he did not know he needed to report the falls to Licensing. Refer to 809d. A copy of this report was provided with appeal rights and plans of correction.the state’s words, verbatim · CDSS document, Jan 26, 2026

From the deficiency page — Deficiency type: Type B · Section cited: CCR 87211(a)(1) · Plan of correction due date: Jan 30, 2026

87211 Reporting Requirements (a) Each licensee shall furnish to the licensing agency such reports as the Department may require, including, but not limited to, the following: (1) A written report shall be submitted to the licensing agency and to the person responsible for the resident within seven days of the occurrence of any of the events specified in (A) through (D) below. This report shall include the resident's name, age, sex and date of admission; date and nature of event; attending physician's name, findings, and treatment, if any; and disposition of the case. This requirement was not met as evidenced by: Licensee did not report R1's falls which poses a potential health safety and or personal rights risk to residents in care.the state’s words, verbatim · CDSS document, Jan 26, 2026

Plan of correction: Licensee agrees to submit in writing an understanding of this regulation and how the facility will meet this regulation by POC due date 01/30/26.

Allegation investigated: Staff neglected resident of goods and services. Staff neglected resident of physical care. Resident's health and safety endangered.

Licensing Program Analyst (LPA) Shawna Doucette arrived at the facility unannounced to conduct a complaint investigation. LPA explained the purpose of the visit and was granted entry by Medication Technician Jessica Onsurez. Administrator Alena Lema and Administrator David Shellhamer responded to the facility to assist with the visit. LPA obtained a copy of the staff roster. Based on records review there was not a staff listed on the staff roster that are listed in this complaint. Based on interviews, the facility has not received any residents from the skilled nursing facility that is listed in this complaint. Based on LPA's interviews and record review, this agency has investigated the complaint alleging, Staff neglected resident of goods and services, Staff neglected resident of physical care and Resident's health and safety endangered. We have found that the complaint was UNFOUNDED, which means it could not have happened, and/or is without a reasonable basis, therefore we have dismissed the complaint. An exit interview was conducted and a copy of this report was provided. Unfoundedthe state’s words, verbatim · CDSS document, Jan 10, 2026 · control 24-AS-20251106212728

Allegation investigated: Licensee is not ensuring that staff are seeking medical attention for resident as necessary.

On 07/08/25, Licensing Program Analyst (LPA) L. Salazar arrived to the facility unannounced to conduct the required 10 day site visit. LPA was greeted by Administrator, stated the purpose of the visit and was allowed entry into the facility. LPA met with Administrator and Residential Care Coordinator (RCC) to discuss the allegation. During the investigation, LPA toured the facility, reviewed Resident R1's records and interviewed staff. Based on the information received, R1 was admitted on Infinite Heart Hospice on 06/04/25 with a plan of care to include Hospice Nursing visits and Home Health visits . LPA observed Hospice records including the plan of care , nursing visits and assessments. Medical attention is being provided. Although the allegation may have happened, there is not a preponderance of evidence to prove that the alleged violation occurred, therefore the allegation is Unsubstantiated. Exit interview conducted and copy of report was left with Administrator. No deficiency cited on this visit. Unsubstantiatedthe state’s words, verbatim · CDSS document, Jul 8, 2025 · control 24-AS-20250630132724

Allegation investigated: Staff retained resident whose needs are beyond the scope of care of the facility Staff did not treat residents with respect Staff allowed family members to reside at the facility

On 05/30/25, Licensing Program Analyst (LPA) L. Salazar arrived to the facility unannounced to deliver findings on the above allegations. LPA was greeted by Administrator, stated the purpose of the visit and was allowed entry into the facility. LPA met with Administrator, David Shellhamer to discuss the findings. During the investigation, LPA interviewed Reporting Party and staff. LPA reviewed R1's records and observed R1 was a new admission on 03/11/25. R1 was discharged from the hospital on 03/11/25, placed on hospice and passed away on 03/13/25. Hospice care plan was observed on file. Interviews with staff and residents were conflicting in regard to residents not being treated with respect. Resident R2 was admitted to the Skilled Nursing Facility (next door) on 02/27/25 and discharged from Assisted Living on 03/30/25. R2's son stayed in the AL facility for 3 days during the period 03/09/25-03/12/25. The Department has investigated the allegations. Although the allegations may have happened, there is not a preponderance of evidence to prove that the alleged violations occurred, therefore the allegations are Unsubstantiated. Exit interview conducted and copy of report was left with Administrator. Unsubstantiatedthe state’s words, verbatim · CDSS document, May 30, 2025 · control 24-AS-20250312094236

