Lovies Board and Care II

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Valeria Conway arrived at the facility unannounced to conduct a one year required annual at 9:15 A.M. Upon arrival, the LPA was greeted at the door by Administrator, Sophia Bonoan, and the reason for the visit was explained. At 9:50 A.M. House Manager, Maria Del Rocio Partida, joined the visit. Entrance interview conducted. At 10:00 A.M., the LPA along with the Administrator toured the physical plant areas inside and outside to ensure there are no health and safety hazards and facility is in compliance with Title 22 Regulations. This facility doesn’t have a staff room; facility will provide 24/7 care. The following observed: KITCHEN: Kitchen appliances appeared to be in operable condition. The facility has a sufficient supply of perishable and non-perishable food at the time of the visit. All knives, cleaning solutions, and chemicals were observed to be locked under the kitchen sink. LPA reviewed expiration dates on product labels and observed five (5) items that had expired on September 1st 2026. Administrator discarded all five (5) items during today’s visit. At 10:45 A.M. the hot water temperature measured 99.5 degrees Fahrenheit. During today’s visit, the administrator adjusted the water temperature. LPA observed a fire extinguisher fully charged and recently purchased on 08/31/2026. Continued on LIC 809-C Continued from LIC 809 BEDROOMS: There are five (5) bedrooms, which Room #5 is for ambulatory individuals only and Room #1 for double occupancy. The LPA observed the resident bedrooms, which were furnished appropriately with clean linens, appropriate furnishings and sufficient lighting. RESTROOMS: There are two (2) bathrooms, LPA observed toilets and hand-washing stations to be in operation with grab bars and slip-resistant surfaces. Hot water temperature was measured in both bathrooms and measured 124.7 - and 129.0 degrees Fahrenheit. During today’s visit, the Administrator adjusted the water temperature. Administrator stated that the facility’s water temperature had been previously checked by staff and was within regulatory range, LPA requested documentation verifying the date and time the water temperature was checked and the temperature recorded at the time of monitoring. However, the Administrator stated that facility does not keep track of hot water temperatures. COMMON SPACES: In the common areas, walls and flooring were checked for cleanliness and good condition. At the time of the visit, living room and dining room furniture was observed to be in good condition. A fireplace was noted and was observed to be adequately screened and inaccessible to residents in care. The LPA observed the required postings in the common area. The facility serves residents with dementia, the auditory alarms on the exit doors were tested and functioned properly at the time of visit. The facility maintained a temperature of 83 degrees Fahrenheit. Administrator stated that the facility’s air conditioning system is not currently operational and that efforts are underway to repair the system. Administrator further stated that, during periods of high temperatures, portable fans and ceiling fans are used to assist in maintain the indoor temperature between 78 – 85 degrees Fahrenheit. Facility has a fire door to contain a fire from one side of the house to the other side. At 10:31 A.M. hardwire smoke alarms and carbon monoxide were tested and found to be functional at the time of the visit. OUTDOOR SPACE: The backyard area contains a shaded area with a table and chairs for residents’ use. LPA observed that the side exit gate had a self-closing and self-latching mechanism. However, an additional lock had been installed on the side gate. Administrator stated that the lock was added to prevent residents from exiting the facility without staff supervision. No bodies of water noted at the time of visit. Continued on LIC 809-C Continued from LIC 809-C GARAGE: A garage is accessible from the interior and exterior of the building. Inside the garage LPA observed an extra fridge, emergency water, emergency food and extra medical supplies. The washer, dryer, cleaning supplies and chemicals are safely stored and inaccessible to residents. All residents’ and staff members’ files were observed to be securely stored and locked in a file cabinet to ensure privacy and confidentiality. RECORDS: Records review began at 11:42 A.M. LPA reviewed two (2) residents’ records for, but not limited to care plans, medical records, admissions agreement, and consent forms. LPA observed that Resident #1’s (R1’s) physician’s report (LIC 602) had not been updated and did not reflect the resident’s current and accurate information. Report dated 01/2025 indicates that R1 is bedridden and does not have capacity for self-care. However, during today’s visit, LPA observed R1 drinking coffee, having lunch and repositioning in bed. LPA requested a new LIC 602 to be sent to LPA. At 12:45 P.M., LPA reviewed five (5) personnel records including administrator. All staff files were reviewed for, but not limited to health assessments, criminal record clearances, first aid/CPR training, and the appropriate training. LPA observed that 20 hours staff training was dated between September and October 2025. Administrator stated that the 20-hour required staff training are conducted yearly during the months of September and October. Adding that the facility’s 2026 annual 20-hour staff training will be conducted between September and October 2026. LPA requested a copy of this year’s training when conducted. MEDICATIONS: Medications review begin at 1:11 P.M., medications are centrally stored and locked in a hallway cabinet. Medications are labeled and checked for expiration dates. LPA observed that medication was being pre-popped in advance of administration. During today’s visit LPA informed the Administrator and House Manager that removing medication from their original packaging in advance of administration (pre-popping) is not permitted. Technical Violation (TV) issued. A first aid kit was observed in the hallway cabinet. Continued on LIC 809-C Continued from LIC 809-C Additionally, the LPA reviewed the facility's infection control practices and the emergency disaster plan. LPA observed that both plans were not updated/reviewed yearly as required by regulations. Technical Violation (TV) issued. Pursuant to Title 22 of the California Code of Regulations Division 6, Chapter 8, the following deficiencies were cited (refer to LIC 9099-D). Failure to correct the deficiencies may result in additional civil penalties. A civil penalty in the amount of $250 for a repeat violation issued within 12 months is being assessed on the attached LIC 421FC. The Administrator was informed that additional civil penalties might be assessed. Exit interview conducted. Citations issued. A Copy of report and appeal rights provided.the state’s words, verbatim · CDSS document, Sep 9, 2026

