Ladera Homes I

Type of visit: Case Management - Other

On 08/31/2026 at 8:05am LPA Zina Brown arrived at the facility to conducted a case management at this facility listed above. LPA informed Renee Faulkner that the purpose of the visit is to conduct a final walk-through and to retrieve the license from Department of Social Services Community Care License. At 8:10am, the Department conducted a tour of the entire facility. During the inspection, the Department observed the following: (4) bedrooms, (1) full bathroom, (1) half bathroom, a living room, a dining room, kitchen, a laundry area, a backyard area, and an attached garage. Also the Department did not observe any residents residing at this home. Ladera Homes I submitted a closure notification to the Department on 08/27/2026, which stated Ladera Homes I closed the facility on 03/13/2026. The licensee informed the Department on 08/27/2026 that R1 & R2 moved out into Collaborative RCFE on 03/13/2026. On 08/27/2026 between the hours of 2:42pm - 2:44pm, the Department called to confirm the placement for R1 & R2 who resides at Collaborative RCFE as of 03/13/2026. On 08/31/2026 at 8:15am, Ladera Homes I has voluntarily surrender the Department of Social Services Community Care License. The original license was given to LPA Brown during the time of the inspection. The licensed facility has been operating since 09/09/2016. Effective as of 08/31/2026 Ladera Home I will no longer hold a license to operate from Community Care Licensing. According to California Code of Regulations, Title 22, Division 6 and Chapter 8, the Department did not observe deficiencies; therefore no citations are being issued. Exit interview conducted with Renee Faulkner (Administrator) & a copy of this report is being provided.the state’s words, verbatim · CDSS document, Aug 31, 2026

Type of visit: Required - 1 Year

On 09/20/25 at 9:15AM, Licensing Program Analyst (LPA) Gina Saucedo, arrived to conduct an unannounced, annual inspection at the facility. Upon arrival, LPA Saucedo met with Caregiver, Norman Meadows and disclosed the purpose of the visit. The Administrator, Renee Faulkner arrived about thirty (30) minutes later. LPA asked for the census, resident, and staff files. A physical tour was conducted at 10:10am and observed the following: The Kitchen area was toured, and LPA observed there to be sufficient seven (7) day supply of non-perishable foods and perishable food for all residents. The kitchen area was clean at the time of the tour. The fire extinguisher is located against the wall on your right-hand side of the kitchen. It is fully charged dated 12/23/2024. There is extra, food emergency kits in the kitchen and in the kitchen pantry. The sharps are locked and inaccessible to the residents in one (1) of the right side cabinets. The medication is also locked and inaccessible to the residents in one (1) right hand side cabinets. Outside/Backyard: There is a ramp at the entrance of the facility. The outside/backyard has furniture for residents with proper seating. The facility has a cameras in common areas. The facility has no pool or bodies of water. There is a garage that can be accessed from the living room area. The garage has extra storage. LIC 809C-continued Bedrooms and Bathrooms: There are four (4) bedrooms, one (1) 1/2 bedrooms. There are four (4) bedrooms that are single, occupied with no bathroom. Two (2) bedrooms are currently unoccupied. All bedrooms and bathrooms were toured and were properly furnished and have appropriate bedding, linens, toiletry and lightning. There is one (1) and half bathrooms for resident and staff use. The bathrooms have proper toiletry and grab bars. The bathroom temperatures of the water are within regulations reading at 108.3 degrees Fahrenheit. There is no staff bedroom. There is also extra linen kept in the hallways in between the bedrooms and bathroom. The dining area/living room area has enough seating for the residents and the staff. There is a large television against the wall and there is also internet access and telephone access. There is one (1) washer and dryer. There are chemicals/toxins that are kept in this area that are locked and inaccessible to the residents. The carbon monoxide and smoke detectors are located throughout the facility and are operable and interconnected. The house temperature is set at 75 degrees. Administrative: At the entrance of the facility on your left-hand side there is COVID signs, YES signs, Emergency Disaster Plan, Rights of Resident Council, Personal Rights, Theft and Loss, Ombudsman sign The insurance plan is updated and is dated 12/2025. The last emergency disaster drill was July of 2025. There is one (1) transportation vehicle that is mandatory to have which is available and functioning. Staff and Resident Files were reviewed: Resident files were missing physician's report/tuberculosis, resident appraisal, pre-appraisal and functional capabilities. Both residents observed were ambulatory. An exit interview was conducted, citation(s) were issued, appeal rights was provided and a copy of this report was given to the administrator.the state’s words, verbatim · CDSS document, Sep 20, 2025

Type of visit: Annual/Random

On 12/14/2024 around 9:20 AM, the California Department of Social Services (CDSS) – Community Care Licensing Division (CCLD) staff conducted an unannounced Required – 1 Year Inspection to the above-named facility and met with Administrator/Licensee, Renee Faulkner. CCLD staff explained the purpose of the visit and was accompanied by a staff member inside and outside the facility during this inspection. This facility is licensed to serve 5 ambulatory adults ages 55 and above, of which 2 maybe on hospice. A total of 3 residents are currently residing in this facility. The Annual Licensing Fees are current. Facility Layout: The facility is a one-story house located on a main residential street. The home consists of 4 resident bedrooms, 1 full bathroom, 1 toilet room, 1 kitchen area, 1 laundry area, 1 living room area, 1 community room area with a dinning table, office area, and activity table, 1 backyard area with a table and seats, and 1 attached garage. Outside Grounds: were toured no bodies of water were observed, walkways around the home were clear of hazards, and there are security bars on the back windows but not on the resident bedroom windows. Kitchen Area/Facility Food: The facility has supplies of nonperishable foods for a minimum of one week and fresh perishable foods for a minimum of two days. Knives were kept inaccessible to residents in care. There is fire extinguisher in the kitchen area. Living Room/Community Room: There is a landline telephone, videoconferencing device, and games/activity work (i.e puzzles) for residents in the community room area. There are sofas and a large television in the living room. Resident Bedrooms: 4 out of 4 resident bedrooms were toured. There is adequate lighting, plenty of dresser and closet space observed. Walls and floors were clean and in good condition. Bathrooms: Toilets, showers, and water faucets worked, grab bars were secure, and a non-skid mat was in place. Adequate lighting and toiletries accessible to residents. Medications: were inaccessible to residents in care. All medications observed were labeled and maintained in compliance with label instructions and State and Federal law. 3 out of 3 Medication Administration Records (MARs) were reviewed and they were current and up to date. Miscellaneous: Documents are posted as mandated. First aid kit is fully stocked with manual. Smoke and carbon monoxide detectors were in compliance and operational. The last Disaster Drill was conducted on 01/30/2023. 5 staff records were reviewed, 5 out of 5 staff records had required documentation. 3 resident records were reviewed and, 3 out 3 resident records did not have their Tuberculosis Test Results and 1 out of 3 resident records did not have their Physicians Report (Physical Exam). A technical advisor is being provided regarding removing facility small refrigerator and facility file cabinet from a resident’s bedroom. The licensee has agreed to find a new place for the items. A deficiency is being cited based on record review in accordance with the California Code of Regulations, Title 22, see LIC809D. A violation regarding resident records. An exit interview was conducted, Plans of Corrections were reviewed and developed. A copy of this report and appeal rights were discussed and left with the Licensee.the state’s words, verbatim · CDSS document, Dec 14, 2024