Gretchen Haven

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Michael Cava conducted an annual required visit and inspection of the facility. LPA was greeted with staff Maureen Phiri and was advised for the reason of the visit. The administrator, Christine Loyola was called, and she joined visit shortly. At 12:00 PM, LPA took a tour of the physical plant. Required postings were observed in the entry area. The smoke alarms are operational that are located each bedroom, the hallway and kitchen. There are carbon monoxide detectors that functions properly. There are two (2) fire extinguishers. One in the kitchen and one in the hallway. The charge date for both extinguishers are 01/09/26. Kitchen: The kitchen appliances and fixtures were functional. The kitchen has a working gas stove, faucet, freezer, refrigerator, and microwave. LPA observed a sufficient amount of two (2) days perishable and seven (7) days non-perishable food at the facility that is properly stored. Frozen foods are wrap, dated, and stored properly as well. Knives were stored in a locked drawer in the kitchen. Food storage and preparation areas are clean and inaccessible to pests. Garbage cans have tight fitting covers. Cleaning supplies, pesticides or toxic cleaning supplies were stored and locked away in the kitchen below the sink. Bedrooms: There are four (4) bedrooms designated for residents' use. Bedroom #1 and bedroom #3 are private and is used for residents only. Bedroom #2 and bedroom #4 are shared. The resident bedrooms were properly furnished with appropriate dresser, beddings, and linens with sufficient lighting and closet space. BATHROOMS: The facility has two bathrooms. Bathroom #1 is located by bedroom #1. Bathroom #2 by the hallway in between bedroom #1 and bedroom #2. Hot water in both bathrooms measured between 105 to 107 degrees Fahrenheit. The bathrooms were observed to have the proper fixtures, grab bars, and non-skid mats. Common Areas: LPA toured all common areas of the facility. These included the living room and dining area for residents. The common areas were properly furnished. Residents dining table fits enough for six (6). LPA observed common areas to be very clean and tidy. LPA observed the floors to be in very good condition. No obstructions and or tripping hazards throughout the facility. Furniture in common area was observed to be in good repair. There are no issues with Fire Clearance. Surrounding Grounds: Entry and exits were free of obstruction. There was furniture appropriate for outdoor use. The outdoor area was free of hazards. The facility does not have a swimming pool or bodies of water. The garage is detached and is converted into a storage. Laundry: Laundry area is located in the garage. There is enough linen available to change weekly or more if need. Cleaning supplies and detergents stored in the garage. Medications: LPA observed medication in the kitchen cabinet to be locked and inaccessible to residents. Medications and medication records were reviewed for proper storage and documentation. Client records: Client records are reviewed. Client records appear to be complete and updated. Staff records: LPA conducted a complete file review of staff records. Staff records appeared to be complete and updated. Pursuant to Title 22 Division 6 of the CA Code of Regulations, there were no deficiencies observed during the day's inspection. Staff is advised and a copy of this report issued.the state’s words, verbatim · CDSS document, Apr 18, 2026

