Irvine Cottage #7

Type of visit: Required - 1 Year

On April 14, 2026, Licensing Program Analyst (LPA) Brandon Lopez made an unannounced visit to the facility for the purpose of conducting the required annual inspection. LPA was greeted and granted entry into the facility by care giving staff after explaining the purpose for the visit. Compliance Manager (CM) Michelle Nesbitt and Assistant Administrator (AA) Kimberly Arnett were notified via telephone and later arrived to assist with the inspection. LPA observed that Kimberly Arnett has a valid Administrator certificate which expires on July 21, 2026. The facility is a Residential Care Facility for the Elderly (RCFE) licensed for six non-ambulatory residents and has a hospice waiver for six. The facility is a single story home with five resident bedrooms, one of which is shared, two staff bedrooms, three resident bathrooms, a living room, a dining room, a kitchen, a laundry room, and an attached two car garage. LPA, accompanied by the CM and the AA, conducted a tour of the interior portion of the facility. On today's visit, LPA observed five residents in care and four care giving staff present. LPA observed the See Something, Say Something poster (PUB 475) mounted on the wall by the entryway of the facility. LPA inspected the five resident bedrooms and they were observed to be free of hazards. LPA observed resident bedrooms to have the required furnishings of a bed, a chair, a chest of drawers, and a lamp. LPA observed resident beds to have clean linens and blankets. LPA observed additional linens to be stored in a hallway cabinets. LPA inspected the three resident bathrooms and they were observed to be clean. Resident bathrooms are equipped with grab bars and nonskid floor mats. Faucets and toilets were operational. Hot water temperature measured between 107.2 and 112.4 degrees Fahrenheit. LPA observed the two staff bedrooms to be kept locked and inaccessible to residents in care. CONTINUED ON LIC809-C LPA observed the kitchen has a two day perishable and a seven day nonperishable food supply on hand. LPA observed kitchen appliances to be clean and operational. The four burner gas stove lights unassisted. LPA observed knives and sharps to be stored in a locked kitchen cabinet. LPA observed chemicals and toxins to be stored in a locked kitchen cabinet under the sink. LPA observed fire extinguishers to be located in the kitchen, in the laundry room, and in the two car garage. LPA observed fire extinguishers to be charged and serviced as of April 8, 2026. LPA tested the smoke detectors and carbon monoxide detectors which tested operational. LPA observed the facility conducted their last emergency disaster drill on March 1, 2026. LPA observed the centrally stored medication to be kept in a locked storage cabinet located in the kitchen. LPA observed a first aid kit mounted on the wall in the kitchen and it had all the required components. LPA observed chemicals and toxins to be stored in a locked cabinet located in the laundry room. LPA observed the door leading to the attached two car garage to be kept locked and inaccessible to residents in care. LPA observed the garage to be used for storage. LPA observed the facility has a three day emergency food and water supply to be stored in the garage. LPA, accompanied by the CM and the AA, conducted a tour of the exterior portion of the facility which includes a patio and the backyard. LPA observed the exterior to be clear of obstructions and hazards. LPA observed a shaded outdoor seating area with furniture for resident use in both the patio and in the backyard. The perimeter gates of the facility are self-latching and can be opened in an evacuation. There are no bodies of water on the premises. LPA reviewed all five resident files. All the required documentation were present and current in the resident files reviewed. LPA reviewed all five residents' medication and medication records. LPA reviewed four staff files. All staff are background cleared and associated to the facility. Based on the observations made during today's visit, no deficiencies are being cited per the Title 22 of the California Code of Regulations. An exit interview was conducted with Compliance Manager Michelle Nesbitt and Assistant Administrator Kimberly Arnett. A copy of the report was provided at time of visit.the state’s words, verbatim · CDSS document, Apr 14, 2026

Allegation investigated: Staff did not seek medical attention for resident.

