Love Circle Home Care

Type of visit: Post Licensing

Licensing Program Analyst (LPA) Martha Arroyo arrived at the facility unannounced to conduct a post-licensing visit today. Upon arrival, there were two (2) staff members and four (4) residents present. The LPA met with facility staff who contacted Administrator, Jennifer Pantig and at this time the reason for the visit was explained. The Administrator arrived at the facility during the inspection. Entrance interview. Beginning at 10:02 AM, the LPA along with staff toured the physical plant areas inside and outside to ensure there are no health and safety hazards and that facility is in compliance with Title 22 Regulations. The following was observed: KITCHEN: The LPA observed the kitchen area to be clean. Kitchen appliances appeared to be in operable condition. The facility has a sufficient supply of two (2) days perishable and seven (7) days non-perishable food. The LPA observed knives and sharps in a locked drawer at the time of the visit. Cleaning supplies were observed under the kitchen sink locked and inaccessible. Refrigerator and pantry were checked for expirations dates. COMMON AREAS: This includes the two (2) living rooms and dining area. The LPA observed the living rooms to be clean and properly furnished at the time of the visit. The dining area was observed to be equipped with adequate seating for resident use. All furniture throughout the facility was observed to be clean and in good repair. Report Continued on LIC 809C... Report Continued from LIC 809... There is a fireplace adequately screened at the time of the visit. The LPA observed two (2) fire extinguishers with a purchase date of 08/07/2025. The LPA observed a working telephone on premises. No tripping hazards were observed inside or out. BEDROOMS: There are five (5) bedrooms in the facility for resident use; four (4) are designated for single occupancy, and one (1) is designated for shared / double occupancy. All resident rooms were observed to be furnished with appropriate furnishings and sufficient lighting. Additional clean linens and towel were observed in a storage closet by the hallway. The LPA observed personal hygiene items locked and inaccessible to residents in care at the time of the visit. BATHROOMS: There are two (2) bathrooms at the facility for resident use. One (1) is designated as a private resident bathroom, and one (1) is designated as a shared/common resident bathroom. All resident bathrooms were observed to be clean and were equipped with nonskid surfaces. Beginning at 10:10 AM, the water temperature was measured in resident bathrooms, and they measured within the required range of 105 – 120 degrees Fahrenheit. OUTDOOR SPACE: The LPA observed an adequate shaded seating area with appropriate outdoor furniture for resident use. The facility has one (1) self-latching gate for emergency use. All passageways were observed to be clear of any obstructions. No bodies of water noted at the time of the visit. GARAGE: The garage is attached to the house. Washer and dryer were observed inside. Laundry detergents and cleaning supplies were observed inaccessible to residents at the time of the visit. The LPA observed an adequate amount of emergency food and water at the time of the visit. RECORD REVIEW: Record review began at 10:25 AM. Four (4) resident files were reviewed for but not limited to; signed admissions agreement, medical assessment, negative tb test results, consent for treatment form, pre-appraisal, appraisal, needs & service plan, and personal rights. Report Continued on LIC 809C... Report Continued from LIC 809C... Six (6) staff files were reviewed for but not limited to; personnel record, health screening with negative tb test result, fingerprint clearance, first aid / cpr certification, and annual staff training. Files were in order. Administrator Certificate valid until 01/15/2027. MEDICATION REVIEW: Medication review began at approximately 12:50 PM. Medications are centrally stored and kept in a locked kitchen cabinet. Medications for two (2) residents were observed. Start dates noted and actual start dates did not match. LPA was unable to verify pill count. The Administrator will review centrally stored medications and records to match correct dates. EMERGENCY DISASTER PLANNING: During today’s visit, the LPA reviewed facility's emergency disaster plan. The facility’s emergency disaster plan is up to date and is adequate. Emergency disaster drills are conducted quarterly; the facility’s last emergency disaster drill was conducted on 02/13/2026. Pursuant to Title 22, California Code of Regulations (CCR), the following deficiencies are cited (refer to LIC809-D). Exit interview conducted. A copy of report and appeal rights were provided.the state’s words, verbatim · CDSS document, Mar 2, 2026

