Magnolia

Type of visit: Required - 1 Year

At 10:00am on 01/26/2026 Licensing Program Analyst (LPA) Jeffries arrived unannounced to conduct the annual facility inspection. LPA met with Administrator Dorothy Berger, announced who he is and the reason for the visit. LPA conducted facility annual for both facilities under this Licensee during this annual inspection. This facility has a fire clearance for a secured perimeter and has 12 resident room. 2 rooms are single resident occupancy (rooms #6 and #7),the remaining rooms are double resident occupancy. All resident rooms are properly furnished with bedding, storage, seating and lighting according to regulations There is one on suite bathroom for room #8 and there are 4 bathrooms that are located through out the facility that are community use bathrooms. All bathrooms have liquid soap and paper towels. LPA noted non-skid mats showers. There is a large great room that serves as a dining room, living room and activities room. LPA noted that there is a kitchen inon the north side of the facility and is the main kitchen for both facilities. The main food supply is located at the adjacent "barn" outside the facility gate, where LPA noted at least a 2 day supply of non perishable foods and at least a 7 day supply of perishable foods on hand for 28 (both facilities have a maximum number of 14 residents per facility) residents and staff. LPA noted that the facility has a medication room in the hallway near resident room #8. LPA noted that the first aide kit is located in the medication room. LPA noted the facility has overhead sprinkler system with smoke detection that was last tested and certified by Santa Barbara County Fire department on 04/07/2025. LPA noted three fire extinguishers throughout the facility that were charged in the green and currently tagged as serviced. LPA noted that all passage ways were free and clear of debit and obstacles. LPA noted that the fire clearance authorized locked gates on the perimeter gates. LPA conducted a sample review of staff and resident files. LPA noted and reviewed facilities current emergency disaster plan and infection control plan, and liability insurance LPA conducted a full review of the annual care tools and found no citations or deficiencies. This annual inspection did not revel any citations or deficiencies. Exit interview, report read, and report provided.the state’s words, verbatim · CDSS document, Jan 26, 2026

Type of visit: Required - 1 Year

On 01/27/2025, Licensing Program Analyst (LPA) Melisa Rankin arrived unannounced for an unscheduled visit to conduct a required Annual Facility site inspection visit at the facility above. LPA met with Administrator Dorothy Berger and informed her of the reason for the visit. The LPA toured the physical plant areas inside and outside to ensure there are no health and safety hazards and the facility is in compliance with Title 22 Regulations. This is a Residential Care Facility for the Elderly (RCFE), with an approved fire clearance capacity of fourteen (14) Non-Ambulatory residents, of which two (2) may be bedridden. The facility has an approved Hospice Waiver for seven (7) residents. The facility has been approved for a secured perimeter of electronically locked gates/fencing. KITCHEN: The LPA inspected the kitchen/food service area and observed that knives/sharp instruments are stored in a locked drawer inaccessible to residents. Kitchen appliances were in operable condition and looked clean/in good repair. The facility has a sufficient supply of perishable and non-perishable food. Items that could constitute a danger to residents are kept inaccessible to residents in the kitchen area. The kitchen was clean and sanitary. A review of all food items will be done to ensure expiration dates are adhered to. COMMON AREAS: At the time of the visit, the common areas of the facility were observed to be appropriately furnished, with all furniture in good condition. The facility maintained a comfortable temperature of 68 to 70 degrees. Smoke detector(s) and carbon monoxide detector(s) were inspected along with the sprinkler system in October of 2024. The facility has multiple fire extinguishers that were fully charged and serviced in October of 2024. Continued on 809-C This is a single-story facility with a main dining room/living room area, kitchen area, library room, laundry room, 8 resident bedrooms, 4 resident restrooms, a locked centrally stored medication containment area, extra storage areas for additional perishable food, cupboards in the hallways of the facility containing extra linen/bedsheets/pillows, and storage areas for resident personal hygiene equipment. The LPA observed required postings throughout the common spaces. All window screens observed were in good repair. There is appropriate lighting in the common areas of the facility. All passageways through the common areas of the facility were free of obstruction, and all inclines are well-lit with no stairwells/stairs for resident use. OUTSIDE/LAUNDRY/MISCELLANEOUS: The exterior of the facility has an approved secured perimeter which consists of a metal fence around the entire facility with locked gates. The gates are locked through a combination of electronic punch numbered locks as well as traditional key locks. Inside of the locked perimeter is the outdoor/outside