LG Guest Home II

Type of visit: Required - 1 Year

On today's date Licensing Program Analyst (LPA) made an unannounced inspection for the purposes of completing an annual inspection. Upon arrival LPA was greeted and granted entry to the facility by Administrator's son. LPA spoke with Administrator (AD) via telephone and explained the purpose of the visit. AD states that they are not in the country at this time, but they do not have any current residents in care. LPA conducted a tour of the facility and observed the following: The facility is a one storied home with five bedrooms three of which are used for residents in care, and two of which are used for staff on duty. The facility is equipped with a detached two care garage, and a large backyard. LPA observed for there to be no residents in care. LPA advised administrator; prior to admitting any new residents they will need to come into compliance. LPA advised that Licensing staff will come out once again to verify they are in compliance of title 22 regulations prior to them accepting new residents. Administrator understood and assured that they would contact Licensing prior to admitting any new residents. An exit interview was conducted and a copy of this report was provided to the facility.the state’s words, verbatim · CDSS document, May 5, 2026

Type of visit: Required - 1 Year

On September 22, 2025, Licensing Program Analyst (LPA) Garlli Tat conducted an unannounced visit to the facility for the purpose of a required annual inspection. LPA explained the purpose for the visit and was greeted and granted entry by staff on duty. During the visit, the facility administrator (AD) Stella Ladaban was also present during the visit. For this visit, there are two staff members on duty, AD and caregiver, both of which are background cleared and associated. AD assisted with the inspection. The PUB475 ‘See Something, Say Something’ poster was observed to be located by the front entrance. LPA observed the Administrator's Certificate for Stella Ladaban, which has been submitted for renewal and has an expiration date of July 14, 2027. The facility is a Residential Care facility for the Elderly (RCFE) licensed for six residents, five of which may be non-ambulatory, one of which may be bedridden, and three of which may be on hospice. LPA toured the interior and exterior portions of the facility with the AD. For this visit, there is just one bedridden resident in care, who is also on hospice. The facility is a single-story home. There are a total of five bedrooms, three of which are private resident rooms, and two serve as staff quarters. LPA toured each bedroom with the AD and observed that bedrooms were provided with furniture in good repair, clean linens, adequate storage space, and free of any hazards. LPA observed the staff quarters to be kept locked and inaccessible to residents in care. Smoke and carbon monoxide detectors as well as auditory exit alarms were tested and operational. There are a total of two bathrooms and one powder room, one of which is for residents and one is for staff. Continued on LIC 809-C Bathrooms were observed to be in good repair, toilets and faucets were operational and showers were equipped with grab bars and non-skid floor mats. Water temperature in the restrooms were measured to be 109.4 degrees Fahrenheit. There is a detached garage which is kept organized and used for storage. Facility met the minimum two-day perishable and seven-day non-perishable food supplies. Sharp items and knives were locked in the kitchen and inaccessible to residents in care. Fire extinguisher was charged, mounted and located in the kitchen and the garage. Fire extinguishers were dated and tagged on January 27, 2025. LPA observed the emergency disaster and evacuation plan, which is posted in the dining room. Facility had back-up emergency food and water supply, located in the pantry next to the kitchen and in the garage. LPA observed that the First Aid kit had all the required components. Medications were observed to be locked in a storage in the hallway, inaccessible to residents in care. Chemicals were locked underneath the kitchen sink. For the exterior portion, LPA observed patio furniture under shading, and the grounds were free of any hazards or obstructions. There are two self-latching gates in the backyard that can be opened in case of an emergency. No bodies of water were observed. All resident files (1) were reviewed and three staff files were reviewed. During this review, LPA observed that staff #2 did not have up-to-date training. Based on today's observations, there is one deficiency being cited per Title 22 of the California Code of Regulations. An exit interview was conducted with Stella Ladaban. This report was reviewed with the administrator and a copy was provided at the end of the visit. Appeal Right were reviewed.the state’s words, verbatim · CDSS document, Sep 22, 2025

Type of visit: Required - 1 Year

Licensing Program Analysts (LPA) Jerome Haley conducted an unannounced visit to the facility to complete the required Annual inspection. LPA Haley met with Licensee/Administrator Stella Ladaban and toured the facility. The facility has a capacity of 6, of which 5 can be non-ambulatory and 1 may be bedridden. The facility phone number 714.484.1493. Structure: The facility is one level structure with six bedrooms. Currently three bedrooms are being occupied by residents and 1 bedroom is being occupied by staff. Kitchen: Clean and organized. Sharps locked in a drawer. A perishable food supply was observed in the refrigerator and freezer. Non-perishable food supply was observed in the cabinets and in the pantry near the front door across from the kitchen. Stove/Appliances: There’s one stove with 4 burners and a warmer, a refrigerator, dishwasher, washer, and dryer. All appliances are clean. The top left burner on the stove does not light unassisted. The washer machine in the garage is not currently working. Toxins: All cleaning supplies and chemicals are locked under the kitchen sink. Medications, First-Aid Kit: Resident medications are locked in a close next to the front door. In the locked medication closet, a first aid kit with all the required elements was observed. Resident & Staff Files: The Resident and Staff Records are kept locked in the closet next to the front door with the medications and the first aid kit. Bedrooms: Resident bedrooms were clean, organized and were in compliance with regulation guidelines. Bathrooms: The bathroom has a working toilet, wash basin and shower. Grab bars were tightly secured to the wall. Hot Water: Hot water was measured at 110.1 degrees F. Continued on LIC809C Hygiene Supplies: The facility has an adequate supply of hygiene items on hand. Linens, Hygiene, Emergency Supplies: Additional linens for each resident are stored in the resident closet and dresser drawers. The facility has a large amount of non-perishable food items in the pantry and an emergency water supply in the garage. There are several solar powered lamps and a solar powered radio equipped with a cell phone charger for emergency use and a large supply of batteries in the medication closet. Emergency Evacuation Drills: The most recent evacuation drill was conducted January 16, 2024. Evacuation drills are conducted quarterly and the evacuation drill for the second quarter will be conducted before the end of the month. Medication Review: There are currently three residents in the facility and medication was reviewed for all three residents. Resident File Review: A file review was completed for all three residents. Staff File Review: 4 staff files were reviewed during the visit. Garage: The garage is clean and organized, and walk ways were free of obstruction. A washer and dryer was observed. Several cases of water, adult wipes, adult diapers, and several miscellaneous items are being stored in the garage. Backyard: Clean, organized and walkways are free of obstruction. There was a table with a sunshade and chairs. There is a locked storage shed used to store tools, additional adult diapers, a printer, wood, and gardening items. Both side exit gates are self-closing and self-latching. Smoke Detectors/Carbon Monoxide Detectors: Smoke detectors and the carbon monoxide detector tested operational. There’s a fully charged fire extinguisher mounted on the wall in the kitchen next to the dining table. Misc (P&I): N/A. The facility does not manage any of the resident’s money. Activities, Recreation, Reading Material, etc: Board games, and painting materials were observed in the living room area. Citation(s) & TV/TA: Citations will be issued for violations of Title 22 regulations observed during todays inspection. Exit Interview: Exit interview was conducted, and a copy of this report and appeal rights were provided to Administrator Stella Ladaban.the state’s words, verbatim · CDSS document, Jun 13, 2024