Type of visit: Prelicensing

Licensing Program Analyst (LPA), Martha Arroyo conducted a pre- licensing visit to the facility noted above at 10:00 a.m. Upon arrival, LPA met with Applicant Representative, Jennifer Pantig as this is a change of ownership application from Love Circle Home Care LLC #565802407 to Love Circle Home Care #565850456. The applicant has obtained fire clearance for a total capacity of six (6) residents, of which one (1) may be bedridden in bedroom #4. The facility has a dementia program in place. Hospice waiver approved for three (3) residents. LPA inspected facility for Fire Safety, Personal Accommodations and Services, and Food Service. The smoke alarms and carbon monoxide detectors were tested and function properly. LPA observed two (2) new fire extinguishers with a purchase date of 08/07/2025. There is one (1) double occupancy bedroom and four (4) single occupancy bedrooms for resident use. There is no staff room on premises. Facility has 24-hour wake staff. Each bedroom is equipped with clean mattresses, pillows, and bedding. Bedrooms have sufficient lighting. There is a closet in the hallway with a sufficient supply of linens, including blankets, bath towels and wash cloths. There is a locked closet with the residents personal hygiene items. The facility has two (2) bathrooms for resident use. Resident bathrooms contained appropriate non-skid mats and grab bars. Bathrooms have sufficient paper products. Hot water temperature was measured in both bathrooms, and they measured between 105- and 120 degrees Fahrenheit. LPA observed trash cans with tight fitting lids at the time of the visit. Report Continued on LIC 809C... Report Continued from LIC 809... LPA toured the kitchen area at 10:20 a.m. The facility has at least seven (7) day supply of non-perishable food and two (2) days perishable food. Appliances and all equipment appear to be clean and in good repair. Kitchen knives and sharps were observed locked and inaccessible under the kitchen sink. The kitchen has a sufficient supply of plates, cups, cookware, and utensils. The living areas and dining areas are clean and properly furnished. All window screens and coverings are in good repair. Enough seating for six (6) residents at the same time in the dining room table. A working telephone is present. There are activity supplies in the living room and family room. LPA observed a fireplace adequately covered. Night-lights were present in the common areas. Medications are stored and locked in the hallway closet. First aid kit was observed to be complete next to the medications. The garage is attached to the house and inaccessible to residents in care. There is one (1) additional refrigerator in the garage with extra food for residents. The washer and dryer was observed inside the garage. Detergents, disinfectants, and cleaning supplies are stored locked and inaccessible. There will be no firearms/ammunition stored on the property. There is a sufficient supply of emergency food and water. The facility has required postings, including emergency exit plan, Licensing Complaint Poster, Resident Personal Rights, Theft and Loss Policy, and Resident Council Rights. The exterior passageways were clean and clear of any obstructions. There is one (1) gate with latching mechanisms for emergency use. There are no bodies of water noted on the premises at the time of the visit. LPA observed the backyard, which has a covered outdoor area with a table and chairs for resident use. Report Continued on LIC 809C... Report Continued from LIC 809C... Physical plant is accurate with the submitted facility sketch / floor plan. Comp III conducted with Applicant Representative. This report will be sent to the Centralized Application Bureau (CAB). You will be notified by the CAB Analyst when your license has been approved. You are not allowed to begin operating until you have been notified that your license has been approved by the CAB Analyst. Failure to comply could affect approval of your license. Exit interview conducted. The report was reviewed, and a copy was provided.the state’s words, verbatim · CDSS document, Oct 9, 2025

Type of visit: Office

Facility Type: Residential Care Facility for the Elderly Application Type: Change of Ownership Capacity: 6 Census (if any clients in care): 4 COMP II Participants: JENNIFER PANTIG Interview Method: Telephone interview On September 30, 2025, applicant/administrator participated in COMP II. Identification of the applicant and administrator was verified through interview questions based on photo ID and other identifying personal information. During COMP II, applicant and administrator confirmed the understanding of the California Code Title 22 Regulations. Signed LIC 809 with copy of photo ID have been obtained. During COMP II, CAB analyst confirmed Applicant/Administrator’s understanding of following areas: 1. Facility operation: License type, client/resident populations, and program 2. Admission Policies 3. Staffing requirements & Training 4. Restricted/Prohibited Health Conditions 5. General provisions 6. Emergency Preparedness 7. Complaints & Reporting 8. Pre-licensing readinessthe state’s words, verbatim · CDSS document, Sep 30, 2025