activity area for residents with a patio, furniture, shade, a small garden, and a fountain that currently is empty of water and filled with stones. The designated laundry area is where cleaning products are stored, which are kept locked and inaccessible to residents. There was emergency food and water in a storage area pantry next to the kitchen and in the extra perishable food storage area which was observed to be in good condition. LPA did not observe any noticeable outdoor hazards in areas accessible to residents. There is a garage outside of the locked perimeter fence of the facility that contains extra perishable food, hygiene products, PPE material, and cleaning products. The garage is also locked at all times. BEDROOMS: The LPA observed the resident bedrooms, which were furnished appropriately with clean linens, appropriate furnishings, and sufficient lighting. There are eight (8) designated resident rooms in the facility with either 1 resident per bedroom or shared bedrooms with 2 residents per bedroom. The resident bedrooms are big enough for all beds, furniture, and any resident assistive device a resident might need such as a wheelchair or a walker. RESTROOMS: The facility restrooms were sanitized and in operating condition while the LPA toured the facility. There are four (4) bathrooms in the facility. All restrooms inspected had assistive equipment for residents including grab bars and/or non-skid surfaces. Continued on 809-C The restrooms were sufficiently stocked with soap, paper towels, and additional supplies; towels and washcloths are not shared. The facility maintains both communal restrooms for residents in the hallways of the facility, as well as a personal restroom for residents in a shared bedroom. RECORDS: The facility keeps confidential storage of resident records as well as staff member records on-site at the facility. Staff member records were reviewed for, but not limited to Personnel records, Health assessments with Tuberculosis (TB) test results, Criminal record Statements/Criminal record clearances, first aid/CPR certification, and the appropriate training. All staff members’ personnel records had the appropriate documentation. Two staff are scheduled to complete required training this week, administrator will provide completed certificates to the LPA. The administrator is currently Active in the Administrator Certificate listing, expiring in 9/9/2025. Resident records were reviewed for Pre-Admission/Placement appraisals, Physicians Reports, Consent Forms, Personal Rights for Residents, Emergency Information, Release of Medical Information, and Needs and Services Plan (ANS)/Resident Activity Assessments. The Needs and Services plan form used by the state is required annually, facility does a more detailed process of doing daily assessment of residents needs, and administrator reviews and adjusts what resident requires as needed. All resident records reviewed by the LPA had the appropriate documentation with no missing or incomplete information. MEDICATIONS: The facility maintains a locked centralized storage area for resident medications. Centrally Stored Medications are in a locked room that has a combination electronic lock on the door, which remains locked at all times. LPA audited a sampling of medications for residents. Due to review, House Manager will do an audit of medications, and records to ensure all documents are updated consistently across all shifts by all med techs. Training and update will be provided to LPA. Staff were able to explain and answer all LPA inquires. Document used by the facility include PRN Authorization, centrally stored listing of all medications, pharmacy refill requests, resident refusals, and physician contacts. Continued on 809-C FACILITY DOCUMENTATION: Facility has an approved Infection Control Plan on file with the department. There are required postings throughout the facility, including emergency exit. The facility keeps hard copies of facility documentation such as LIC 500 Personnel Report, Emergency Disaster Plan for Residential Care Facilities for the Elderly (RCFE), and a Facility Sketch. Facility will update their Emergency Disaster Plan to the revised state form and provide LPA with a copy of the document. Provider Information Notices are easily accessible and presented to LPA upon request during the inspection process. No deficiencies cited. Exit interview conducted. A copy of the report will be emailed to the facility.the state’s words, verbatim · CDSS document, Jan 27, 2025

Type of visit: Required - 1 Year