From the deficiency page — Deficiency type: Type B · Section cited: CCR 87555(b)(8) · Plan of correction due date: Sep 9, 2026

87555 General Food Service Requirements (b) The following food service requirements shall apply:(8) All food shall be of good quality... Food in damaged containers shall not be accepted, used or retained. This requirement is not met as evidenced by: Based on observation the Administrator did not comply with the section cited above as hamburger buns, tortillas, and 3 canned items in the emergency food supply were found to be past their expiration dates which poses a potential health risk to clients in care.the state’s words, verbatim · CDSS document, Sep 9, 2026

Plan of correction: Administrator discarded all expire items during today's visit. POC cleared.

From the deficiency page — Deficiency type: Type B · Section cited: CCR87303(e)(2) · Plan of correction due date: Sep 10, 2026

(e) Water supplies and plumbing fixtures shall be maintained as follows:(2)...Hot water temperature controls shall be maintained to automatically regulate the temperature of hot water... not more than 120 degree F (49 degrees C). This requirement is not met as evidenced by: Based on observation, the licensee did not comply with the section cited above by not maintaining hot water temperature within reulation which poses an immediate health, safety or personal rights risk to persons in care.the state’s words, verbatim · CDSS document, Sep 9, 2026

Plan of correction: Administrator adjusted water temperature during today's visit. POC cleared. A hot water log will be kept at the facility.

From the deficiency page — Deficiency type: Type A · Section cited: CCR 87705(f)(1-4) · Plan of correction due date: Sep 10, 2026

87705 Care of Persons with Dementia (f) Licensees that lock exterior doors or perimeter fence gates shall meet the following initial and continuing requirements: (1-4). This requirement is not met as evidenced by… Based on observation during facility tour, the licensee did not comply with the above cited section, as side gate had a additional lock to prevent residents elopingd which poses an immediate safety risk to residents in care.the state’s words, verbatim · CDSS document, Sep 9, 2026

Plan of correction: Administrator will remove the additional lock added to prevent resident from leaving the facility. A picture of the side gate without the lock will be sent to LPA before POC due date.

