Helping Hands Care Home

Allegation investigated: Staff do not safeguard resident’s belongings.

On 8/5/2026 at 9:45 AM Licensing Program Analyst (LPA) Reza Jamaly arrived unannouced at the facility to deliver the compliant investigation findings for allegation noted above. LPA met staff on duty Alecia Allen and explained the purpose of the visit. Later on LPA talked to Administrator Sylvester Okoro on the phone and shared the investigation findings. To investigation the allegation, LPA Jamaly conducted interviews with Reporting Party (RP), Resident 1 (R1), Resident 2 (R2) and facility Administrator (AD) Sylvester Okoro, made observation of the facility and reviewed records. During the interview, RP stated that two and half years ago (RP states conflicting information, sometimes says it was two years ago, when LPA said you were not here two years ago, PR stated that it was 12 months ago), I was in a drug induced sleep and in coma, R1 thought I was dead. R1 took my wallet out of my pocket and stole $6443 in 100 dollar bills and R2 my roommate got $3700 of the money from R1 and R1 told R2 not to say anything with anyone. Continues on LIC 9099C on page 2 Unsubstantiated Page 2 R2 returned the stolen money to R1 and stated that R2 did not want to do anything with it. Per RP, R1 confronted with this and thought RP was dead and later commented that RP isn't supposed to have any money because RP is on a conservatorship. RP also stated that I shared the issue with Staff 1 (S1). LPA Jamaly made a phone to S1 on 8/5/2026 and asked if RP shared any concerns regarding money in the past, S1 denied the claim and stated that RP didn't have cash to be stolen and no one was complaining about money when I was there. LPA asked if any other resident shared complaint about stealing money? S1 stated no. S1 added that RP was on a conservatorship and RP was asking us in the past to call RP's conservator, we tried multiple times but conservator was not reached. LPA asked reason for the attempted call, S1 stated I don't know, RP was asking us to call RP's conservator and RP wanted to talk to conservator. RP also stated that R1 stole my bank statement. LPA asked how RP knew R1 stole your money while you were on coma, RP stated when I got out of coma, I saw my money was stolen and its not in my wallet. LPA Jamaly interviewed R1 asked about the allegation, R1 stated that what? $ 6443 from RP?, RP never had such amount of money, RP wants to get attention, RP is dealing with court, and has many problems, RP is smoking too much cigarettes, going in and out of room to the yard all day long smoking and sometimes laughing at himself. That claim is absolutely not true, I am here since Feb 2025 and I know RP very well, I caught him stealing my cigarette and my $100 four months ago. LPA asked how RP stole your money and cigarette, R1 stated that I was sleep, RP come into my room got my wallet and stole my money and cigarette, I woke up and got my money and cigarette back. LPA asked if R1 shared the issue with staff, R1 stated yes, I shared with the S1 who was working here, but S1 is no longer here, I don't know if S1 shared with administrator or not. R1 also stated that I never been in RP's room more then two times in all times since I am here, RP's room stinks, RP and R2 are thieves, I did a lot to RP, gave cigarette to RP, ordered Uber, bought food and gifts in Christmas, now RP is claiming that I stole RP's money. R1 added that R2 has mental issue and never knows what is going on. Page 3 While asking questions, R1 was showing frustration and stated that i need to get out of this house, I need to talk to