Licensing Program Analyst (LPA) Jessica Cho arrived at the facility unannounced for the purpose of delivering the findings into the above allegation for the complaint investigation. LPA was greeted and granted entry by Caregiver Jesus Abad and stated the purpose of the visit. Executive Administrator (EA) Jozef Springer was informed of the visit by telephone at 8:08am and arrived on premise at 8:45am. During the course of the investigation, LPA interviewed four staff, successfully interviewed one out of five residents, family member, and obtained pertinent documents such as the Face Sheets, Physician's Reports, Pre-Appraisal, Emergency Consent Form, Discharge Summary, Photos, Vital Records, Correspondences, and Call Log History. Regarding the allegation, Staff did not seek medical attention for resident, it is alleged that the facility did not assess resident after the fall to ensure no further injury was sustained. The investigation revealed the following: Unsubstantiated On Saturday, March 22, 2025, Resident #1 (R1) had a fall in their bedroom at or approximately 6am verified by R1. As a result of the fall, R1 sustained a small one inch laceration to the right brow bone region per the hospital discharge summary dated March 24, 2025. Three out of the four staff interviewed indicated conducting a fall assessment, taking vitals, and administering first aid to the wounded area immediately. The photograph demonstrates R1 with a band aid applied by the facility while the second photograph shows R1 with steri strips applied by the hospital which was noted on the discharge summary. R1 also confirmed facility staff treating the wound the day of the fall. In an interview with EA, there was not an immediate need to call 9-1-1 based on the assessment and R1 not showing/expressing any signs of pain. EA indicated that R1's representative was immediately notified by telephone following the fall. Based on the review of the call log screen shot, EA placed the call to R1's representative and left a voice message the day of the fall at 6:32am. The outgoing call was for 6 minutes. EA indicated that at 6:48am, the call was returned the same day by R1's representative and discussed R1's condition and vitals for four minutes. EA indicated that R1's representative was asked if they wanted R1 to be taken to the emergency room, even though EA did not believe the injury required immediate medical attention. EA indicated that the representative declined. Due to conflicting information obtained during the investigation, although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur, therefore the following allegation: Staff did not seek medical attention for resident is deemed UNSUBSTANTIATED. An exit interview was conducted with Executive Administrator Jozef Springer, and a copy of this report including the LIC811 were provided at exit.the state’s words, verbatim · CDSS document, Apr 17, 2025 · control 22-AS-20250409144044