Type of visit: Case Management - Deficiencies

Licensing Program Analyst (LPA) Valeria Conway conducted an unannounced visit at the facility in conjunction with a complaint investigation that occurred today. LPA met with Administrator, Sophia Bonoan, and explained the purpose of the visit. Entrance interview conducted. During today’s facility tour and record review conducted with the Administrator, the LPA observed that Resident’s #1(R1’s) file, with an admission date of 11/01/2025, did not contain all required on-boarding documentation. Specifically, the pre-admission appraisal form, a reappraisal form, or an appraisal/needs and service plan. The administrator stated that R1 was referred by the hospital and believed it was not necessary to complete a pre-placement assessment on R1 prior to admission. Regarding the appraisal and the appraisal/needs and service plan, the administrator explained that R1 had a short stay at the facility due to health complications, and the facility did not have sufficient time to complete these documents. Additionally, it was noted that the facility did not notify Community Care Licensing (CCL) of an apparent fall incident or of a 911 emergency response in which R1 was transported to the hospital. According to the administrator, on 11/01/2025, Resident #1 (R1) slid from their bed; however, the caregiver on duty cushioned the fall with one of their feet. The facility notified R1’s family member, who declined to have emergency services contacted. On 11/04/2025, R1 received an Xray due to ongoing discomfort and pain. On 11/30/2025, R1 was subsequently transported to the hospital via Emergency Services due to an apparent Urinary Tract Infection (UTI). When LPA inquired about the details of the fall, the administrator stated they were not present when the fall occurred. Continued on LIC 809-C Continued form LIC 809-C The administrator confirmed that they contacted 911 on 11/30/2025 after observing blood in R1’s urine. Regarding notifying CCL of these events, the administrator stated that they are aware of the CCL reporting requirements, however, because they believe this incident did not occur as a result of facility neglect, they did not believe that it was necessary to report it to CCL. LPA explained to the Administrator that a written report shall be submitted to the licensing agency and to the person responsible for the resident within seven days of the occurrence Furthermore, the LPA requested R1’s plan of care from the hospice agency. According to the administrator, the hospice nurse maintains all notes and the plan of care for R1 in their office. At 10:10 A.M., the hospice nurse was contacted by phone and was asked to email the notes and plan of care to the LPA by noon. The nurse stated that the office was closed at that time and that the documents would be emailed by the end of the business day. As a result, the LPA was unable to obtain these documents during today’s visit. The LPA explained the importance of having required documents readily available and accessible at all times. Pursuant to Title 22 of the CA Code of Regulations and/or CA Health and Safety Code, the following deficiencies were cited (refer to LIC 809-D). Administrator was informed that failure to correct the deficiencies may result in additional civil penalties. Exit interview conducted, today's reports, civil penalties and appeal rights were reviewed and issued.the state’s words, verbatim · CDSS document, Dec 8, 2025

From the deficiency page — Deficiency type: Type B · Section cited: CCR 87457(c) · Plan of correction due date: Dec 23, 2025

(c) Prior to admission a determination of the prospective resident's suitability for admission shall be completed... comparison with the admission criteria specified in Section 87455, Acceptance and Retention Limitations. This requirement is not met as evidenced by: Based on record review, the licensee did not comply with the section cited above. No Preplacement or resident appraisal on file for resident #1 which poses/posed a potential health, safety or personal rights risk to persons in care.the state’s words, verbatim · CDSS document, Dec 8, 2025

Plan of correction: Administrator agreed to have a complete pre-admission appraisal for all residents. An statement of understanding including this regulation will be provided to CCLD by the POC due date.

From the deficiency page — Deficiency type: Type B · Section cited: CCR87211(a)(1) · Plan of correction due date: Dec 23, 2025

(a) Each licensee shall furnish to the licensing agency such reports…: (1) A written report shall be submitted to the licensing agency… within seven days of the occurrence of any of the events...This requirement was not met as evidenced by: Based on interview and record review the Licensee did not comply with the above cited section as CCL did not receive a report/notification of an apparent fall incident or of a 911 emergency response whiich poses a potential health, safety, or personal rights risk to persons in care.the state’s words, verbatim · CDSS document, Dec 8, 2025

Plan of correction: From now on the administrator agrees to report any unusual incident to CCL. An in-service staff training will also be conducted on CCL reporting requirements and will be provided to LPA the POC due date.