administrator. During the interview, R1 was talking about unrelated topic, R1 stated that this is my house, I paid cash, I got the paperwork. These people are here for short period of time. In another instances, R1 stated that I am a veteran, captain in Us navy. I am retired now. LAP Jamaly interviewed with Resident 2 (R2) on 7/22/2016. R2 is RP's roommate, LPA asked about the allegation, R2 stated I am not aware of anything, I don't do financing, I am living here since a year ago. LPA asked who is responsible for managing your financial, R2 stated that I am responsible for myself. I don't know what is going on. LPA asked if R2 know roommate and the name? R2 stated I don't know the name of my roommate but I know someone is here. LPA asked that RP claims that you got money $3700 from R1 which belongs to RP and you returned that money back to R1, is that true? R2 stated that who is RP? i don't know RP, I have difficulty remembering things and I never got money from anyone. During the interview with R2, R2 was forgetting previous questions and names. On 7/22/2026 LPA Jamaly interviewed with administrator (AD) Sylvester Okoro. LAP asked about the RP's claim in term of stealing RP's money by R1. AD stated that a while ago RP came to me and said my money is stolen, then later on RP told me never mind I might misplaced it or lost it, after that no body made any complaint about losing money. AD also stated that RP did not had any money when admitted to the facility, the way RP pays to the facility is that RP receives checks from Nevada County from social security, I take RP to the bank to cash the checks then pays to the facility, RP does not hold cash. AD added that we are not handling resident's cash just keeping RP's valuables such as IDs. When asked about R1, AD stated that R1 is not that kind of person. R1 formulate story and scenarios, if you be here for a while, you will notice such behaviors. Previously, R1 was telling that R1 has been in coma for 200 yeas, or another case, R1 was claiming that R1 is the owner of Uber company. Regarding R1 finance, AD stated that CPF sends around $500 to R1 debate card and R1 is using it for shopping, R1 is not holding cash. Page 4 LPA asked about R2 and if RP's claim regarding R2 being witnessed stealing RP's money by R1, AD stated that R2 doesn't know about finance and R2 is in his own world, R2 also doesn't hold cash, CPF send around $500 to R2's debit card, I drive R2 to store to buy what R2 needs. AD added that RP and R1 has dementia but their physician didn't diagnosed them with dementia, which should. LPA Jamaly reviewed records for RP, per LIC 601, Nevada County Public Guardian is listed as placement agency. LPA attempted to contact to two Responsible Parties listed on LIC 601 but they were not reached. Per LIC 602 RP is not able to manage own cash resources, can manage small sums. LPA reviewed facility Theft and Loss Policy dated 10/3/2024 signed by RP, it reads" We suggest that valuables not to be brought to the facility such as .. jewelry, cash and ... facility can not be responsible for valuables. Based on LPA observations, interviews conducted, and records reviewed, the preponderance of , the preponderance of evidence standard is not met, and this allegation is UNSUBSTANTIATED. A finding of unsubstantiated means the allegation may have happened or is valid, but there is not a preponderance of the evidence to prove that the alleged violation occurred. An exit interview was conducted with Administrator, and a copy of this report was provided.the state’s words, verbatim · CDSS document, Aug 5, 2026 · control 27-AS-20260716163836

