Lewis Bailey Senior Home Care

Type of visit: Case Management - Licensee Initiated

On November 7, 2025, Licensing Program Analyst (LPA) Yolanda Delgado conducted an unannounced visit for the purpose of the facility's closure. LPA met with Tari Lewis, Licensee/Administrator to tour the facility. Licensee sent closure letters to the Riverside Regional Office on 10/31/2025. The department learned of the closure on 10/31/2025, Licensee contacted the department to advise of their intentions on closing the facility due to financial reasons. During today's visit, LPA toured the facility, and observed no residents in care, observed two bedrooms emptied, no Health and Safety concerns at this time. LPA spoke with Tari Lewis and he stated they had a collateral visit by CCLD in June, 2025. LPA observed discharge notification letters by the Licensee for Resident #1 and Resident #2, LPA requested and received the license, LPA informed and explained to Tari that the license will no longer be valid and therefore no required care and supervision should be provided in the home unless the state approves licensure in the future. An exit interview was conducted with Tari Lewis, and a copy of this report has been discussed with Tari Lewis, Licensee.the state’s words, verbatim · CDSS document, Nov 7, 2025

Type of visit: Case Management - Deficiencies

Regional Manager (RM) Reyna Lacey conducted an onsite visit and met with Tari Lewis, Administrator and Licensee. During the visit, it was discovered the facility is retaining two residents who are bedridden. Physician reports, hospice care plans and interviews were conducted. Facility staff confirmed both residents are assisted with repositioning. Hospice care plan for Resident 1 (R1) indicates R1 is bedbound. Pre-placement Appraisal dated 04/29/25 for R1 indicates bedridden. Hospice care plan for R2 indicates bedbound. Physician Report dated 12/07/2023 indicates R2 is bedridden. This facility does not have an approved fire clearance to accept or retain bedridden residents. A deficiency was cited and a civil penalty was assessed in the amount of $500. An exit interview was conducted with Nikita Leiws where this report, the LIC809D, and LIC421 civil penalty assessment form was reviewed. Appeal Rights were reviewed and provided. Due to technical issues, the report and forms will be emailed to the licensee/administrator.the state’s words, verbatim · CDSS document, Jun 23, 2025

From the deficiency page — Deficiency type: Type A · Section cited: CCR 87202(a)(2) · Plan of correction due date: Jun 24, 2025

Fire Safety (a) All facilities shall maintain a fire clearance approved by city or county fire department ... Prior to accepting/retaining ... the licensee shall notify the licensing agency & obtain an appropriate fire clearance...(2) Bedridden persons. This requirement was not met as evidenced by: Based on document review and interview, R1 and R2 are bedridden and need assistance repositioning and this facility does not have a fire clearance for bedridden. This poses an immediate H&S risk to the residents in care.the state’s words, verbatim · CDSS document, Jun 23, 2025

Plan of correction: Licensee stated they will eviction notices to both R1 and R2 by the POC due date. In addition, licensee has submitted an LIC 200 requesting a bedridden fire clearance.