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Leslie Ngo-Castaneda conducted an annual required visit and inspection of the facility. LPA was greeted with staff Jesse Phillips and was advised for the reason of the visit. At 8:45 AM Christine Loyola who is the administrator met with LPA, explained the reason for the visit. At 8:20 AM, with the assistance of designee, LPA took a tour of the physical plant. Required postings were observed in the entry area. The smoke alarms are operational that are located each bedroom, the hallway and kitchen. There are carbon monoxide detectors that functions properly. The fire extinguisher is in the kitchen. The charge date is 1/20/2025. During the visit the facility is at 71 degrees Fahrenheit. The facility is fire cleared maybe for six (06) non-ambulatory residents. Hospice waiver for three (3); two (2) maybe bedridden bedroom #2. Kitchen: The kitchen appliances and fixtures were functional. The kitchen has a working gas stove, faucet, freezer, refrigerator, and microwave. LPA found enough at least two (2) days perishable and seven (7) days non-perishable food at the facility that is properly stored. Frozen foods are wrap, dated, and stored properly as well. Knives were stored in a locked drawer in the kitchen. Food storage and preparation areas are clean and inaccessible to pests. Garbage cans have tight fitting covers. Cleaning supplies, pesticides or toxic cleaning supplies were stored and locked away in the kitchen below the sink. Bedrooms: There were four (4) bedrooms designated for residents' use. Bedroom #1 and bedroom #3 are private and is used for residents only, the bedrooms were properly furnished with appropriate dresser, beddings, and linens with sufficient lighting. Bedroom #2 and bedroom #4 are shared. Continue to LIC 809-C BATHROOMS: The facility has two bathrooms. Bathroom #1 is located by bedroom #1. Hot water measured at 105.6 degrees Fahrenheit. Bathroom #2 by the hallway in between bedroom #1 and bedroom #2. Hot water measured at 109.2 degrees Fahrenheit. The bathrooms were observed to have the proper fixtures, grab bars, and non-skid mats. Common Areas: LPA toured all common areas of the facility. These included the living room and dining area for residents. The common areas were properly furnished. Residents dining table fits enough for six (6). LPA observed common areas to be very clean and tidy. LPA observed the floors to be in very good condition. No obstructions and or tripping hazards throughout the facility. Furniture in common area was observed to be in good repair. There are no issues with Fire Clearance. Infection control: Facility mitigation plan to make sure licensee was following current infection control recommendations. LPA obtain a copy and reviewed the infection control plan during this visit. Surrounding Grounds: Entry and exits were free of obstruction. There was furniture appropriate for outdoor use. The outdoor area was free of hazards. The facility does not have a swimming pool or bodies of water. The garage is detached and is converted into a storage. Laundry service: There is enough linen available to change weekly or more if need. Cleaning supplies are being stored in a locked cabinet in the laundry area and is located in the garage. Staff Files: LPA also conducted a file review of staff records to ensure forms and training are up to date and compliance with licensing forms. Office is located in the living room. Records were checked for expired or missing certificates and clearances: LPA conducted a file review of staff for criminal record clearances and current First Aid. The administrator file was reviewed for current first aid, fingerprint clearance, administrator certificate, and HIV/AIDS and TB training. Continue to LIC 809-C Medications are in a centrally stored and locked place, including over-the-counter medicines; medications are properly labeled and checked for expiration dates. Each centrally stored prescription and PRN medication has been logged in the medications log with proper documentation from the clients’ doctor. Upon reviewing residents medication. LPA found R1 to have a surplus of medication (VItamin D). Deficiency will be cited on LIC 809-D. Proper medication dispensing instruction are NOT followed and checked for contamination. First-aid has all proper items and is current. Resident records were reviewed for requirements and legibility: LPA reviewed client’s files for current appraisal. Planned activities are offered. Facility is within CA code of Regulations Title 22 or Health and Safety Code. No deficiencies were found, exit interview conducted, copy of report has been issued and discussed.the state’s words, verbatim · CDSS document, Apr 2, 2025

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Gary Tan conducted an unannounced visit at this facility for a One (1) year Required visit. LPA met with staff Virgilio Goze who called the administrator Christine Loyola and explained the purpose of the visit. Ms. Loyola arrived twenty (20) minutes later. A tour of the physical plant was conducted at 3:18 PM. The facility has five (5) bedrooms and two (2) bathrooms currently occupying six (6) residents on two (2) private rooms and two (2) shared room. One (1) bedroom is designated for staff use. The facility fire cleared for six (6) non-ambulatory residents, two (2) of which may be bedridden in Room #2. Hospice waiver for three (3) residents. There is only one entrance being utilized at the facility, there are required poster posted at the main door. Screening area is located immediately upon entrance. Sign in sheet, hand sanitizer, gloves and masks are available. The facility had submitted and approved Mitigation plan and Infection plan. Physical environment was checked for cleanliness and condition. Walls, windows, ceilings, floors and floor coverings, and doors were checked, the following was noted: Living and dining room furniture were also checked. The living room is neat and clean along with the family room. The facility maintains a comfortable temperature at 75°F. The carbon monoxide and smoke detector are tested and observed to be operational. Smoke detectors are hardwired and interconnected. Fire extinguisher was observed to be full and last inspected on 01/27/24. The backyard of the facility has outdoor furniture, with a covered shaded area for clients. There is no body of water at the facility. (continued on LIC 809-C) (continued from 809-C) The Garage is attached to the house and currently being used as old equipment, PPE and laundry area. The garage was observed to be locked during visit. Food Service/Kitchen area was sufficiently stocked with two (2) days perishable and seven (7) days non-perishable food. Frozen foods are properly wrapped and stored appropriately. Food storage and preparation areas are clean and inaccessible to pests. Cleaning supplies, pesticides and other toxins are stored in a kitchen cabinet and observed to be locked and inaccessible to residents. The Clients' rooms are adequately furnished with appropriate furniture and lighting system. Clients have sufficient amounts of personal hygiene products on each bathroom which is provided by the licensee. Staff Rooms: Staff rooms was locked. No medications are observed in the staff room. The bathrooms were checked for cleanliness and proper operation. LPA observed the appropriate grab bars for each toilet, bathtub and shower. The hot water temperature measured at a range of 105.9°F to 109.2°F. There is sufficient supply of clean linen available in stock at the cabinet. Medications: LPA observed medication in the kitchen cabinet to be locked and inaccessible to residents. Medications are listed on the centrally stored medication and destruction record. Complete first aid kit is readily available. Client records: Client records are reviewed. Client records appear to be complete and updated. Staff records: LPA conducted a complete file review of staff records. Staff records appeared to be complete and updated. Disaster drill was last conducted on 05/09/24. Required posting observed in facility (complaint hot line poster). Exit interview conducted and copy of this report issued.the state’s words, verbatim · CDSS document, Aug 2, 2024