Type of visit: Case Management - Other

Licensing Program Analyst, Noel Wolf Petersen, arrived to the facility at 9am to deliver an amended report for a Previous complaint. LPA met with staff Alecia Allen, who was designated by the administrator over the phone to explain the purpose of the visit and recive related paperwork. The text of the amended report is unchanged, just that the investigation report should have been marked as public after it was completed. Physical inspection of the facility was conducted. There is a current sensus of 4. 2 Residents are responding postively to questions about their care. 1 Staff is responding postiviely to questions about adequate resources in the facility. LPA reviewed a LIC 500. LPA gave guidance that Staff scheduling and administrator presence appear to be roughly the same as before the complaint, and those circumstances may contribute to issues in the future. Two Technical assistances were issued, 87405(a) and 87411(a), as related to the most recent complaint. 87405(a) relates to the adequate presence of the administrator, 87411(a) relates to the adequate presence of the staff. A copy of this report was left with the staff, a copy will be emailed to the administrator on the email attached to the facility file. Exit interview was conducted.the state’s words, verbatim · CDSS document, Jun 17, 2026

Allegation investigated: Staff zip ties doors causing a safety hazard. Staff mismanaging residents medications. Staff do not refill residents medication prescription in a timely manner.

**This report is ammended, originally designated as confidential but now corrected to be public. Text of this document is unchanged.** Licensing Program Analyst, LPA Noel Wolf Petersen arrived unannounced to the facility 10am to open an investigation in to the above allegations as a complaint. LPA met with designated signatory Valeisa Cole and later sylvester okoro by phone to explain the purpose of the visit. Physical inspection was conducted to investigate the zip tie situation of the doors. no doors were zip tied at the time of the physical inspection. Physical inspection had some locked food, no posted facility sketch with evacuation route, and no mattress encasements. One of the clients was doing some wandering behaviors, singing. LPA interviewed 2 residents, and 2 staff. consensus statement is that, a ziptie was used at least once to secure a door, the explination provided by staff is that a resident was expressing some behaviors while the staff on shift needed to use the bathroom, leading to a situation where a lack of staff necessitated a temporary restriction of the client's movement for thier own safety. LPA was shown five pictures of a door that seperates the resident rooms from the common area with zipties securing the door, the ties appear to be in different orientations and lengths indicating multiple times the door was ziptied. Continued on c Page. Substantiated LPA gave guidance that the staff should not be introducing obstructions to accessing the emergency exit, the facility should be assessing if it has the necessary staff to meet the needs of the clients instead. In regard to medication mismanagement, in interviews with staff and clients, a consensus statement was reached that an error was introduced back in late december/early january, where a staff seemingly distributed a PRN medication as a daily medication. As the client had a very limited supply of that medication he was anxious about not having it if he needed it. that staff was let go, since the incident. The facility staff provided that the experinced staff was on vacation leave during this period, but had gone through an extensive medication audit recently where this error was discussed with the ombudsman. Record review of the MARs by the LPA for the client indicated above had a period of 2 weeks where a drug went from prn to twice daily at some point in late december/ early january, and the majority of days it was not given and some days given at half dose. none of the required documentation exists for distributing it as a prn exists from this two week period. Staff recalled a second situation that two medications not being refilled causing a gap in medication being delivered as perscribed 3/16/26 to 3/19/26, they brought the med refill issue to pharmacy, who introduced a delay where the doctor had an appropriate amount of time, but the doctor was having trouble signing into his online prescription pad delaying the medication filled and arriving to the pharmacy. LPA asked the staff in that situation to document what thier attempts were and follow up to those attempts. Staff did not take down documentation in that instance, but resolved to do so in the future. LPA notes these incidents are related to a staff in a situation where there is not significant support from the administrator in the form of scheduling an adequate amount of staff for break relief and not sufficent training in medication administration for the staff. One resident claimed to only have seen the administrator twice in four months. Based on LPAs observations and interviews which were conducted and record review(s), the preponderance of evidence standard has been met, therefore the above allegation(s) is found to be SUBSTANTIATED. California Code of Regulations, is being cited on the attached LIC 9099D.) Citations are issued as part of this visit. A copy of the report was read and given to the designated signatory of the administrator, a digital copy will be emailed to the address on file. appeal rights provided, exit interview was conducted.the state’s words, verbatim · CDSS document, Apr 8, 2026 · control 27-AS-20260402121455

From the deficiency page — Deficiency type: Type A · Section cited: CCR 80072(a)(7) · Plan of correction due date: Apr 9, 2026

80072 Personal rights (a) Except for children’s residential facilities, each client shall have personal rights which include, but are not limited to, the following:(7) Not to be locked in any room, building, or facility premises by day or night. This requirement was not met as evidenced by: interview with staff and clients where a ziptie is being used to lock a room in the facility, record review of 5 photos where zipties are being used to lock a door in the facility. not Following this requirement poses a risk to the health, saftey, and personal rights of a client.the state’s words, verbatim · CDSS document, Apr 8, 2026

Plan of correction: LIC 500 will be sent to the LPA, to include adequate staff for supervision for break relief/at night by end of day on the POC date

From the deficiency page — Deficiency type: Type B · Section cited: CCR 87465(a)(1) · Plan of correction due date: Apr 29, 2026

87465Inc idental 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: (1) The licensee shall arrange, or assist in arranging, for medical and dental care appropriate to the conditions and needs of residents. This requirement was not met as evidinced by: Staff interview where staff claim they could not assist a client as necessary(refill medication) due to pharmacy/doctor action, the facility lacks documentation to support the claim, staff interview where ex-staff of the facility are claimed to have given a PRN as a regular medication instead of on an as needed basis, required PRN documentation for this period was not done and could not be reviewed. not following this requirement posed a risk to the health saftey and personal rights of clients in care.the state’s words, verbatim · CDSS document, Apr 8, 2026