From the deficiency page — Deficiency type: Type B · Section cited: CCR 87412(f) · Plan of correction due date: Dec 23, 2025

Personnel Records. All personnel records shall be available to the licensing agency to inspect, audit, and copy upon demand during normal business hours. This requirement was not met as evidenced by: Based on observation and interview, the licensee did not comply with the above cited section when R1'’s hospice care plan and notes were not available to CCL, which posed a potential health and safety risk to residents in care.the state’s words, verbatim · CDSS document, Dec 8, 2025

Plan of correction: Administrator agreed to provide requested documentation by the end of the day and complete a written statement of acknowledgement and understanding of 87412.

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Valeria Conway arrived unannounced to conduct a one year required annual at 9:10 A.M. Upon arrival, the LPA was greeted at the door by administrator, Sophia Bonoan, and the reason for the visit was explained. At 10:00 A.M. House Manager, Maria Del Rocio Partida, joined the visit. Administrator stated they had a doctor’s appointment to attend and, in the event, they were not available to sign today’s report, authorized the House Manager or caregiver, Altagracia Luna Naranjo, to sign on their behalf. Entrance interview conducted. At 9:35 A.M., the LPA along with the administrator toured the physical plant areas inside and outside to ensure there are no health and safety hazards and facility is in compliance with Title 22 Regulations. This facility doesn’t have a staff room; facility will provide 24/7 care. The following observed: KITCHEN: Kitchen appliances appeared to be in operable condition. The facility has a sufficient supply of perishable and non-perishable food at the time of the visit. All knives, cleaning solutions, and chemicals were observed to be locked under the kitchen sink. At 9:39 A.M. the hot water temperature measured 143.2 degrees Fahrenheit. During today’s visit, the administrator adjusted the water temperature. At 12:38 P.M., LPA rechecked hot water temperature and measured 113.5 degrees Fahrenheit. LPA observed a fire extinguisher fully charged and recently purchased on 08/10/2025. Continued on LIC 809-C Continued from LIC 809 BEDROOMS: There are five (5) bedrooms, which Room #5 is for ambulatory individuals only and Room #1 for double occupancy. The LPA observed the resident bedrooms, which were furnished appropriately with clean linens, appropriate furnishings and sufficient lighting. RESTROOMS: There are two (2) bathrooms, LPA observed toilets and hand washing stations to be in operation with grab bars and slip-resistant surfaces. Between 9:30 A.M. and 9:55 A.M. Hot water temperature was measured in both bathrooms and measured 141.5- and 140.8-degrees Fahrenheit. During today’s visit, the administrator adjusted the water temperature. At 12:42 P.M. LPA rechecked both bathrooms, and hot water temperature measured 110.1- and 111.7 degrees Fahrenheit. COMMON SPACES: In the common areas, walls and flooring were checked for cleanliness and good condition. At the time of the visit, living room and dining room furniture was observed to be in good condition. A fireplace was noted and was observed to be adequately screened and inaccessible to residents in care. The LPA observed the required postings in the common area. The facility serves residents with dementia, the auditory alarms on the exit doors were tested and functioned properly at the time of visit. The facility maintained a comfortable temperature of 73 degrees Fahrenheit. Facility has a fire door to contain a fire from one side of the house to the other side. At 10:00 A.M. hardwire smoke alarms and carbon monoxide were tested and