Inner Circle Assisted Living #1

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Samer Haddadin conducted an unannounced annual inspection of the facility. Upon arrival, LPA Haddadin was greeted by Administrator Eric Lin, who granted entry and was advised of the purpose of the visit. The facility is a single-story building with six private rooms and an approved fire clearance for six non-ambulatory residents, of which one may be bedridden. The facility is also approved to serve up to six residents receiving hospice care. At the time of this visit, five residents were present in the facility, two of whom were on hospice. All residents’ bedrooms were inspected and found to be appropriately furnished with a bed, chair, and clean linens, provided adequate storage, and were free of tripping hazards. The kitchen was in good repair, with all major appliances operational. Sharps and knives were secured and inaccessible to residents. The exterior of the facility was well maintained. Pathways were unobstructed and free of hazards, with a shaded seating area available. Fire extinguisher was fully charged, with indicators in the green zone. The most recent inspection date was August 26th, 2026. Hot water temperature was measured at 106.3 degrees Fahrenheit. Records indicated that the last emergency drill was conducted on July 25th, 2026. {CONTINUE 809C} The facility maintained sufficient food supplies, including at least two days’ worth of perishable items and seven days’ worth of nonperishable items. A review of resident files revealed no discrepancies. Staff files were complete and contained all required documentation. Based on today’s inspection and observations, no deficiencies are being cited in accordance with Title 22, Division 6 of the California Code of Regulations. An exit interview was conducted, and a copy of this report was provided to the licensee. Staff files were complete and contained all required documentation.the state’s words, verbatim · CDSS document, Sep 24, 2026

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Samer Haddadin conducted an unannounced annual inspection of the facility. Upon arrival, LPA Haddadin was greeted by Administrator Eric Lin, who granted entry and was advised of the purpose of the visit. LPA toured both the interior and exterior of the facility and made the following observations. The facility is a single-story building with six private rooms and an approved fire clearance for six non-ambulatory residents, of which one may be bedridden. The facility is also approved to serve up to six residents receiving hospice care. At the time of this visit, five residents were present in the facility, two of whom were on hospice. All resident bedrooms were inspected and found to be appropriately furnished with a bed, chair, and clean linens, provided adequate storage, and were free of tripping hazards. The kitchen was in good repair, with all major appliances operational. Sharps and knives were secured and inaccessible to residents. The exterior of the facility was well maintained. Furnishings were in good repair, pathways were unobstructed and free of hazards, and the grounds appeared safe and inviting, with a shaded seating area available. Fire extinguisher was fully charged, with indicators in the green zone. The most recent inspection date was September, 2024. Hot water temperature was measured at 113.3 degrees Fahrenheit, which is within regulatory requirements. Records indicated that the last emergency drill was conducted on July 20, 2025. The facility maintained sufficient food supplies, including at least two days’ worth of perishable items and seven days’ worth of nonperishable items. A review of resident files revealed no discrepancies. Staff files were complete and contained all required documentation. Based on today’s inspection and observations, no deficiencies are being cited in accordance with Title 22, Division 6 of the California Code of Regulations. An exit interview was conducted, and a copy of this report was provided to the licensee.the state’s words, verbatim · CDSS document, Sep 18, 2025

Type of visit: Case Management - Other

Licensing Program Analyst (LPA) Rose Ruppert made an unannounced visit to the facility today to amend a civil penalty report assessed on September 10, 2024. LPA met with Marie Luciene "Yen" David. LPA was informed caregiver is associated and background cleared. LPA read and delivered amended form to Administrator Designee, Yen David and a copy of this report and LIC421BG was left with the facility.the state’s words, verbatim · CDSS document, Oct 4, 2024

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Rose Ruppert made an unannounced visit to the facility today to conduct an Annual Required Evaluation. LPA was greeted and granted entry by Staff #1. During today’s visit, LPA met with Eric Lin, Administrator (AD). The facility is a single story building with six private rooms and an approved fire clearance of six non-ambulatory residents of which one may be bedridden. The facility is approved for six residents on hospice. Currently the facility has a census of six residents in care. with three on hospice. During today’s visit, LPA toured the facility and inspected the physical plant, including but not limited to testing all smoke detectors, testing hot water temperature in two of two resident bathrooms, and testing auditory devices on all exits. The hot water temperature measured between 111.5 and 113.7 degrees Fahrenheit and all smoke detectors were operational. The fire extinguisher is charged and was serviced on September 10, 2024. The facility’s last fire drill was conducted on August 15, 2024. LPA inspected the facility food supply and observed the facility retained a minimum of two days perishable and seven days non-perishable food on hand. LPA observed medication storage and reviewed the centrally stored medications. Per review medications are being given as prescribed. LPA reviewed four of four staff training and fingerprint records. One staff member was not associated with the facility and was immediately removed from work. An immediate civil penalty of $500 was assessed. LPA conducted a complete review of resident records. LPA interviewed alert residents regarding their quality of care and spoke to staff present regarding care provided. LPA confirmed that administrator has an administrator certificate which is pending renewal which expired on 8/29/2024. Administrator is on the pending renewal list and will expire on August 29, 2026. (Continued on LIC 809-C) (Continued from LIC 809) The following deficiencies are being cited per Title 22 Division 6 of the California Code of Regulations. An exit interview was conducted with Eric Lin, Administrator and a copy of this report was given to the facility along with a copy of the LIC 858, LIC 859; LIC 809-D, LIC421IM and Appeal Rights.the state’s words, verbatim · CDSS document, Sep 10, 2024