Type of visit: Required - 1 Year

On 05/29/25, Licensing Program Analysts (LPAs) L. Salazar and M. Vega arrived at the facility unannounced to conduct the Annual required inspection. LPAs were greeted by Administrator, stated the purpose of the visit and were allowed entry into the facility. LPAs met with Administrator, David Shellhamer. LPAs toured the facility inside out with Administrator. LPA Salazar interviewed residents and LPA M. Vega reviewed staff and employee records. Due to time constraints, LPA Salazar will return to the facility to document the findings of the visit. No deficiencies cited today.the state’s words, verbatim · CDSS document, May 29, 2025

Type of visit: Case Management - Incident

On 05/29/25, Licensing Program Analysts (LPAs) L. Salazar and M. Vega arrived at the facility unannounced to conduct a case management visit based on incidents reported. LPAs were greeted by Administrator, stated the purpose of the visit and were allowed entry into the facility. LPAs met with Administrator, David Shellhamer. LPA requested resident records and obtained copies of information for Resident R1, Resident R2, Resident R2 and Resident R4. Due to time constraints, LPA will review records and return to the facility at a later date. No Deficiencies cited on today's visit.the state’s words, verbatim · CDSS document, May 29, 2025

Allegation investigated: Staff does not ensure resident medication is administered as needed.

On 10/29/24, Licensing Program Analysts (LPAs) L. Salazar and K. Kaur arrived at the facility unannounced to deliver findings on the above allegations. LPAs stated the purpose of their visit and were allowed entry into the facility. LPAs met with Residential Care Coordinator and Adminstrator to discuss the findings. Administrator is out of the facility and was available via telephone. During the investigation, LPA Salazar reviewed Centrally Strored Medication Destruction Records (CSDMR), Medication Administration Record (MAR), and observed 9 out of 23 days in April 2024, Resident R1 did not recieve their medication. LPA interviewed facility Staff S1, who signed off on the MAR. S1 stated they could not read the blood sugar levels and documented as "HI" and did not administer medication on 9 our of the 23 days recorded. Based on LPA’s observation of records and interview with Staff S1, the preponderance of evidence standard has been met; therefore, the above allegation is found to be Substantiated. Per California Code of Regulations, Title 22, Division 6, Chapter 8, a deficiency is being cited on the attached 9099-D. An exit interview was conducted with Administrator via telephone and a Plan of correction was developed. A copy of this report and appeal rights were discussed and will be provided to Administrator A plan of correction was developed by licensee and reviewed with LPA. Substantiatedthe state’s words, verbatim · CDSS document, Oct 29, 2024 · control 24-AS-20240725113052

From the deficiency page — Deficiency type: Type A · Section cited: CCR 87465(a)(4) · Plan of correction due date: Oct 30, 2024

87465 Incidental Medical and Dental Care (a) A plan for incidental medical and dental care shall be developed by each facility. The plan shall encourage routine medical and dental care and provide for assistance in obtaining such care, by compliance with the following:(4)The licensee shall assist residents with self-administered medications as needed. This requirement was not met as evidenced by LPA's observation of Resident R1's records (CSMDR, MARS) and interview with Staff S1. R1 did not receive medication on 9 out of 23 days on the April 2024 MAR.the state’s words, verbatim · CDSS document, Oct 29, 2024

Plan of correction: Administrator was provided with TSP medicaiton guide. Administrator will provide a statement stating they have read and understood the CCR Title 22 medication requirements by POC date.

Allegation investigated: Facility staff did not dispense medications as prescribed Licensee did not ensure that resident's medication was administered by an appropriately skilled professional

On 10/29/24, Licensing Program Analysts (LPAs) L. Salazar and K. Kaur arrived at the facility unannounced to deliver findings on the above allegations. LPAs stated the purpose of their visit and were allowed entry into the facility. LPAs met with Residential Care Coordinator and was available via telephone. During the investigation, LPA Salazar toured facility, and conducted interviews with staff. Based on the information received,facility staff was giving medication per Dr.'s order and staff were allowed to administer the predosed medication from Hospice. Based on the information recieved, the allegations Facility staff did not dispense medications as prescribed and Licensee did not ensure that resident's medication was administered by an appropriately skilled professional are Unfounded. Meaning, that the allegations are false, could not have happened and/or are without reasonable basis, therefore, we have dismissed the complaint. Exit interview conducted. Nothe state’s words, verbatim · CDSS document, Oct 29, 2024 · control 24-AS-20240913135352