Plan of correction: No Immediate POC, employee was let go, LPA asked that a signed afadavit of 87465 be sent to the LPA by the poc date

From the deficiency page — Deficiency type: Type B · Section cited: CCR 87405(a) · Plan of correction due date: Apr 29, 2026

87405 Administrator - Qualifications and Duties (a)...The administrator shall have sufficient freedom from other responsibilities and shall be on the premises a sufficient number of hours to permit adequate attention to the management and administration of the facility as specified in this section. When the administrator is not in the facility, there shall be coverage by a designated substitute who shall have qualifications adequate to be responsible and accountable for management and administration of the facility as specified in this section... This requirement was not met as evidenced by: A consensus statement from staff and clients they see the administrator less than 20 hours a week. Record review of at least one dementia client with a needs and services plan not being updated in the last year. Not following this requirement posed a potential risk to clients health, saftey and personal rights.the state’s words, verbatim · CDSS document, Apr 8, 2026

Plan of correction: LPA gave guidance the Administrator should get around 20 hours of administrator tasks a week, if thats going to be in addition to providing care, more hours would be approprite. sign an affadavit of understanding for section 87405 by the poc date.

Allegation investigated: Staff did not dispense medication to resident as prescribed.

Licensing Program Analyst (LPA) Sommer Hayes arrived unannounced to deliver findings on this complaint investigation. LPA Hayes met with Designated Facility Administrator, Valesia Cole and explained the purpose of the visit. The census is 6. This investigation consisted of observation, interviews, and records review. Designated Facility Administrator Valesia Cole was interviewed, residents R3, R4 were interviewed and a record reviewed for R1 and R2. First allegation: Staff did not dispense medication to resident as prescribed. The investigation into this allegation consisted of interviews and record reviews of relevant documents. A review of R2’s prescription record dated 4/18/2025 shows that Melatonin 3mg was ordered, with directions to take two tablets by mouth daily at bedtime. However, a review of R2’s medication administration records (MARs) show multiple missed doses. Continued on 9099-C Substantiated In May 2025, Melatonin was not given on five different dates 5/25/25, 5/26/25, 5/27/25, 5/28/25,5/30/25 and 5/31/25. In June 2025, Melatonin was not given for 11 days in a row (6/1/25, 6/2/25, 6/3/25, 6/4/25, 6/5/25, 6/6/25, 6/7/25, 6/8/25, 6/9/25, 6/10/25 and 6/11/25 In July 2025, it was not given for 9 days in a row. 07/01/25, 07/02/25, 07/03/25, 07/04/25, 07/05/25, 07/06/25, 07/07/25, 07/08/25 and 07/09/25. Melatonin was not given on the following dates as evidence by the absence of staff initials and/or check marks used to indicate medications was given to R2. During a medication review and interview on 7/30/2025 with LPA Arvin Villanueva and Designated Facility Administrator, Valesia Cole it was noted that the Melatonin on hand was 5mg tablets (photo taken), reported cutting the tablets in half, making the dose 2.5mg. The prescription records do not show an order to cutting the medication. Staff member also admitted they were not sure if the medication was given on the days left blank on the MARs. Staff explained that sometimes R2 did not receive Melatonin if R2 was already too sleepy from other medications, and that a family member instructed staff to hold the Melatonin under those conditions. However, the prescription order dated 4/18/25 does not state that the medication may be held for any reason. LPA Hayes attempted to interview R2, the resident was not cognitively available to participate in an interview. The evidence shows staff did not consistently follow the physician’s order for R2’s Melatonin, and medication was either missed or altered without physician’s authorization. Therefore, the allegation is SUBSTANTIATED. This facility is being cited per Title 22 CCR Section 87465(c)(2). An exit interview, appeal rights and a copy of this report was left with Valesia Cole.the state’s words, verbatim · CDSS document, Dec 24, 2025 · control 27-AS-20250410153909

