Iris Home Care

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Graham Gunby arrived at the facility unannounced to conduct a Required-1 Year Inspection utilizing the inspection tool. LPA met with Administrator, Brigitte Peterson and explained the purpose of the visit. LPA and Administrator conducted a tour of the interior and exterior of the facility. Areas toured include but not limited to resident bedrooms, bathrooms, kitchen, common areas and backyard. LPA observed required furniture, and lighting throughout the residents' bedrooms and facility. LPA observed residents' bathrooms to be clean, sanitary, and in good repair. LPA observed food supplies of non-perishables for a minimum of seven (7) days and perishable foods for a minimum of two (2) days. Toxins and cleaning supplies are locked and inaccessible to residents in care. The hot water temperature was measured in the kitchen sink at 108.6 degrees Fahrenheit. LPA observed fire detectors and carbon monoxide alarms to be operable. The fire extinguisher is located in the living room and was last serviced on 01/16/2026. LPA observed required Licensing posters posted in the entry of the facility. LPA observed medications to be locked and inaccessible to residents in care. LPA reviewed five (5) resident files. Resident files contained all required documentation. LPA reviewed two (2) staff records. Staff have all required documentation and first aid training. No deficiencies are being cited during today's inspection. Exit interview conducted and a copy of the report will be emailed to Administrator.the state’s words, verbatim · CDSS document, Mar 18, 2026

Allegation investigated: Resident was involuntarily transferred

On 1/14/26, Licensing Program Analyst (LPA) Kevin Mknelly conducted an unannounced complaint investigation visit to deliver the findings for the above allegations and met with Admin. LPA conducted records review and interviews. LPA is unable to find and or meet the preponderance, per policy. Investigation found that R1 resided at this home for a short time. During R1's time in the home admisiion paperwork and payment were not yet completed. Though R1's condition had not changes, emergency responders were called and agreed to take R1 to the hospital. From the hospital, arrangement was made to transport R1 to a diffferent facility. LPA conducted a collotaeral visit to R1's new home and found R1 to not suffer and negative effects from the transfer. Licensee denied evicting R1 nor deny R1 a return from hospitalization. As a result of this investigation, LPA finds allegation to be (US)Unsubstantiated - A finding that the complaint is Unsubstantiated means that although the allegation may have happened or is valid, there is not a preponderance of the evidence to prove that the alleged violation occurred. Exit interview with administrator. Unsubstantiatedthe state’s words, verbatim · CDSS document, Jan 14, 2026 · control 59-AS-20251202074543

Type of visit: Post Licensing

On 02/12/2025 Licensing Program Analyst (LPA) Cheyenne Ratajczak arrived at the facility unannounced to conduct an annual required and post licensing visit. LPA met with Administrator Brigitte Peterson and explained the purpose of the visit. For more information on the post licensing visit, please see LIC809 for Required - 1 Year dated 02/12/2025. No deficiencies cited for the post licensing visit. Exit interview conducted a copy of the report was left at the facilitythe state’s words, verbatim · CDSS document, Feb 12, 2025

Type of visit: Required - 1 Year

On 02/12/2025 Licensing Program Analyst (LPA) Cheyenne Ratajczak arrived at the facility unannounced to conduct a Required 1 year annual inspection utilizing the care tool. LPA met with Administrator Brigitte Peterson and explained the purpose of the visit. LPA and Administrator conducted a tour of the facility. Areas toured included but not limited to the kitchen, dining room, residents bedrooms, bathrooms, common areas and backyard. LPA observed sufficient furniture and lighting throughout the facility. LPA observed the facility to have sufficient food supplies for seven (7) day non-perishable and two (2) day perishable. LPA observed toxins, knives and centrally stored medications to be locked and inaccessible to residents in care. All required Licensing posters are present in the facility. Hot water temperature was measured at 108.5 degrees Fahrenheit at the kitchen sink, which is within the required range of 105 to 120 degrees. Fire extinguishers was last inspected on 01/29/2025. Smoke detectors are working and present throughout the facility. LPA reviewed three (3) resident records. Resident records contain signed admission agreements, physician's reports, appraisals, identification sheets, consent forms and resident's rights. LPA reviewed two (2) staff files. A review of staff records indicates that all facility staff has received criminal record clearances and/or are associated to this facility. Staff records reviewed indicated current training completed. LPA requested a copy of the current liability insurance, LIC500, LIC308 and updated facility sketch to be sent to LPA Ratajczak by 02/14/2025. LPA completed the full care tool and no deficiencies was observed. Exit interview conducted a copy of the report was left at the facility.the state’s words, verbatim · CDSS document, Feb 12, 2025

Type of visit: Prelicensing

On 03/12/24, Licensing Program Analyst (LPA) Talwinder Bains met with administrator ,Brigitte Peterson , to conduct an Pre- Licensing visit. This application is a change in ownership (CHOW) . This address is currently licensed as IRIS HOME CARE, Facility # 342700684 . Administrator holds a current administrator certificate (# 6065158740 with expiration date 01/25/25). The facility currently has 5 residents during today's inspection. Facility has Fire Clearance Approved (date-10/25/23) for 4 non ambulatory and 2 bedridden ( in bedrooms with exit 5 and 6 only as shown in facility sketch) residents. LPA toured the facility inside and outside with administrator . LPA toured residents bedrooms and they were properly furnished and maintained. LPA toured common bathrooms and observed to be clean and sanitary. The food supply is within compliance, 2 days of perishable and 7 days’ worth of non-perishable food items. Smoke detectors are operational. There are carbon monoxide detectors which are functioning. The Fire extinguisher was charged, serviced (01/28/24) and functional. Grab bars were present at the toilet and in the shower. All exits were unobstructed. All toxins, medications, and sharps were locked and stored away. The disaster drill is current. Facility's temperature was 73 degree F during inspection. Hot water temperature was observed to be 120 degrees F, which is within the regulation range of 105-120 degree. First aid kit found to be complete. All required postings were observed. Facility has staff room which was shown in facility sketch. Facility has pool in the backyard which was properly fenced and locked during inspection. Backyard area was found to be clean and well maintained. LPA reviewed 1 sample file for 1 resident and for 1 staff and found out that all required paperwork was present . Component III was waived as the current administrator has been administrator for other RCFEs licensed by CCLD . LPA will forward findings to the Centralized Application Bureau (CAB) that facility met all the pre-licensing components. Applicant has satisfied all requirements in accordance to Title 22, California Code of Regulations on today's pre-licensing inspection. A copy of this report was provided to the facility. Exit interview conducted.the state’s words, verbatim · CDSS document, Mar 12, 2024

Type of visit: Office

COMP II by CAB successfully completed Facility Type: RCFE Application Type: CHOW Capacity: 6 Census (if any clients in care): 5 Method: Telephone call with CAB COMP II Participants: Brigitte Peterson, Administrator/Owner; Shannon Betker, analyst. Applicant/administrator participated in COMP II at CAB via telephone call with analyst at CAB. Identification of the applicant and administrator was verified by confirming driver’s license number. During COMP II, applicant and administrator confirmed the understanding of Title 22. Component II was successfully completed. Applicant and administrator were advised to email/fax signed LIC 809 with copy of photo ID to CAB. 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, Mar 4, 2024