Type of visit: Case Management - Deficiencies

On 10/29/2024, Licensing Program Analysts (LPAs) K.Kaur and L. Salazar arrived unannounced to deliver findings on subsequent complaint visit. A resident (R1) approached LPAs and informed LPAs of a roommate that went to a hospital and disclosed details of the resident’s condition. LPAs reviewed (R2’s) file and interviewed staff. Based on interview R2 is on home health. LPA reviewed resident home health visit history. Further review of files revealed Facility did not have a Home Health Care Plan on file. Resident Care Coordinator requested and received Home Health Care plan. LPAs reviewed Care plan and observed a prohibited health condition was diagnosed from September 9, 2024. Deficiencies are being cited on the attached 809D in accordance with California Code of Regulations, Title 22, Division 6. An exit interview was conducted with staff. Administrator was contacted via phone to review the findings. Report signed on-site by . Resident Care Coordinator and printed copy provided with appeal rights.the state’s words, verbatim · CDSS document, Oct 29, 2024

From the deficiency page — Deficiency type: Type A · Section cited: CCR 87615(a)(4) · Plan of correction due date: Oct 30, 2024

87615 Prohibited Health Conditions (a) Persons who require health services for or have a health condition including, but not limited to, those specified below shall not be admitted or retained in a residential care facility for the elderly: (4)…infection or other serious infection. This requirement was not met as evidenced by: Based on LPA's observation of records review and interview with Staff R2 was sent to hospital on10/29/2024 due to a serious infection diagnosed on 9/9/2024.the state’s words, verbatim · CDSS document, Oct 29, 2024

Plan of correction: Administrator agrees to schedule an in-service training on restricted and prohibited health conditions and provide documentation of training when completed. Administrator agrees to submit a statement of understanding of steps required for prohibited health conditions by POC date.

From the deficiency page — Deficiency type: Type A · Section cited: CCR87609(4)(C) · Plan of correction due date: Oct 30, 2024

87609 Allowable Health Conditions and the Use of Home Health Agencies (4) The licensee and home health agency agree in writing on the responsibilities of the home health agency, and those of the licensee in caring for the resident’s medical condition(s). (C)The written agreement shall be signed by the licensee or licensee representative, and representative of the home health agency, and placed in the resident’s file. This requirement was not met as evidenced by: LPAs request for R2's Home Health care plan. During File review, LPAs did not observe a Plan of Care between Therapeutic Home Healthcare and Facility regarding a serious infection and how to care for it.the state’s words, verbatim · CDSS document, Oct 29, 2024

Plan of correction: Residential Care Coordinator contacted the Home Health agency during the time of visit and was able to obtain the Plan of Care for R2. Plan of Correction completed during visit. Administrator will provide a list of residents who are receivng Home health care services to LPA. Administrator will verify all residents have a care plan in file.

From the deficiency page — Deficiency type: Type B · Section cited: CCR 87211(a) · Plan of correction due date: Nov 5, 2024

87211 Reporting Requirements (1) A written report shall be submitted to the licensing agency and to the person responsible for the resident within seven days of the occurrence of any of the events specified in (A) through (D) below. This report shall include the resident's name, age, sex and date of admission; date and nature of event; attending physician's name, findings, and treatment, if any; and disposition of the case. (B) Any serious injury as determined by the attending physician and occurring while the resident is under facility supervision. This requirement was not met as evidenced by: Facility did not submit an incident report for (R2) who was referred to their PCP for a change of health condition/ injury on 8/28/2024.the state’s words, verbatim · CDSS document, Oct 29, 2024

Plan of correction: Administrator agrees to conduct in-service training on reporting requirements provide documentation of training when completed.

Type of visit: Post Licensing

On 10/29/24 Licensing Program Analyst (LPA) arrived at the facility unannounced to conduct the Post Licensing inspection. LPA was greeted by Residential Care Coordinator (RCC), stated the purpose of the visit and was allowed entry into the facility. Administrator on record is David Shellhamer, who is available via telephone on today's visit. LPA toured the facility inside and out. All passageways and exits are clear and free from obstruction. Facility was adequately furnished and lit. Fire extinguishers had current service tag dates. Facility had operational smoke detectors. LPA observed all hazardous materials and cleaning supplies to be secured in locked storage closets. LPA observed the dining room to be clean. 8 residents were observed drinking coffee at tables while dinner was being prepared. LPA observed a seven day supply of nonperishable food and a two day supply of perishable food. Medications were observed to be kept in a locked medicine cart located near a locked medication room. Facility was decorated for the holidays, activities room carpet neat the med cart was observed to be stained. Administrator assigned the cleaning to staff at the time of visit. LPA toured the outside and observed a shaded seating area with pathways and exits free from obstruction. This is one of 3 visits LPA is conducting at the facility on this date, LPA is documenting the physical plant facility tour, facility records will be reviewed at a later date on a continuation visit. No deficiencies cited during the inspection. Exit interview conducted. A copy of the report was provided to the licensee via email.the state’s words, verbatim · CDSS document, Oct 29, 2024

Allegation investigated: Licensee did not provide a copy of the resident's records to the resident's legal representative.