From the deficiency page — Deficiency type: Type A · Section cited: CCR 87465(c)(2) · Plan of correction due date: Dec 26, 2025

87465 (c) (2) (c) If the resident's physician has stated in writing that the resident is unable to determine his/her own need for nonprescription PRN medication but can communicate his/her symptoms clearly, facility staff designated by the licensee shall be permitted to assist the resident with self-administration, provided all of the following requirements are met: (2) Once ordered by the physician the medication is given according to the physician's directions. This was not met as evidence by: Based on interviews and observations, staff is not administering medications as prescribed by resident’s physician.the state’s words, verbatim · CDSS document, Dec 24, 2025

Plan of correction: By the Plan of Correction (POC) due date, the Licensee/Administrator email LPA Sommer Hayes with a training plan to sommer.hayes@dss.ca.gov. Including training dates and staff who will attend. This training will ensure that all staff who assist with medication administration receive updated training on proper medication administration practices to ensure that medications are administered in a timely manner and in accordance with each resident’s physician’s orders. After training is complete, Licensee/Administrator will email sommer.hayes@dss.ca.gov with training curriculum, training instructor and proof of attendance by staff.

Type of visit: Case Management - Annual Continuation

Licensing Program Analysts (LPAs) Sommer Hayes and Arvin Villanueva conducted an unannounced Case Management- Annual Continuation visit today, 9/10/2025, to continue with the Annual visit initiated on 07/30/2025. LPAs met with The Designated Facility Administrator (DFA) Valesia Cole and a brief interview followed and LPAs stated the purpose of this visit. The LPAs continued with the facility visit to ensure there are no health and safety hazards and facility is in compliance with Title 22 Regulations. LPAs conducted a facility walk-through including the garage, front and backyard. LPAs observed similar deficiencies during this visit. This facility was cited on 04/20/2025 for Fire Clearance--not being in compliance with the fire clearance as the rooms are being used differently that what is indicated on the sketch provided to the fire inspector. The plan of correction was not received by LPA Hayes by the indicated due date. Per the California Code of Regulations, Title 22, Division 6, Chapter 8, deficiencies are being cited today and advisories were given. In addition civil penalties are being assessed. Exit interview was conducted and a copy of the report was provided to DFA Valesia Cole upon exit.the state’s words, verbatim · CDSS document, Sep 10, 2025

The state marks this report as 11 pages; the online copy we transcribed has 7. You can request the full file from the county licensing office.

Type of visit: Case Management - Deficiencies

On 04/18/25, Licensing Program Analyst(s) Sommer Hayes and Kimberly Viarella arrived unannounced to open an initial 10-day complaint investigation visit and observed deficiencies to be addressed on a case management visit. Upon arrival, LPAs met with Caregiver (S1) and stated the purpose of the visit. The caregiver contacted the Administrator Sylvester Okoro (Administrator) regarding today’s visit. Administrator said he would be there in about an hour and a half and arrived 2 hours later. The following deficiencies were observed when opening the complaint on 04/18/25. A walk through was conducted with S1 and LPAs observed that the non-ambulatory resident room with a capacity of 2, is now being used as a live-in staff room. This room was not cleared by Fire for staff use and is also the only bedroom that has immediate access to an exit and bathroom. An immediate civil penalty will be accessed in the amount of $500. Based on observation, file review and document review LPAs cited for a violation of fire clearance, 87202(a). Please refer to report dated 4/18/2025 for regulation citation. LPAs spoke to 3 care staff; (S1, S2, and S3) none were associated to this facility. LPAs cited for the following civil penalty. LPAs cited for this deficiency on the LIC 9099-D page and civil penalties were assessed on the LIC 421D in the amount of $1500.00, for background clearance, 87355(e)(3). Please refer to report dated 4/18/2025 for regulation citation. Due to technical difficulties LPAs were unable to print the 421IM and 421BG on 4/18/2025. This report is reflective of issuance of the Immediate Civil Penalties and have been cited on the 4/18/2025 complaint investigation report, which was documented in error of a Case Management visit.. A copy of this report was provided along with appeal rights, and an exit interview was conducted.the state’s words, verbatim · CDSS document, Jul 30, 2025

