Millennium Care II

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Martha Arroyo arrived at the facility unannounced to conduct a required annual visit today. Upon arrival, there were two (2) staff and five (5) residents present. Administrator, Iris Van Kralingen was contacted and arrived shortly after LPA. The reason for the visit was explained. At approximately 11:20am, the LPA and staff 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. COMMON AREAS: This includes the living room and dining room area. The common areas were furnished appropriately, and all furniture was observed to be in good condition at the time of the visit. The facility maintained a comfortable temperature. LPA observed required postings throughout the common space. Activities were observed in the living room. There is a working telephone on premises. BEDROOMS: There are three (3) bedrooms for resident use all of which are designated as double occupancy rooms. All resident rooms were observed to be furnished appropriately with clean linens, appropriate furnishings, and sufficient lighting. Additional clean linens, towels, and washcloths were observed in the hallway closet. There is one (1) staff room on premises. RESTROOMS: The two (2) resident restrooms were clean and sanitary and in operating condition with grab bars and non-skid surfaces. Sufficiently supplies observed. Hot water temperature was measured in the first bathroom at 110.5 degrees Fahrenheit and the 111.2 degrees Fahrenheit in the second bathroom. Report Continued on LIC 809C. LPA observed functioning auditory alarms at the time of the visit. No obstructions or hazards were observed inside or out. GARAGE: The garage is maintained locked and inaccessible to residents in care. Laundry room was observed locked at the time of the visit. Cleaning supplies, detergents, and toxins were observed in a locked cabinet inaccessible to residents in care. Facility has an adequate amount of emergency food and water. BACKYARD: The backyard has a covered patio area with furniture including a table and chairs for resident use. The property is completely fenced with a self-latching mechanism. There is a completely fenced swimming pool, which is kept locked and inaccessible to residents. The exterior passageways were clean and clear of any obstructions at the time of the visit. RECORDS: LPA reviewed Resident Records at 11:45am and Personnel Records at 12:30pm. Five (5) resident files were reviewed for, but not limited to, the following: signed admission agreements, current medical assessments with TB results, LIC627(c) Consent for Treatment form, and current needs and services plan. All files were complete. Three (3) personnel files including the Administrator’s file were reviewed for, but not limited to: personnel records, health assessments, criminal record clearances, first aid / CPR training, and the appropriate yearly training. All records were in order. MEDICATIONS: Medications review began at approximately 1:15pm. The medications are locked in a cabinet adjacent to the living room. All medications including PRNs were labeled, stored, and locked inaccessible to residents in care. PRNs have physicians order on file. Medications appeared to be given as prescribed at the time of the visit. INFECTION CONTROL/ EMERGENCY DISASTER PLANNING: During today's visit, LPA reviewed the facility's infection control policy as well as the emergency disaster plan. The facility’s policies and procedures as it pertains to infection control are adequate. Several fire extinguisher are located throughout the facility and were observed to be fully charged and last serviced 01/16/2026. At 11:30am, the smoke detectors and carbon monoxide detector were tested and operational at the time of the visit. Emergency disaster drills conducted quarterly as per regulation; the last fire drill was conducted on 08/15/2026. No deficiencies cited at this time. Exit interview conducted. A copy of the report was issued.the state’s words, verbatim · CDSS document, Sep 30, 2026

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Martha Arroyo arrived at the facility unannounced to conduct a required annual visit. Upon arrival, there were three (3) staff and five (5) residents present. The LPA was greeted by staff and at this time the reason for the visit was explained. The Administrator, Iris Van Kralingen arrived at approximately 09:15 a.m. Entrance interview conducted. During today’s inspection, 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. The following was observed: Kitchen: The LPA inspected the kitchen/food service area at approximately 09:18 a.m. Knives and sharps were observed locked and inaccessible in a kitchen drawer. Kitchen appliances were in operable condition. The facility has a sufficient supply of perishable and non-perishable food. Refrigerator and food pantry were checked for proper labels and expiration dates. Common Areas: At the time of the visit, furniture in the common areas was observed to be in good condition. The facility maintained a comfortable temperature. The LPA observed several fire extinguishers throughout the facility to be recently charged with a date of 06/15/2025. Required postings were observed throughout the common space. There is a working telephone on premises. Activities were observed in the living room. Auditory alarms were observed functioning during the inspection. No hazards/obstruction observed inside or out. Report Continued on LIC 809C... Report Continued from LIC 809... Restrooms: There are two (2) restrooms for resident use. The first bathroom is located by the main hallway and the second bathroom is located in bedroom #2. Bathrooms were clean and sanitary and in operating condition with grab bars and non-skid surfaces. The bathrooms were sufficiently stocked with supplies and paper towels. Starting at 09:29 a.m., the hot water temperature was measured in both bathrooms, and they measured within the required range of 105 – 120 degrees Fahrenheit. Personal hygiene items were observed locked and inaccessible to residents at the time of the inspection. Bedrooms: There are three (3) bedrooms for resident use. All bedrooms are designated as double / shared occupancy. Resident rooms were observed to be furnished appropriately with linens, appropriate furnishings, and sufficient lighting. The LPA observed a staff bedroom on premises. Laundry Room: The washer and dryer were observed locked and inaccessible to residents at the time of the inspection. Detergents and cleaning supplies were observed in a locked cabinet inside the laundry room. Garage: The garage was locked and inaccessible to residents at the time of the visit. The LPA observed an adequate amount of emergency food and water. An adequate amount of Personal Protection Equipment (PPE) was also observed. Outdoors: The backyard and front yard each has a covered patio area with patio furniture adequate for resident use. There is (1) side gate with latching mechanisms. The LPA observed a pool locked and inaccessible to residents in care at the time of the visit. All passageways were observed to be clear of any obstructions. Report Continued on LIC 809C... Report Continued from LIC 809C... RECORDS: The LPA began record review at approximately 09:42 a.m. Five (5) resident files were reviewed for, but not limited to, the following: signed admission agreements, current medical assessments with TB results, LIC627(c) Consent for Treatment form, and current needs and services plan. All files were in order. Three (3) personnel files were reviewed for, but not limited to: personnel records, health assessments, criminal record clearances, first aid/CPR training, and the appropriate yearly training. All files were complete. Emergency Disaster Planing: During today’s visit, the LPA reviewed the facility's emergency disaster plan, which was observed to be complete and recently reviewed/updated. Emergency disaster drills conducted quarterly as per regulation; the last one was conducted on 09/08/2025. Medications: Medications review began at approximately 11:30 a.m. Medications are centrally stored and kept in a locked cabinet adjacent to the living room. All medications including PRNs were labeled, stored, and locked inaccessible to residents in care. During medication review, two out of four residents’ medication pill count did not match that according to the start dates on file. Pursuant to Title 22, California Code of Regulations (CCR), the following deficiencies are cited (refer to LIC809-D). Failure to correct deficiencies may result in civil penalties. Exit interview conducted. A copy of report and appeal rights were provided.the state’s words, verbatim · CDSS document, Sep 10, 2025