On 9/12/2024, Licensing Program Analyst (LPA) M. Medina conducted an unannounced initial 10-day complaint visit. LPA introduced self and stated purpose of visit. David Shellhamer, Administrator was not available to conduct today's visit. LPA met with Wendi Valdez, Resident Care Coordinator. This agency has investigated the complaint alleging Licensee did not provide a copy of the resident's records to the resident's legal representative. Based on the information received, Resident R1 passed away prior to the licensure of Grand Oaks Assisted Living on 06/06/24. We have found that the complaint was unfounded, meaning that the allegation was false, could not have happened and/or is without a reasonable basis. Nothe state’s words, verbatim · CDSS document, Sep 13, 2024 · control 24-AS-20240904155634

Allegation investigated: Staff administered the incorrect medication to residents in care. Staff opened residents mail.

On 08/28/24, Licensing Program Analyst (LPA) L. Salazar arrived at the facility unannounced to conduct the required 10 day site visit. LPA was greeted by Administrator and Residential Care Services Coordinator, stated the purpose of the visit, and was allowed entry into the facility. LPA conducted interviews and records review. Based on the information received, and although the allegations may have happened, there is not a preponderance of evidence to prove that the alleged violations occurred, therefore the allegations are Unsubstantiated. Nothe state’s words, verbatim · CDSS document, Aug 28, 2024 · control 24-AS-20240819102011

Allegation investigated: Staff did not provided care for resident Staff did not shower and bathe resident Staff did not change resident's bedding

On 07/23/24, Licensing Program Analyst (LPA) arrived to the facility unannounced to conduct the required 10 day site inspection. LPA was greeted by Residential Care Coordinator (RCC), stated the purpose of the visit, and was allowed entry into the facility. LPA requested the facility roster and did not observe resident's name that was reported in the allegations. LPA asked RCC to contact the Administrator next door at Grand Oaks Skilled Nursing Facility (SNF) to obtain a facility roster. Administrator of SNF, Michelle Lawrence, arrived at the facility with the SNF roster. LPA observed resident on SNF roster and it was verbally confirmed the resident does not live in the jurisdiction of CCL regulations. A cross report to CDPH has been made. Based on the information received, the allegations are UNFOUNDED, meaning they are false, could not have happened, and/or without a reasonable basis. Therefore, we have dismissed the complaint. Unfoundedthe state’s words, verbatim · CDSS document, Jul 22, 2024 · control 24-AS-20240719161548

Type of visit: Prelicensing

On 04/17/24, Licensing Program Analyst (LPA) L. Salazar arrived at the facility unannounced to complete the pre licensing inspection that was initiated on 01/12/24. LPA was greeted by Administrator and allowed entry into the facility. LPA toured the facility inside and out and observed new flooring throughout the facility. LPA will contact Sacramento to advise facility is ready for license. LPA will return to review files on a post licensing visit. LPA conducted exit interview with Administrator and will email a copy of this report by 04/18/24.the state’s words, verbatim · CDSS document, Apr 17, 2024

Type of visit: Prelicensing

A Prelicensing visit was conducted on the date & times indicated above by Licensing Program Analyst (LPA) L. Salazar & LPA K. McClurg. LPAs met with Administrator Michelle Lawrence & Acting Administrator David Shellhamer. Physical plant toured. Flooring in 3 out of 3 hallways, located off of resident rooms observed to be in disrepair & unsafe. Carpet is worn, frayed, pulling up & has large ridges through-out. Pulling up & areas with large ridges are unsafe & create an immediate trip/fall risk to residents. Hot tub in fitness room observed to not be in use, requiring removal from premises. The following must be done prior to licensure: Flooring throughout hallways off of resident rooms to be replaced Written plan with specific dates, including completion date committing to removal of hot tub. Plan to be submitted to LPA L. Salazar. Plan should also include how residents will be made safe & with minimal impact to residents during removal process Applicant to contact LPA Lisa Salazar when both items above have been completed. This facility is not ready to be licensed at this time. Another Prelicensing will be conducted once the above items have been completed. Exit interview conducted with Administrator Michelle Lawrence & Acting Administrator David Shellhamer. Report provided.the state’s words, verbatim · CDSS document, Jan 12, 2024

Type of visit: Office

Facility Type: RCFE Application Type: CHOW Capacity: 85 Census (if any clients in care): 56 COMP II Participants: Michelle Lawrence,admin & Marissa Arroyo Region Director Interview Method: Telephone interview On December 18, 2023, 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.the state’s words, verbatim · CDSS document, Dec 18, 2023