On 01/11/2024, Licensing Program Analyst (LPA) Brian Phillips arrived unannounced for an unscheduled visit to conduct a required Annual Facility site inspection visit at the facility above. When the LPA arrived, they were greeted by Administrator Dorothy Berger and Licensee/Owner Margie Halsell, and informed them of the reason for the visit. The LPA toured the physical plant areas inside and outside to ensure there are no health and safety hazards and the facility is in compliance with Title 22 Regulations. This is a Residential Care Facility for the Elderly (RCFE), with an approved fire clearance capacity of fourteen (14) Non-Ambulatory residents, of which two (2) may be bedridden. Bedridden residents are approved to be in bedrooms #1, #2, and #8 of the facility. The facility has an approved Hospice Waiver for seven (7) residents. The facility has been approved for a secured perimeter of electronically locked gates/fencing. The physical plant of the facility contains eight (8) resident bedrooms, and four (4) resident bathrooms, kitchen area, dining room/living room, library room, laundry room, and garage/storage area. There is an outside area of the facility for residents to utilize for outdoor activities and an outdoor patio area with furniture and shade. KITCHEN: The LPA inspected the kitchen/food service area and observed that knives/sharp instruments are stored in a locked drawer inaccessible to residents. Kitchen appliances were in operable condition and looked clean/in good repair. The LPA observed perishable items in good condition, with proper expiration dates precluding the perishable items from expiring. The facility has a sufficient supply of perishable and non-perishable food, which would last over a week (7 days). Additional perishable food items were maintained in a storage area in the garage of the facility as well as an extra refrigerator and extra freezer located in the garage of the facility. The hot water temperature was measured in the kitchen at an appropriate temperature as per the regulation between 105-120 degrees Fahrenheit. Items that could constitute a danger to residents are kept inaccessible to residents in the kitchen area. The kitchen was clean and sanitary, with covered trashcans and operating ventilation systems. Continued on 809-C No toxic substances are stored in any food preparation or storage area, and all cleaning supplies for the kitchen are kept in a separate area than the food supplies. The freezer and refrigerator were both in the appropriate temperate Fahrenheit. There is enough tableware and utensils for all residents living in the facility, and enough equipment for the storage, preparation, and service of food. COMMON AREAS: At the time of the visit, the common areas of the facility were observed to be appropriately furnished, with all furniture in good condition. There is a fireplace in the facility, located in the dining area/living room that is covered an inaccessible to residents. The facility maintained a comfortable temperature. Smoke detector(s) and carbon monoxide detector(s) were operational at the time of the visit. The facility has multiple fire extinguishers that were fully charged and serviced annually, the last service being March 2023. This is a single-story facility with a main dining room/living room area, kitchen area, library room, laundry room, 8 resident bedrooms, 4 resident restrooms, a locked centrally stored medication containment area, extra storage areas for additional perishable food, cupboards in the hallways of the facility containing extra linen/bedsheets/pillows, and storage areas for resident personal hygiene equipment constituting the interior areas of the facility. The LPA observed required postings throughout the common spaces including Resident Personal Rights and Contact information for Ombudsman as well as Licensing. There are activity supplies and equipment, including activity materials for the residents such as television, puzzles, games, etc. All window screens were in good repair. There is appropriate lighting in the common areas of the facility. All passageways through the common areas of the facility were free of obstruction, and all inclines are well-lit with no stairwells/stairs for resident use. OUTSIDE/LAUNDRY/MISCELLANEOUS: The exterior of the facility has an approved secured perimeter which consists of a metal fence around the entire facility with locked gates. The gates are locked through a combination of electronic punch numbered locks as well as traditional key locks. Inside of the locked perimeter is the outdoor/outside activity area for residents with a patio, furniture, shade, a small garden, and a fountain that currently is empty of water and filled with stones. The recycling bin, green waste bin, and trash bins are standard bins with flip lids. The facility has an outdoor activity area that is provided with a shaded area and furnished for outdoor use. There is a body of water noted on the facility property which is a small water collection reservoir inaccessible to residents as it is outside of the locked perimeter fence. The designated laundry area is where cleaning products are stored, which are kept locked and inaccessible to residents. The laundry room is accessible through the interior hallway of the facility as a specific area which has all hazardous items locked with key locks. Staff members are the only individuals allowed to do laundry and the entire room is kept locked at all times. Continued on 809-C There was emergency food and water in a storage area pantry next to the kitchen and in the extra perishable food storage area which was observed to be in good condition. Cleaning supplies, disinfectants, and other items that could pose a danger to residents are kept in areas inaccessible to residents. There is a first aid kit that includes sterile dressings, bandages, thermometers, scissors, tweezers, and a first aid manual. The vehicles used to transport residents are in safe operating condition with appropriate insurance information. LPA did not observe any noticeable outdoor hazards in areas accessible to