Haskell Gardens Senior Living

Type of visit: Prelicensing

Licensing Program Analyst (LPA) Tihesha Smith conducted an announced pre-licensing visit at this facility at 10:00 am. The licensee/administrators’ identity were verified by CA photo ID. The facility has a capacity of six (6). Purpose of today’s visit is to inspect the facility to ensure that the facility is following the rules and regulations of California Code of Regulations, Title 22, Division 6. The facility is a single-story building with 9 bedrooms and four (4) bathrooms, 8 bedrooms #2-#9 cleared for bedridden. One (1) or two (2) rooms to be used as staff/administrators office. Today's site visit consisted of LPA Smith touring the physical plant inside and outside and the following was observed: The common areas (kitchen, living room, and dining areas were appropriately furnished, and lighting was adequate. The living room has a television and comfortable furniture. Games and activities for residents are stored on the bookshelf in the living room near the television. There are eight (8) wall attached fire extinguishers throughout the inside and outside of the facility and all were observed to be new and fully charged. Dual Smoke and Carbon Monoxide detectors were observed all over the facility, tested, and observed to be operational at time of visit. The facility has posting requirements on the wall in the living room and in the administrators’ office The facility has some non-perishable food with emergency supply water/food in the kitchen and in the garage. Appliances in the kitchen were new. (Continued to 809C) (cont from 809) The medication and sharps are to be stored and locked in the kitchen cabinet near the stove and toxins are stored under kitchen sink cabinet and in the locked laundry room. There are three (3) first aid kits, two are in the administrator’s office and one (1) is stored in the kitchen. Laundry room is located near bedroom # 4. The laundry appliances observed to be new with linens stored in the cabinets above the appliances. Staff and residents’ files to be stored in the administrator’s office. The bedroom showroom was appropriately furnished with lamp, nightstand, dresser, closet and chair. All other rooms have furniture items except the dresser will provide proof of purchase. There are four (4) bathrooms in the facility with one (1) of the bathrooms located inside a bedroom. One (1) of the four (4) bathrooms will be used as a staff bathroom. The hot water was tested for the bathrooms and measured 118-119.6°F. Due to the facility water heater being commercial grade maintenance was contacted and water temperature adjusted to meet licensing standards. Bathrooms have trash cans, nonslip mats and functional grab bars. There is no body of water at the facility. Courtyard space in center of home observed to be clear and no hazards observed Backyard has large gazebo with sufficient seating and is in good repair. The attached garage will be used for facility storage. Component III presentation completed during visit and administrator acknowledged understanding. The following were discussed during the visit: · Additional structures on back of property: one will be used as administrator quarters and all not part of the facility. Administrator notes pending fence construction and separate access. Separate access verified at time of visit. At this time licensing regulations are be followed. Copy of this report will be forwarded to the CAB specialist.the state’s words, verbatim · CDSS document, Aug 20, 2026

Type of visit: Office

Facility Type: RCFE Application Type: Initial Capacity: 6 Interview Method: Telephone interview On 5/29/2026, applicant/administrator participated in COMP II. Identification of the applicant / administrator was verified through interview questions based on photo ID and other identifying personal information. During COMP II, applicant / 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. 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, May 29, 2026