Type of visit: Required - 1 Year

On 07/30/25, an unannounced annual inspection was made to this facility by Licensing Program Analyst (LPA) Sommer Hayes. The LPA identified themselves and the purpose of the visit and asked to speak to the Designated Facility Administrator (DFA). LPA was met by DFA Valesia Cole and a brief interview followed. LPA was allowed entry into the facility that is licensed to serve a total capacity of 6 residents. The current census is 6. This facility is licensed for 6-non ambulatory residents and a hospice waiver granted for 2. LPA Hayes observed the refrigerator to be locked with a black bike lock. A fire drill was held on 05/26/25 at 2pm for 1 hour. The drill included 3 staff and 6 residents. LPA toured the facility with the DFA, Valesia Cole. The kitchen was accessible to residents and clean and sanitary. The LPA observed 7 days of non-perishable food supplies and did not observe 2 days of perishable food supplies. There were enough clean plates, cups and bowls and cutlery to meet capacity. LPA observed opened packages and storage containers with food items in the refrigerator were not dated appropriately. LPA observed a glass top stove in the kitchen. The bottom left “eye” was shattered. DFA stated the homeowner will be replacing the range. The garage was not accessible to residents. LPA observed non-perishable food items, a freezer with frozen food and other storage items. The garage was clean and sanitary. Continued on an 809-C LPA observed a malodorous odor in R2’s room. The facility living room was clean and free of obstruction. The temperature reading was 75 degrees Fahrenheit per Title 22 regulations. The seating is efficient for the number of residents in this facility. There was a fire extinguisher, smoke and carbon monoxide detectors, and central heating and air in the facility. LPA observed the centrally stored medications area to be locked and inaccessible to residents. The Medication Administration Record (MAR) was reviewed. LPA Hayes observed that R4’s melatonin medication did not have a prescription. Through staff interview this medication has been given to the resident. In addition, R3’s melatonin prescribed to be given at 3mg and through an interview with staff LPA learned that 5mg was being cut in half by staff and given to the resident. LPA reviewed 6 resident records and 2 staff records. LPA Hayes found the review of staff records to be missing required documents and incomplete. During the review of the resident records there was no documentation that the facility reported an AWOL, and a fall to the Department based on an interview with staff. LPA observed the residents’ bedrooms. There were three double occupancy rooms. LPA Hayes observed R5 and R3’s room did not have sufficient lighting. LPA Hayes observed each resident room to be without a chair, an individual night stand for each resident and a chest of drawers for each resident. LPA observed the backyard of the facility. There was a shaded area with an awning for residents to enjoy. Fencing was in good repair. The fence on the left side of the house was locked with a key lock. There were no bodies of water. LPA observed a hose that was left out in the walkway leading to the garden boxes. This could pose a tripping hazard to residents in care. Facility corrected this at the time of the visit. Based on today’s visit this Annual needs continuation. Exit interview completed with DFA and a copy of this report was provided to the DFA, Valesia Cole.the state’s words, verbatim · CDSS document, Jul 30, 2025

