Heavenly Care

Type of visit: Required - 1 Year

On 07/23/26 at 1PM, Licensing Program Analyst (LPA) D Panlilio arrived unannounced to conduct an annual required inspection. LPA met with staff (S1) and spoke to administrator on the phone who authorized S1 to act on her behalf and sign the reports. LPA explained the purpose of the visit with ADM and S1. ADM has current administrator certificate# 7000732740 which expired 04/19/27. At 1:15PM, LPA inspected including, but not limited to, living room, bathrooms, bedrooms, kitchen, dining area, garage and outside areas. Facility has four (4) bedrooms and three (3) bathrooms. One bedroom and one bathroom designated for staff use only. 2 day perishable and 7 day non-perishable food supply available. Sufficient lighting and furnishing observed. Ample linens and toiletries available. Medications, toxins and sharps stored locked. There were no bodies of water present during inspection. Facility maintained a temperature of 74 degrees, F. Hot water temperature in a resident's bathroom measured at 119 degrees, F. Carbon monoxide detector, fire extinguisher and smoke detectors observed operational and fully charged. LPA reviewed 2 staff and 5 resident files. Licensee does not handle resident's cash resources. Updated copies of the following documents were obtained during visit:  LIC500- Personnel Report  Residents Roster  LIC308- Designation of Facility Responsibility  Evidence of Liability Insurance Continued on 809-C The following deficiencies were observed during visit: At 1:20PM, LPA observed open trash bins in R1, R2, R3's bedrooms At 1:45 PM, Emergency/Disaster plans including infection control plans not reviewed and signed for 2026 Deficiencies are cited per Title 22 California Code of Regulations and listed on LIC9099D. Failure to submit proof of correction (POC) by plan of correction due date and/or any repeat deficiencies within a 12-month period may result in civil penalties. Exit interview conducted. Appeal Rights and a copy of this report provided.the state’s words, verbatim · CDSS document, Jul 23, 2026

From the deficiency page — Deficiency type: Type B · Section cited: CCR 87470(5)(A) · Plan of correction due date: Aug 21, 2026

A tissue shall be disposed of in the nearest waste receptacle with a tight-fitting cover immediately after use This requirement was not met as evidenced by open trash bins used by R1, R2, R3 in their bedrooms whoch posed a potential health & safety risk to residents in carethe state’s words, verbatim · CDSS document, Jul 23, 2026

Plan of correction: By POC due date, ADM agrees to submit proof of purchase of trash bins with foot operated lid to CCLD in compliance with Section 87470 (5)(A) infection control regulations.

From the deficiency page — Deficiency type: Type B · Section cited: CCR87212(b) · Plan of correction due date: Jul 23, 2026

The plan shall be subject to review by the Department and shall include...(A thru G)... This requirement was not met as evidenced by Emergency/Disaster plan including infection control plan not reviewed and signed for 2026 which posed a potential health & safety risk to residents in care.the state’s words, verbatim · CDSS document, Jul 23, 2026

Plan of correction: By POC due date, ADM agrees to complete and submit to CCL copies of reviewed and signed Emergency/Disaster/Infection control plans in compliance with Section 87212 (b) regulations.

Type of visit: Required - 1 Year

On 03/12/25 at 4PM, Licensing Program Analyst (LPA) D Panlilio arrived unannounced to conduct an annual required inspection. LPA met with staff (S1) and spoke to administrator on the phone who authorized S1 to act on her behalf and sign the reports. LPA explained the purpose of the visit with ADM and S1. ADM has current administrator certificate# 7000732740 which expired 04/19/25. ADM stated her certification renewal is pending since she has submitted all required documents prior to the expiration date. At 4:15PM, LPA toured the facility including but not limited to the front entrance, screening station, kitchen, bathrooms, bedrooms and common areas. There is one central entry point for universal screening for staff, residents and visitors. A sign-in policy, visitor’s logs, no touch thermometer, additional face masks and hand sanitizers were observed at the screening station. Emergency Disaster Plan, Complaint poster, Personal rights, Cough/sneeze etiquette, proper hand-washing signs were observed posted in common areas. Facility has a sufficient 2-day perishable and 7-day non-perishable food supply. Facility has a 30-day supply of PPEs, paper, medications locked in cabinets. Comfortable temperature is maintained at 74 deg F. Hot water temperature was measured at 117 deg F. Facility has a mitigation plan in place and the infection control leader is the administrator. Inside and outside pathways were free of obstruction and fire hazards. Smoke and Carbon monoxide detectors were operational. LPA reviewed 2 staff and 5 resident files. Updated copies of the following documents were collected for facility file:  LIC500- Personnel Report  Residents Roster  LIC308- Designation of Facility Responsibility  LIC610E- Emergency/Disaster Plan including infection control plans  Evidence of Liability Insurance No deficiencies cited during visit. Exit interview conducted and a copy of this report provided.the state’s words, verbatim · CDSS document, Jun 20, 2025

Type of visit: Required - 1 Year

On 05/02/24 at 1:55PM, Licensing Program Analyst (LPA) D Panlilio arrived unannounced to conduct an annual required inspection. LPA met with staff (S1) and spoke to administrator (ADM) on the phone who authorized S1 to act on her behalf and sign the reports. LPA explained the purpose of the visit with S1 and ADM. At 2:20PM LPA toured the facility including but not limited to the front entrance, screening station, hand washing stations, kitchen, bathrooms, bedrooms and common areas. There is one central entry point for universal screening for staff, clients and visitors. A sign-in policy, visitor’s logs, no touch thermometer, additional face masks and hand sanitizer were observed at the screening station. Emergency Disaster Plan, Complaint poster, Personal rights, Cough/sneeze etiquette, proper hand-washing signs were observed posted in common areas. Facility has a sufficient 2-day perishable and 7-day non-perishable food supply. Facility has a 30-day supply of PPEs, paper, medications locked in storage cabinets. Comfortable temperature is maintained at 74 deg F. Hot water temperature was measured at 111 deg F. Facility has a mitigation plan in place and the infection control leader is the administrator. Inside and outside pathways were free of obstruction and fire hazards. Smoke and Carbon monoxide detectors were operational. Fire extinguisher was observed fully charged and last inspected on 04/12/24. LPA reviewed 5 staff and 5 resident files. LPA also conducted 2 staff and 2 resident interviews during visit. Updated copies of the following documents were obtained for facility file:  LIC500- Personnel Report  Resident Roster  LIC308- Designation of Facility Responsibility  LIC610E- Emergency/Disaster Plan including infection control plans  Evidence of Liability Insurance No deficiencies cited during visit. Exit interview conducted and a copy of this report provided.the state’s words, verbatim · CDSS document, May 2, 2024