found to be functional at the time of the visit. OUTDOOR SPACE: The backyard area contains a shaded area with a table and chairs for residents’ use. Exit gate was observed to be self-closing and self-latching and it was clear and free of hazards. During today’s visit, the front yard passageway was observed to be obstructed by a pumpkin vine. The plant was trimmed, and the passageway was cleared of hazards. Technical Violation (TV) issued. No bodies of water noted at the time of visit. GARAGE: A locked garage is accessible from the interior and exterior of the building. Inside the garage LPA observed an extra fridge, emergency water, emergency food and extra medical supplies. The washer, dryer, cleaning supplies and chemicals are safely stored and inaccessible to residents. All residents’ and staff members’ files were observed to be securely stored and locked in a file cabinet to ensure privacy and confidentiality. Continued on LIC 809-C Continued from LIC 809 RECORDS: Records review began at 11:16 A.M. LPA reviewed three (3) residents’ records for, but not limited to care plans, medical records, admissions agreement, consent forms. LPA observed that Resident #1 (R1) is missing consent forms. A physician’s report dated 01/2025 indicates that R1 is bedridden and does not have capacity for serf-care. However, during today’s visit, LPA observed R1 self-feeding a salad for lunch and repositioning in bed. LPA requested that the administrator update R1’s physician’s report and Needs and Service Plan. Furthermore, Resident #2 (R2) has a Medical Assessment (LIC602A) signed in 09/2025 indicating ambulatory status of bedridden. In addition, Resident #3 (R3), a non-ambulatory individual, was observed occupying room #5 which is designated for ambulatory residents only. At 1:45 PM, LPA reviewed four (4) personnel records including administrator. All staff files were reviewed for, but not limited to health assessments, criminal record clearances, first aid/CPR training, and the appropriate training. LPA requested and received a copy of the current Personnel Record Form (LIC 500). Upon review, LPA compared the LIC 500 with the Guardian background check system and absorbed that Staff# 1 (S1) is listed on the LIC 500 as the House Manager with a Monday through Friday night shift. However, S1 does not have an exemption granted and is not associated with this facility in the Guardian background check system. House manager left the facility at 2:45 PM. Administrator then assigned caregiver, Altagracia Luna Naranjo, will be signing today’s report. All other files were in order. Liability insurance is current. Last emergency drill (Evacuation Plan) was conducted on 06/10/2025. MEDICATIONS: Medications review begin at 2:25 P.M., medications are centrally stored and locked in a hallway cabinet. Medications are labeled and checked for expiration dates. Medications are not being documented on the Centrally Store Medication log, a file containing this form was emailed to the administrator during today’s visit. A first aid kit was observed in the hallway cabinet. Pursuant to Title 22 of the California Code of Regulations Division 6, Chapter 8, the following deficiencies were cited (refer to LIC 9099-D). Failure to correct the deficiencies may result in additional civil penalties. A civil penalty in the amount of $500 for a fire clearance and a civil penalty in the amount of $500 for background check violation is being assessed on the attached LIC 421IM and LIC 421 BG. The Administrator was informed that additional civil penalties might be assessed based on health and safety code 1569.49(f) via telephone. Exit interview conducted. Citations issued. A Copy of report and appeal rights provided via email.the state’s words, verbatim · CDSS document, Sep 30, 2025

