Granny's Place #3

Type of visit: Required - 1 Year

On this day, Licensing Program Analyst (LPA) Kevin Saborit-Guasch made an unannounced visit to the facility to conduct the required annual inspection. LPA was greeted and granted entry by facility caregiving staff after introducing himself and stating the purpose of the visit. Assistant administrator Kimberly Arnett was notified of the visit via telephone and arrived later to assist. There are currently six residents in care, none of which are receiving hospice care at this time. Residents are observed relaxing in their respective bedrooms or in the common areas. LPA accompanied by facility staff toured the physical plant. The facility is a one-story house with one shared bedroom and four private bedrooms, along with two shared bathrooms. None of the residents are assessed to be bedridden at this time. All occupied bedrooms appear clean and sanitary. All resident bedrooms have the required furnishings. Bathrooms appear clean and sanitary and are all equipped with grab bars and slip mats. Hot water temperature measured at 108F in the shared bathrooms equipped with faucets used for personal grooming by residents. LPA observed the kitchen has a minimum two (2) day perishable and seven (7) day non-perishable food supply. Sharp items, cleaning supplies and the medication central storage are verified to be secure. Fire extinguishers are present and verified to be charged. Maintenance receipts are current. Carbon monoxide and smoke detectors are present and verified to be operational. CONTINUED ON FORM LIC809-C CONTINUED FROM FORM LIC809 LPA and facility staff toured the outside of the facility. LPA observed a shaded outdoor seating area with outdoor furniture for resident use in the backyard. There is an adequately fenced swimming pool in the backyard. The identified route of egress is free of clutter and obstructions. There is one self-latching gate on the side of the premises. The facility does not utilize either locked perimeters or delayed egress. LPA reviewed six resident records which were found to include all necessary elements of documentation. LPA reviewed resident medication records and prescription orders with no discrepancies observed for all residents. LPA reviewed staff records for four staff members during the visit. All staff members on the schedule are background cleared and associated. CPR training is current for all staff reviewed. Annual and initial training reviewed. Disaster drills are conducted quarterly. The administrator certificates are current. Based on the observations conducted during the present visit, no deficiencies is being cited per Title 22 of the California Code of Regulations. An exit interview was conducted and a copy of this report was provided to a facility representative.the state’s words, verbatim · CDSS document, Jan 29, 2026

Type of visit: Case Management - Other

On this day, Licensing Program Analyst (LPA) Kevin Saborit-Guasch made an unannounced visit to the facility for the purpose of delivering findings into the investigation of complaint 22-AS-20230901120346 filed against facility #306000639 which was formerly licensed at this location. LPA was greeted and granted entry after introducing himself and stating the purpose of the visit before delivering findings and the corresponding report to administrator Michelle Nesbitt over the phone. Permission was given to caregiving staff to sign on the administrator's behalf. An exit interview was conducted and a copy of this report was provided to a facility representative.the state’s words, verbatim · CDSS document, Oct 29, 2025

Type of visit: Required - 1 Year

On this day, Licensing Program Analyst (LPA) Kevin Saborit-Guasch made an unannounced visit to the facility to conduct the required annual inspection. LPA was greeted and granted entry by facility caregiving staff after introducing himself and stating the purpose of the visit. Administrator staff Michelle Nesbitt, Kimberly Arnett and Jozef Springer were notified of the visit via telephone and arrived later to assist with the visit. There are currently six residents in care, none of which are receiving hospice care. LPA observed residents relaxing in their respective bedrooms and in the facility's common living areas. LPA accompanied by facility staff toured the physical plant. The facility is a one-story house with an attached garage. The facility has four private bedrooms and one shared room assigned to a couple, in addition to a room for use by staff. There are two full bathrooms throughout the facility. Bedrooms appeared clean and sanitary. Three beds are equipped with half rails. Physician orders for the postural support reviewed. LPA observed all the resident bedrooms have the required furnishings. Bathrooms appear clean and sanitary. Bathroom are equipped with grab bars and slip mats. Hot water temperature measured at 107.5F in two separate bathrooms with faucets used for personal grooming. LPA observed the kitchen has a minimum two (2) day perishable and seven (7) day non-perishable food supply. Sharp items are stored in a secure drawer. Fire extinguishers are charged and mounted, with up-to-date maintenance documented on the attached tags. LPA tested the smoke and carbon monoxide detectors which were found to be operational. The centrally stored medication is located in a secure closet located in the dining area. The attached garage is inaccessible to residents and is used for storage and laundry, with an additional refrigerator/freezer present. Cleaning supplies are stored securely in the garage as well as under the kitchen sink and bathroom sinks. CONTINUED ON FORM LIC809-C CONTINUED FROM FORM LIC809 LPA and facility staff toured the outside of the facility. LPA observed an shaded outdoor seating area with furniture for resident use. The perimeter gate on one side of the property is self-latching and can easily be opened in an evacuation. There is a fully fenced swimming pool on the premises, which has been emptied at the time of the visit. LPA reviewed six resident records which included all necessary components. LPA reviewed resident medication records and prescription orders for all residents with no discrepancies observed. Three resident interviews conducted during the visit. There are no bedridden residents present on the premises. LPA reviewed three staff records which were found to be complete. Training and CPR/First aid training reviewed and up-to-date. All staff are background cleared and associated to the licensed location accurately. Based on the observations made during today’s visit, no deficiencies are being cited per Title 22 Division 6 of the California Code of Regulations. An exit interview was conducted and a copy of this report was provided to a facility representative.the state’s words, verbatim · CDSS document, Feb 3, 2025

Type of visit: Prelicensing

Licensing Program Analyst (LPA) Dwayne Mason Jr. made an announced inspection to the facility for purpose of conducting an initial pre-licensing inspection. LPA arrived at the facility and was greeted and granted entry by Compliance Manager (CM) Michelle Nesbitt. An application to operate a Residential Care Facility (RCFE) for (6) capacity, (0) ambulatory, (6) non-ambulatory, and (0) bedridden clients was received by Community Care Licensing (CCL) on 7/18/2023. Structure: The facility is a one-story home with four client resident bedrooms, two bathrooms, living room, kitchen, dining room, staff room, laundry room, backyard with pool and attached two car garage. There is one exit gate in the back yard. The backyard has a shaded seating area. The pool is surrounded by a fence that both latches and locks. Client Bedrooms: All resident bedrooms had the necessary furnishings. LPA observed all resident beds had linens and blankets. LPA observed all windows were screened. Bathrooms: The bathrooms have working plumbing. Hot water measured at 112.3 degrees Fahrenheit and 116 degrees Fahrenheit in resident bathrooms. Toxins: LPA observed chemicals, cleaning solutions, laundry toxins and disinfectants are inaccessible to client and will be stored under the kitchen sink and in the garage. Medications, First-Aid Kit & Files: Medication and files will be stored in a locked closet near the front of the house. First aid kit will be in cabinets in the laundry area. There is also a first aid kit hanging on the wall in the kitchen. Records are digitized and were accessible to LPA during inspection. Fire Extinguisher: LPA observed the fire extinguishers to be fully charged as indicated by the arrow pointing in the green zone. Extinguishers were serviced on 10/4/2023.the state’s words, verbatim · CDSS document, Jan 11, 2024

The state marks this report as 2 pages; the online copy we transcribed has 1. You can request the full file from the county licensing office.