Irvine Cottage #5

Type of visit: Required - 1 Year

On this day, Licensing Program Analyst (LPA) Andrea Mendivil made an unannounced visit to conduct a required annual visit. LPA was greeted and granted entry by staff and explained the reason for the visit. Facility is licensed for 6 non-ambulatory residents and has 6 residents during today's visit. During today’s visit, LPA along with Compliance Manager Michelle Nesbitt toured the facility and inspected the physical plant, including but not limited to testing all smoke detectors, testing hot water temperature in bathrooms. The hot water temperature measured between 106.5 and 111.5 degrees Fahrenheit and all smoke detectors were operational. 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 emergency food in locked garage. Facility conducted last fire and earthquake drill 03/01/2026. LPA observed resident's medication securely stored in hallway cabinet. LPA reviewed medications and all appear to be given as prescribed LPA reviewed two out of two staff training and fingerprint records. LPA conducted a complete review of resident records. LPA confirmed that administrator has a current administrator certificate which expires on 07/21/2026. Therefore based on observations made no deficiencies are being cited per California Code of Regulations Title 22. An exit interview was conducted and a copy of this report was provided.the state’s words, verbatim · CDSS document, Mar 25, 2026

Type of visit: Required - 1 Year

On this day, Licensing Program Analyst (LPA) Andrea Mendivil made an unannounced visit to conduct a required annual visit. LPA was greeted and granted entry into the facility and explained the reason for the visit. Facility is licensed for 6 non-ambulatory residents and has 5 residents during today's visit. Administrator Certificate expires on 07/21/2026. Administrator Kimberly Arnett and Compliance Manager Michelle Nesbitt arrived at the facility. LPA Mendivil toured the facility with Compliance Manager. LPA toured the physical plant, checked food service, and the first aid kit. The home consists of 6 resident bedrooms, 1 staff bedroom, 2 resident bathrooms, living room, dining room, and kitchen. LPA observed smoke detectors/carbon monoxide in common areas and bedrooms and are operational. Resident bedrooms had the required furniture, bed linens and closet/drawer space to accommodate each resident comfortably. Resident bathrooms were checked. Toilets and water faucets worked properly, grab bars were secure and shower was free of mold/mildew. Water temperature measured between 106 degrees and 115 degrees in both bathrooms. Resident bath towels, toiletries and personal hygiene supplies were adequately stocked at time of visit. Common areas were clean and clear of hazards, doorways were free of obstructions. First aid kit had all the required elements including tweezers, thermometer, and scissors. LPA observed a locked storage area for cleaning supplies in the garage. Kitchen was inspected. Perishable and non-perishable food supply was checked and adequately stocked at time of visit. LPA observed sharps locked in a kitchen drawer. LPA observed secured medications in a cabinet. Kitchen appliances are operational during today's visit. LPA toured the outside grounds and there is ample seating and the exit gate is self latching and operational. LPA observed emergency food and water supply in the garage. LPA reviewed the emergency disaster plan during the visit. Plan is thorough and complete. Facility provides activities in the form of music and exercise. LPA Mendivil reviewed five resident files and five staff files. Residents files and staff files contained all required documentation. LPA Mendivil reviewed medication storage and administration. Based on the observation made during today’s visit, no deficiencies were noted today in the areas inspected per Title 22 Division 6 of the California Code of Regulations. This report was reviewed with the Administrator and a copy of this report was provided to the facility.the state’s words, verbatim · CDSS document, Mar 25, 2025

Type of visit: Required - 1 Year

Licensing Program Analysts (LPAs) Andrea Mendivil and Michael Tea conducted an unannounced visit. The purpose of today’s visit was to conduct the Annual Required inspection. LPAs were greeted and granted entry into the facility and explained the reason for the visit. Facility is licensed for 6 non-ambulatory residents and has 4 residents during today's visit. Administrator Certificate expires on 07/21/2024. Administrator Kimberly Arnett ,Compliance Manager Michelle Nesbitt, Tammy Sampedro Executive Administrator arrived shortly after. LPAs Mendivil and Tea along with the Compliance Manager toured the facility at 1:50 PM. LPA toured the physical plant, checked food service, and the first aid kit. The home consists of 6 resident bedrooms, 1 staff bedroom, 2 resident bathrooms, living room, dining room, and kitchen. At 2:30PM LPA observed smoke detectors/carbon monoxide in common areas and bedrooms and operational. Resident bedrooms had the required furniture, bed linens and closet/drawer space to accommodate each resident comfortably. Resident bathrooms were checked. Toilets and water faucets worked properly, grab bars were secure and shower was free of mold/mildew. Water temperature measured between 105.4 degrees and 106 degrees in both bathrooms. Resident bath towels, toiletries and personal hygiene supplies were adequately stocked at time of visit. Common areas were clean and clear of hazards, doorways were free of obstructions. First aid kit had all the required elements including tweezers, thermometer, and scissors. LPA observed a locked storage area for cleaning supplies in the garage. Kitchen was inspected. Perishable and non-perishable food supply was checked and adequately stocked at time of visit. LPA observed sharps locked in a kitchen drawer. At 2:30pm, LPA observed secured medications in a cabinet. Fire extinguishers are fully charged. Kitchen appliances are operational during today's visit. LPA toured the outside grounds and there is ample seating and the exit gate is self latching and operational. LPA observed emergency food and water supply in the garage. LPA reviewed the emergency disaster plan during the visit. Plan is thorough and complete. Facility provides activities in the form of music and exercise. At 1:45PM, LPA Mendivil reviewed four resident files and four staff files. Residents files and staff files contained all required documentation. At 1:50PM LPA Mendivil reviewed medication storage and administration. Medications are stored in a locked cabinet. Medications are being administered per physician order. Based on the observation made during today’s visit, no deficiencies were noted today in the areas inspected per Title 22 Division 6 of the California Code of Regulations. This report was reviewed with the Administrator and a copy of this report was provided to the facility.the state’s words, verbatim · CDSS document, Mar 22, 2024