Type of visit: Prelicensing

Licensing Program Analyst (LPA) Valeria Conway conducted an announced Pre-Licensing Inspection to the above listed facility. Upon arrival LPA met with Administrator Sophia Bonoan. Entrance interview conducted. An application to operate a Residential Care Facility for the Elderly (RCFE) was received by Community Care Licensing (CCL) on 04/17/2024. A Fire Clearance was approved for a maximum capacity of six (6), 1 (one) ambulatory and five (5) non-ambulatory residents, with a hospice waiver for three (3) on 04/16/2024. The facility consists of five (5) total bedrooms – 4 will be private resident rooms and 1 shared resident room. There are two (2) bathrooms in the facility for resident use. The proposed physical plant is a one (1) story single family dwelling located in a residential neighborhood of Camarillo, CA. This facility will be housing residents with dementia. There are no client residing in the facility at the moment. This facility doesn’t have a staff room, facility will provide 24/7 care. LPA inspected facility for Fire Safety, Personal Accommodations and Services, Medication Procedures, and Food Service. Fire extinguisher is fully charged and recently purchased on 04/01/2024. Fire alarms/carbon monoxide detectors were tested at 10:37 A.M. and were functional at the time of the visit. LPA observed all required postings on the facility wall, a revised Emergency and Disaster Plan and a Plan of Operation in use. At 10:15 am a tour of the physical plant was conducted and the following observed: BEDROOMS: There are five (5) bedrooms, which Room #5 is for double occupancy. All bedrooms were equipped and supplied with appropriate furniture including but not limited to a bed, a chair, a night stan, a lamp and a chest of drawers, bedding, and linens. No client bedroom will be used as a public or general passageway to another room, bath, or toilet. There were no visible hazards or discrepancies observed. Continues on LIC 809-C Continued from LIC 809-C BATHROOMS: There are two (2) bathrooms, LPA observed toilets and hand washing stations to be in operation condition. Solid waste containers are in good repair and have tight-fitting covers. Hygiene items of general use such as soap and toilet paper were observed in each bathroom. Facility provides each resident privacy and personal accommodations. Additionally, bathrooms had non-skid mats, and grab bars. Water temperatures were measured in all client bathrooms and measured within the required range of 105 degrees Fahrenheit to 120 degrees Fahrenheit at the time of the visit. KITCHEN: Appliances and fixtures appeared clean and functional. At the time of the visit, LPA observed a sufficient amount of dining and cook ware, non-perishable and perishable food to accommodate a maximum capacity of six (6) clients and facility staff for seven (7) days. Minimal cleaning supplies, sharps and knives will be stored in locked under-sink cabinets. There were no visible immediate hazards observed. At 10:20 A.M. hot water measured at 115.6 degrees Fahrenheit . COMMON AREAS: These include the Family Room, Living Room and Dining Room. The common areas were checked for cleanliness and furniture was checked for functionality during time of visit. The facility has a fireplace in the dining room. LPA observed the fireplace to be properly screened. There is a designated telephone available and internet service for resident use. Facility has enough space to store clean common linen items such as bed sheets, towels, pillowcases, and mattress pads. LPA observed night lights in all hallways and passages to non private bathrooms. Facility has an auditory signal system in place at the time of the visit. Facility is equipped with fire door to enhance safety and prevent the spread of fire. MEDICATION: Medications and complete first aid kit will be stored in a locked closet in the hallway next to room #5. At the time of the visit LPA observed five (5) individual empty plastic containers where medication will be store for each resident. Facility will properly document medication on the Centrally Store Medication and Destruction log. Continues on LIC 809-C Continued from LIC 809-C SURROUNDING GROUNDS: Garden and yard are easily accessible to residents, and they are sufficient in size, comfortable and appropriately equipped for outdoor use. There was a shaded area with proper furniture for outdoor use. Gate was observed to be self-closing and latching. There are no bodies of water on the premises. LPA observed sufficient space to accommodate both indoor activities and outdoor activities for residents. All outdoor and indoor passageways were observed free of obstruction. GARAGE: LPA also observed the locked garage, which contains emergency disaster supplies, locked chemical storage, washer and dryer. All residents’ and staff members’ files will be securely stored in the garage, locked in a file cabinet to ensure privacy and confidentiality. LPA observed sufficient amount of emergency water and emergency food at the time of the visit. COMPONENT III ORIENTATION: A Component III Orientation was conducted with Administrator Sophia Bonoan during today's visit. The following needs to be completed/Photos sent to LPA prior to licensure:  No corrections at this time. 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. A copy of the Licensing Report was issued.the state’s words, verbatim · CDSS document, Sep 4, 2024

Type of visit: Office

Facility Type: RCFE Application Type: Initial Capacity: 6 Census (if any clients in care): 0 COMP II Participants: Bonoan, Sophia - Applicant/Administrator Interview Method: Telephone interview On 08/01/2024, 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 that they have read and understand community care facility licensing laws included in the Health and Safety Codes and the California Code of Regulations Title 22. 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. Restrictive/Prohibited Health Conditions 5. General provisions 6. Emergency Preparedness 7. Complaints & Reporting 8. Pre-licensing readinessthe state’s words, verbatim · CDSS document, Aug 1, 2024