Type of visit: Prelicensing

On 8/20/24, at 10am, Licensing Program Analyst (LPA), Arvin Villanueva conducted an announced inspection to the above facility for purpose of a pre-licensing evaluation. An application was submitted to Community Care Licensing Department (CCLD) on 7/18/23, for an Initial license for a Residential Care for the Elderly. The requested capacity is for 6 residents (ambulatory/non-ambulatory). LPA was greeted and accompanied on inspection by the Administrator, Sylvester Okoro. At 10:25am, LPA and Administrator inspected the physical plant. Facility is a single-story house located in a residential neighborhood. Facility has 4 resident bedrooms, 2 resident bathrooms, living room/dining room kitchen, garage, and outdoor living space equipped with automatic awning. Additionally, fence and gates were observed to be in good repair. Outdoor passageways, walkways, driveways, and steps are free from obstructions. LPA did not observe hazards, such as ladders, gardening tools and/or motorized equipment in the front, back and/or side areas of the facility. LPA observed a fire door leading to the hallway to the resident bedrooms and bathrooms. Resident's Personal Rights, Resident Counsel, and Let Us Know posting in main area accessible to all residents, family, visitors, and staff. Residents' Bedrooms: LPA observed 4 resident bedrooms. The resident bedrooms are spacious and will easily accommodate the resident's furnishings. Bedrooms were observed to be equipped with a night stand, overhead lighting/fan, closet or wardrobe and a dresser with several drawers. All drawers comply with the requirement of 8 cubic feet of space and there was ample closet space. Bathroom: Facility has 2 resident bathrooms. One of the bathrooms is located in master bedroom. All bathrooms have working toilets, wash basins and full baths and showers. Both bathrooms are equipped with grab bars, non-skid mats and close-lid garbage cans. LPA observed adequate lighting in hallway leading to bathrooms via nigh lights. {Con't on LIC809-C} Linens & Hygiene Supplies: Beds have the required linen/supplies which include, pillowcases, mattress pads, fitted sheet, blanket and bedspreads. Adequate supply of linen and hygiene supplies stored in linen closet, which is at end of the hall between the bedrooms. Emergency Phone Numbers, Exit Plan & Menu: The facility will have a landline be installed as per Administrator. One fully charged fire extinguisher were found in hallway located in the kitchen by the door to the garage. Fire extinguisher was last serviced on 8/29/23. Toxins: Toxins locked/stored under kitchen sink and are inaccessible to residents. Water temperature: Water temperature in both bathrooms measured between 110* F and 114* F. Hot water in the kitchen faucet was measured at 121*F. Administrator printed a warning sign to be placed at the kitchen area. Food Service: Dishes, cups and flat ware are stored in the kitchen cupboards, inspected and in good repair. Knives, cutlery and other sharp kitchen utensils are in locked. Food supply was adequate and stored in kitchen refrigerator and cabinets. Smoke Detectors and carbon monoxide: LPA observed smoke/carbon monoxide combo detectors in all resident bedrooms, hallway and kitchen area. They were tested and found to be operable during this visit. Appliances: Stove burners and oven are in good working condition. Refrigerator/freezer in the kitchen was inspected and within regulatory temperatures measure at 35*F/0*F. Washer and dryer are located in the garage. Medications, First-Aid Kit & Book: First aid kit has been inspected. Technical assistance was provided for Administrator to purchase current edition of the first aid manual and thermometer. First Aid kit was observed to be stored in the kitchen area, available for staff use. {Con't to LIC809-C} Residents & Staff Files: Licensee will not be handling cash resources of residents at this time. Records of staff and residents shall be stored in a locked kitchen cabinet accessible to staff. Reading Material, Games, Equipment & Materials: The facility has games and reading materials at this time but will be purchasing more activity materials in the future. Outside activity area is properly enclosed. Pool/Jacuzzi & Pets: LPA did not observe any pets or bodies of water at the facility. Component III: Conducted at the Pre-Licensing visit, on 8/20/24 at Helping Hands Care Home, information provided about how to operate the facility within substantial compliance. Pre-Licensing is complete, and this facility has no deficiencies. Accordingly, LPA Villanueva will submit a copy of this facility evaluation report to the Central Applications Bureau (CAB) for review. If the applicant has questions regarding the status of the application, they have been instructed to communicate with the CAB Analyst assigned to their application. An exit interview was conducted with Sylvester Okoro, and a copy of this report was provided.the state’s words, verbatim · CDSS document, Aug 20, 2024

The state marks this report as 9 pages; the online copy we transcribed has 3. You can request the full file from the county licensing office.

Type of visit: Office

Component II completion: Successful Facility Type: RCFE Application Type: INITIAL Capacity: 6 Census (if any clients in care): 0 COMP II Participants: Name - Sylvester O. Okoro CEO/Administrator Interview Method: Telephone interview On August 12, 2024, 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. During COMP II, CAB analyst confirmed Applicant/Administrator’s understanding of the 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, Aug 12, 2024