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Kathleen Banrasavong arrived unannounced to conduct an annual inspection. Upon arrival LPA was greeted by facility staff and granted entry. LPA began inspection with introduction and visit purpose. Upon arrival LPA learned that one (1) resident lives at this facility. The Licensee/Administrator, Tari Lewis and Administrator, Nikita Lewis was advised of the annual and conducted and completed the facility tour. Client Records/Incident Reports/Clients Rights Information: LPA reviewed client records. One (1) record was reviewed. LPA reviewed for identification and emergency information, admission agreement, medical assessment, and TB test results, needs and service plans, placement, functional assessment, centrally stored medication/destruction records, safeguard for personal property/valuables, and personal rights notification. Personnel Records/Training/ Staffing/ Administration: LPA reviewed employee records. Two (2) records were reviewed. LPA reviewed employee records for first aid certification, criminal record clearance or an exemption, health screening and TB test results, employee rights, training verification, and current administrative organization. The Administrator, Tari Lewis, Administrator’s certificate expiration date was 02/10/2026. The Administrator, Nikita Lewis Administrator’s certificate expiration is 07/29/2026. Food Service: Food prep areas are clean and organized. Food supply meets the requirement of one (1) week supply of nonperishable and two (2) day supply of perishables. Emergency food and water supply is present. There is a location for sharps in the kitchen. Physical Plant and Safety of Environment/Operational Requirements: LPA toured the facility inside and outside. LPA observed the facility to be clean and in good repair. The facility is maintained at 75 degrees for the client’s comfort. Lighting is sufficient for safety. Water temperature measured 120 degrees F. Laundry is done in the designated laundry room. There is a location for storing laundry soap, cleaning supplies and chemicals in the laundry closet. All outdoor and indoor passageways are free of obstruction. Emergency lighting is available. There is a telephone working at this location. LPA dialed the facility’s landline number, which rang and was operable. The LIC 610, emergency disaster plan is maintained. There are no firearms at this facility. There are no fireplaces at this facility. There are no pools at the facility. There is one (1) secured gate that has a self-latching lock located on the northwest side of the house. LPA observed emergency supplies and four (4) first aid kits. The last emergency fire drill was conducted on 02/15/2025. Infection Control: The LPA observed the hand washing stations in the facility restrooms and kitchen had hand hygiene supplies and hand washing signs. LPA observed PPE equipment and cleaning supplies to do regular cleaning of the facility. LPA reviewed the facility's infection control plan which met department requirements. LPA reviewed staff records and found that staff had infection control training. Medications/Health Related Services/Incidental Medical Services: The medications are centrally stored. There is a locked cabinet allocated for medication storage. Centrally stored medication and destruction logs are maintained separately. LPA reviewed medication logs and observed that they were dispensed accurately. LPA made observation throughout the inspection process to assess if the facility remains in conformity with the State Fire Marshall regulations. LPA observed seven (7) smoke and carbon detectors and two (2) stand alone, carbon monoxide detectors throughout the facility, that were tested during the inspection. Pursuant to Title 22 of The California Code of Regulations Division 6, there are zero (0) deficiencies observed. An exit interview was conducted, this LIC 809 was reviewed with, and a copy of this report was provided to the Administrators’ Tari Lewis and Nikita Lewis.the state’s words, verbatim · CDSS document, Apr 14, 2025

Type of visit: Required - 1 Year

On 4/19/2024, Licensing Program Analyst (LPA) Janette Romero arrived unannounced to conduct an annual required inspection. LPA was greeted and granted entry by Licensee, Tari Lewis who was informed of the purpose of the visit. During today's visit, there was three (3) residents and two (2) staff present. The facility has a fire clearance for six (6) non-ambulatory residents ages 60 and above. The facility also has a hospice waiver for four (4) residents and LPA was informed three (3) residents are receiving hospice services at the facility. LPA toured the facility's interior and exterior with Licensee, Nikkita Lewis. LPA observed the facility is made up of a one-story home with three (3) resident bedrooms, one (1) bathroom, a kitchen, living room, dining room, and attached garage. Indoor and outdoor passageways are free of obstruction. LPA observed the facility has more than a 2-day supply of perishable foods and 7-day supply of non-perishable foods. LPA observed emergency food and water stored at the facility. Licensee Nikkita tested one of the smoke alarms/carbon monoxide detectors and LPA found it to be operational. LPA observed charged fire extinguishers throughout the facility. Medication is secured in a medication cart stored in the living room. Disinfectants, cleaning solutions, and detergents are secured in the locked laundry room. LPA reviewed all resident and Licensees' files. Resident files reviewed have signed and updated physician reports and admission agreements. Licensees have a valid first aid certification and administrator certificates. Residents rights, complaint procedures, Long Term Care Ombudsman information, and facility sketches are posted near the facility's front entrance. The facility does not safeguard the residents' cash resources. During today's visit, LPA did not observe any issues or concerns. An exit interview was conducted and a copy of this report was reviewed and provided to both Licensees.the state’s words, verbatim · CDSS document, Apr 19, 2024