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Martha Arroyo arrived at the facility unannounced to conduct a required annual visit today. Upon arrival, there were two (2) staff and six (6) residents present. LPA was greeted at the door by Administrator, Iris Van Kralingen and at this time, the reason for the visit was explained. Entrance interview conducted. At 9:54am, 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. The following was observed: KITCHEN: The LPA inspected the kitchen/food service area at 9:55am. Knives and sharps were observed in a locked drawer inaccessible to residents in care. Kitchen appliances were in operable condition. The facility has a sufficient supply of perishable and non-perishable food; properly stored. Refrigerator and food pantry were checked for proper labels and expiration dates. COMMON AREAS: This includes the living room and dining room area. The common areas were furnished appropriately, and all furniture was observed to be in good condition at the time of the visit. The facility maintained a comfortable temperature. LPA observed required postings throughout the common space. Activities were observed in the living room. There is a working telephone on premises. LPA observed functioning auditory alarms at the time of the visit. No obstructions or hazards were observed inside or out. Report Continued on LIC 809C... Report Continued from LIC 809... RESTROOMS: The two (2) resident restrooms were clean and sanitary and in operating condition with grab bars and non-skid surfaces. The bathrooms were sufficiently stocked with supplies and paper towels. Proper hand washing signs were observed inside the bathrooms. Starting at 10:05am, the hot water temperature was measured; the first bathroom measured at 111.3 degrees Fahrenheit; and the second bathroom measured at 108.1 degrees Fahrenheit. BEDROOMS: There are three (3) bedrooms for resident use all of which are designated as double occupancy rooms. All resident rooms were observed to be furnished appropriately with clean linens, appropriate furnishings, and sufficient lighting. Additional clean linens, towels, and washcloths were observed in the hallway closet. There is one (1) staff room on premises. GARAGE: The garage is maintained locked and inaccessible to residents in care. Laundry room was observed locked at the time of the visit. Cleaning supplies, detergents, and toxins were observed in a locked cabinet inaccessible to residents in care. Facility has an adequate amount of emergency food and water. BACKYARD: The backyard has a covered patio area with furniture including a table and chairs for resident use. The property is completely fenced with a self-latching mechanism. There is a completely fenced swimming pool, which is kept locked and inaccessible to residents. The exterior passageways were clean and clear of any obstructions at the time of the visit. RECORDS: LPA reviewed Resident Records at 10:23am and Personnel Records at 11:16am. Six (6) resident files were reviewed for, but not limited to, the following: signed admission agreements, current medical assessments with TB results, LIC627(c) Consent for Treatment form, and current needs and services plan. All files were complete. Report Continued on LIC 809C... Report Continued from LIC 809C... Three (3) personnel files including the Administrator’s file were reviewed for, but not limited to: personnel records, health assessments, criminal record clearances, first aid / CPR training, and the appropriate yearly training. All records were in order. During today’s visit, the LPA conducted interviews with two (2) staff. INFECTION CONTROL/EMERGENCY DISASTER PLANNING: During today's visit, LPA reviewed the facility's infection control policy as well as the emergency disaster plan. The facility’s policies and procedures as it pertains to infection control are adequate. Several fire extinguisher are located throughout the facility and were observed to be fully charged and last serviced 06/15/2024. At 10:15am, the smoke detectors and carbon monoxide detector were tested and operational at the time of the visit. Emergency disaster drills conducted quarterly as per regulation; the last fire drill was conducted on 08/30/2024. MEDICATIONS: Medications review began at approximately 12:20pm. The medications are locked in a cabinet adjacent to the living room. All medications including PRNs were labeled, stored, and locked inaccessible to residents in care. PRNs have physicians order on file. Medications appeared to be given as prescribed at the time of the visit. No deficiencies cited at this time. Exit interview conducted. A copy of the report was issued.the state’s words, verbatim · CDSS document, Sep 12, 2024