Hope Haven

Type of visit: Collateral

Licensing Program Analyst (LPA) conducted an unannounced visit to amend a report issued to another facility managed by Licensee. LPA disclosed the purpose of the visit with Licensee Lizelyn Gonzales. During the visit, LPA and Licensee reviewed and signed the amended report. No deficiencies were cited in accordance with the California Code of Regulations. An exit interview was conducted with Licensee Lizelyn Gonzales, to whom a copy of this report, and the Licensee/Appeal Rights (LIC 9058 03/22) were provided. The signature below confirms the documents were received.the state’s words, verbatim · CDSS document, Jul 2, 2026

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Jose De La Cruz made an unannounced visit to conduct a Required Annual Inspection. The facility file was reviewed prior to the visit. LPA was welcomed by, identified himself to, and discussed the purpose of the visit with Licensee Lizelyn Gonzales. The facility's license shows a maximum capacity of six (6) non-ambulatory of which one might be bedridden and a waiver for 6 residents in hospice. LPA arrived at 1:00 PM to the facility, and requested residents records. At 3:20 PM, LPA and Licensee toured the facility’s interior and exterior, and inspected each residents’ rooms, as well as two bathrooms and a garage. The facility was clean, sanitary, and in good repair. Pathways were free of obstruction and slip hazards. Client bedrooms contained the required furnishings and were personalized by the clients. Doors, windows, screens, toilet, and shower were in working order. Extra linen and hygiene supplies were present, as well as Personal Protective Equipment which was found on the garage. The facility had sufficient space and equipment to facilitate dining, laundry, visitation, meetings, and client activities. The facility contained at least 2 days of perishable food, and at least 7 days of non-perishable food, all safely stored. Cooking, dining equipment, and utensils were present. Toxic chemicals, and sharps were found locked, however the lock was not working properly and Licensee changed locks during today's visit. LPA measured the water temperature in two bathrooms and the kitchen sink in Fahrenheit degrees: B1 114.8, B2, 114.8 kitchen 115.5. [CONTINUED ON LIC809-C] [CONTINUED FROM LIC809] Medications were labeled, as required, and stored in locked areas. No bodies of water or fireplaces are located on the premises. Per Licensee, no firearms or ammunition are kept at the facility. Carbon monoxide detectors, emergency lighting, and facility telephone were all in working order. Fire extinguishers were bought in the last 12 months. First aid kits were complete and readily accessible. Required licensing postings were observed in visible areas of the facility. LPA reviewed facility records. The files reviewed by LPA were complete. Confidential records were stored in locked areas. No deficiencies were cited per California Code of Regulations. An exit interview was conducted with Licensee Lizelyn Gonzales, to whom a copy of this report, and the Licensee/Appeal Rights (LIC9058 03/22) were provided during today’s visit.the state’s words, verbatim · CDSS document, Feb 24, 2026

The state marks this report as 5 pages; the online copy we transcribed has 3. You can request the full file from the county licensing office.

Type of visit: Prelicensing

Licensing Program Analyst (LPA) Marisela Garcia-Centeno conducted an announced Pre-Licensing for a change of ownership visit to observe the facility’s physical plant for compliance with Title 22, Division 6 of California Code of Regulations and Health & Safety Code. LPA was greeted by, identified themselves to, and explained the purpose of the visit to applicants Jose Rafael Gonzales and Lizelyn Gonzales. The facility fire clearance was granted on October 28. 2024 and reflects that the facility is approved for six (6) residents in total, of which five (5) may be non-ambulatory and one (1) may be bedridden. The facility changed ownership from sole proprietor to LLC. During today’s visit, LPA, accompanied by the applicants, toured the interior and exterior of the facility and inspected each room. The facility was clean, sanitary, and in good repair. Pathways were well lit and free of obstruction and slip hazards. Resident bedrooms allowed for easy passage and contained the required furnishings. Toilets and showers were in working order. The facility’s ambient internal temperature was 72 F. Water temperatures at taps accessible to residents were also complaint: Kitchen was 117.5 F. The facility has enough linens, hygiene supplies, dining supplies, and perishable and non-perishable food for future resident use. Refrigerator temperature was 39 F, and freezer temperature was 0 F. The facility has sufficient space and equipment to facilitate laundry, visitation, meetings, and resident activities. The facility has locked areas for storage of medication and confidential resident and staff records. No pools or bodies of water were observed on the premises. There were no toxic chemicals/poisons, fireplaces, or open-faced heaters accessible to residents. Per the applicant, no firearms or ammunition are or will be stored at the facility. (Continue at LIC809C Continue from LIC809 Smoke alarms, carbon monoxide detectors, emergency lighting, and facility telephone were all operational. One (1) fire extinguisher and two (2) first aid kits were present. Required licensing postings were observed in visible areas of the facility. The items reviewed were complaint with Title 22, Division 6 of California Code of Regulations and Health & Safety Code. The applicants passed the pre-licensing inspection. LPA also provided the Component III Training during today’s visit. The Gonzales' were advised that the facility’s application is pending management's final review and approval. An exit interview was conducted with the applicants, to whom a copy of this report and the Licensee/Appeal Rights (LIC9058 03/22) were provided.the state’s words, verbatim · CDSS document, Feb 3, 2025

Type of visit: Office

Facility Type: RCFE Application Type: CHOW Capacity: 6 Census (if any clients in care): 6 / full capacity COMP II Participants: Jose Rafael Gonzales & Lizelyn Gonzales Interview Method: Telephone interview On January 15, 2025, 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 following areas: 1.Facility operation: License type, client/resident populations, and program 2.Unusual Incidents/Reporting Timeframes 3.Staffing & Training 4.Pre Licensing Readiness 5. General provisionsthe state’s words, verbatim · CDSS document, Jan 15, 2025