Type of visit: Required - 1 Year

On 4/15/25 at 12:35 PM, Licensing Program Analyst (LPA) Brandon Lopez made an unannounced visit to the facility for the purpose of conducting the required annual inspection. LPA was greeted and granted entry into the facility by care giving staff after explaining the purpose for the visit. Compliance Manager/Administrator (AD) Michelle Nesbitt and Executive Administrator (EA) Jozef Springer were notified via telephone and later arrived to assist with the inspection. LPA observed that Compliance Manager/Administrator Michelle Nesbitt has a valid Administrator certificate which expires on April 11, 2026. The facility is a Residential Care Facility for the Elderly (RCFE) licensed for six non-ambulatory residents and has a hospice waiver for six. The facility is a single story home with five resident bedrooms, one of which is shared, two staff bedrooms, three resident bathrooms, a living room, a dining room, a kitchen, a laundry room, and an attached two car garage. LPA, accompanied by the AD, conducted a tour of the interior portion of the facility. On today's visit, LPA observed five residents in care and three care giving staff present. LPA observed the See Something, Say Something poster (PUB 475) mounted on the wall by the entryway of the facility. LPA inspected the five resident bedrooms and they were observed to be free of hazards. LPA observed resident bedrooms to have the required furnishings of a bed, a chair, a chest of drawers, and a lamp. LPA observed resident beds to have clean linens and blankets. LPA observed additional linens to be stored in a hallway cabinet. LPA inspected the three resident bathrooms and they were observed to be clean. Resident bathrooms are equipped with grab bars and nonskid floor mats. Faucets and toilets were operational. Hot water temperature measured between 107.7 and 118.2 degrees Fahrenheit. LPA observed the two staff bedrooms to be kept locked and inaccessible to residents in care. CONTINUED ON 809-C LPA observed the kitchen has a two day perishable and a seven day nonperishable food supply on hand. LPA observed kitchen appliances to be clean and operational. The four burner gas stove lights unassisted. LPA observed knives and sharps to be stored in a locked kitchen cabinet. LPA observed chemicals and toxins to be stored in a locked kitchen cabinet under the sink. LPA observed fire extinguishers to be located in the kitchen, in the laundry room, and in the two car garage. LPA observed fire extinguishers to be charged and serviced as of April 8, 2025. LPA tested the dual smoke detectors/carbon monoxide detectors which tested operational. LPA observed the facility conducted their last emergency disaster drill on March 1, 2025. LPA observed the centrally stored medication to be kept in a locked storage cabinet in the kitchen. LPA observed a First Aid Kit mounted on the wall in the kitchen and it had all the required components. LPA observed chemicals and toxins to be stored in a locked cabinet in the laundry room. LPA observed the door leading to the attached two car garage to be kept locked and inaccessible to residents in care. LPA observed the garage to be used for storage. LPA observed the facility has a three day emergency food and water supply to be stored in the garage. LPA, accompanied by the AD, conducted a tour of the exterior portion of the facility which includes a patio and the backyard. LPA observed the exterior to be clear of obstructions and hazards. LPA observed a shaded outdoor seating area with furniture for resident use in both the patio and in the backyard. The perimeter gates on the north side and east-side are self-latching and can be opened in an evacuation. There are no bodies of water on the premises. LPA reviewed all five resident files. All the required documentation were present and current in the resident files reviewed. LPA reviewed all five residents' medication and medication records. LPA reviewed three staff files. All staff are background cleared and associated to the facility. Based on the observations made during today's visit, no deficiencies are being cited per the Title 22 of the California Code of Regulations. An exit interview was conducted with Compliance Manager/Administrator Michelle Nesbitt and Executive Administrator Jozef Springer. A copy of the report was provided.the state’s words, verbatim · CDSS document, Apr 15, 2025

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Celine De Perio conducted an unannounced required annual inspection. LPA De Perio explained reason for visit and was greeted and granted entry by staff on duty, who contacted compliance manager (CM) Michelle Nesbitt. LPA observed the administrator certificate for Kimberly Arnett, which expires on 7/21/2024. The PUB475 "See Something, Say Something" poster was observed to be posted at the entrance. Facility is licensed for 6 non-ambulatory residents, of which 6 may be on hospice. LPA De Perio toured the interior and exterior portions of the facility with CM Nesbitt. The facility is a single level structure. There are a total of 6 bedrooms, of which 4 are private resident rooms, 1 shared resident room and 1 staff room. LPA De Perio toured each bedroom in the facility and observed that bedrooms were provided with furniture in good repair, clean linens, adequate storage space, and kept free of tripping hazards. Smoke and carbon monoxide detector and auditory exit alarms were tested and operational. There are a total of 3 restrooms in the facility. Restrooms were observed to be in good repair, toilets were operational, and grab bars and non-skid floor mats were provided. Water temperature in restrooms were measured to be at 112.6 degrees Fahrenheit. Facility met the minimum two-day perishable and seven-day non-perishable food supplies. Sharp items and knives were locked and inaccessible to residents in care. Fire extinguisher was charged, mounted and located in the kitchen. LPA De Perio observed the emergency disaster and evacuation plan, which is posted in at the entrance. Facility had back-up emergency food and water supply, located in the kitchen and in the garage. LPA De Perio observed that First Aid Kit had all the required components. Medications and toxins were observed to be locked and made inaccessible to residents in care. For the exterior portion, LPA De Perio observed patio furniture under shading, and the grounds were free of any hazards. There are 2 gates in the backyard, which were self-closing and self-latching. No bodies of water were observed. For today's visit no deficiencies were issued per Title 22 Division 6 of the California Code of Regulations. No citations were issued. An exit interview was conducted with CM Nesbitt. A copy of this report was provided and explained.the state’s words, verbatim · CDSS document, Apr 10, 2024