residents. There is a garage outside of the locked perimeter fence of the facility that contains extra perishable food, hygiene products, PPE material, and cleaning products. The garage is also locked at all times by the facility. BEDROOMS: The LPA observed the resident bedrooms, which were furnished appropriately with clean linens, appropriate furnishings, and sufficient lighting. There are four (8) designated resident rooms in the facility with either 1 resident per bedroom or shared bedrooms with 2 residents per bedroom. The bedrooms have storage areas for clean linens, towels, pillows, etc. Each resident’s bedroom has a single bed, nightstand, and lights/nightstand lamps to provide sufficient lighting. Each closet in all the resident rooms has extra pillows, clean/fresh linens, and appropriate incontinence materials if applicable for any resident. The resident bedrooms are big enough for all beds, furniture, and any resident assistive device a resident might need such as a wheelchair or a walker. Each room has sufficient lighting for each resident. RESTROOMS: The facility restrooms were sanitized and in operating condition while the LPA toured the facility. There are four (4) resident bathrooms in the facility. All restrooms inspected had assistive equipment for residents including grab bars and/or non-skid surfaces. The restrooms were sufficiently stocked with soap, paper towels, and additional supplies; towels and washcloths are not shared. The hot water temperature was measured in the restrooms at the appropriate degrees Fahrenheit as per the regulations between 105-120 degrees Fahrenheit. Nightlights are installed in the hallways outside of the resident restrooms. The facility maintains both communal restrooms for residents in the hallways of the facility, as well as a personal restroom for residents in a shared bedroom. RECORDS: The facility keeps confidential storage of resident records as well as Staff member records on-site at the facility. Staff member records were reviewed for, but not limited to Personnel records, Health assessments with Tuberculosis (TB) test results, Personnel Action Notice, Job Description with date of employment, Employee Rights, Criminal record Statements/Criminal record clearances, first aid/CPR certification that is not expired, and the appropriate training. All staff members’ personnel records had the appropriate documentation with no expiration of any training. Continued on 809-C Resident records were reviewed for Pre-Admission/Placement appraisals, Physicians Reports, Consent Forms, Personal Rights for Residents, Emergency Information, Release of Medical Information, Needs and Services Plan (ANS)/Resident Activity Assessments, Resident Assessments, Self-management of medications if applicable, Medication Orders, Medication Logs, and Inventory of Personal Effects/Management of Resident Cash and/or Valuables/Property. All resident records reviewed by the LPA had the appropriate documentation with no missing or incomplete information. The administrator is currently in the Pending Active Administrator Certificate process with Licensing having received payment for renewal from the previous Active Administrator Certificate. MEDICATIONS: The facility maintains a locked centralized storage area for resident medications. Centrally Stored Medications are in a locked room that has a combination electronic lock on the door, which remains locked at all times, inaccessible/locked to residents. The locked room with the centrally stored medications is off of the dining room/living room area of the facility, in between the kitchen and dining room area. The LPA observed the centrally stored medications as well as the Centrally Stored Medication and Destruction Record, The Medication Administration Record, and the record of Controlled Medications. LPA audited the medications for residents and noticed no irregularities or issues concerning the dispensing of medications or the logging of medications. The medications in the facility were labeled appropriately with no additional or prohibited markings by the facility. INFECTION CONTROL: Upon entry, the facility has a central entry point for symptom screening and a sanitation station. The staff members will keep up signs that promote good hand hygiene and symptoms of COVID. The facility has an adequate supply of Personal Protection Equipment (PPE) and the facility is able to obtain additional supplies as needed. The facility’s cleaning protocol is sufficient. If needed, the facility has the capacity to designate a single isolation room if the facility has a confirmed case of COVID-19. The facility’s policies and procedures as it pertains to infection control are adequate. FACILITY DOCUMENTATION: There are required postings throughout the facility, including emergency exit plans with necessary telephone numbers. The facility keeps hard copies of facility documentation such as LIC 500 Personnel Report, Emergency Disaster Plan for Residential Care Facilities for the Elderly (RCFE), Infection Control Plan, and a Facility Sketch. Provider Information Notices are easily accessible and presented to LPA upon request during the inspection process. No deficiencies cited. Exit interview conducted. A copy of the report was issued to the facility.the state’s words, verbatim · CDSS document, Jan 11, 2024