Mrs Scott's Where the Heart Is Homes-San Francisco

Type of visit: Required - 1 Year

On 07/30/26, Licensing Program Analyst (LPA) M. Yang arrived unannounced to conduct an annual visit. LPA introduced self, stated the purpose of the visit and requested to meet with Administrator. LPA met Staff Pauline Peralta. Administrator (A1) Phoeun Marez was called and arrived later during inspection. LPA toured the facility with A1. Two residents were present during inspection. One resident was present sitting in the living room and one resident observed in the bedroom. The facility was observed to be at a comfortable temperature at 75 degree F, clean, in good repair, and no passageway obstructions or fire hazards were observed inside. An adequate supply of perishable and non-perishable food were observed. Refrigerator temperature is maintained at 24 degrees F and freezer at -2 degrees F. Fire extinguisher was observed with purchased date of 6/30/25. Medications were observed unlocked in kitchen closet. LPA reviewed MARS and checked medication. Knife observed unlocked in kitchen drawer. Extra linens and towels were observed. All bedrooms were observed to have the required furnishings and adequate lighting. Bathrooms were toured. Non-skid mats and grabbed bars were observed in bathrooms. Hot water temperature was tested 76.5 degrees F in hall bathroom and 76.3 degrees F in master bathroom. Chemicals observed locked in facility office. Dryer was observed operating during visit. (continued to Lic 809C) (continued from Lic 809) Outside of the facility toured. Adequate outdoor seating is available for residents. Both side gates observed self-latching and self-closing free of debris. All residents’ and staff files were reviewed. Carbon monoxide and smoke detectors observed operational during inspection. A deficiency is being cited on the attached Lic 809D in accordance to California Code of Regulations, Title 22, Division 6. Exit Interview conducted. LPA received copies of Lic 308 and Lic 610E. The following documents are requested and submitted to Fresno CCL by: 08/05/26. Forms requested: Lic 500, Lic 9020, and current liability insurance. A copy of this report and appeal rights was provided to the Administrator, whose signature on this form confirms receipt of this report.the state’s words, verbatim · CDSS document, Jul 30, 2026

Type of visit: Required - 1 Year

On 08/22/25, Licensing Program Analyst (LPA) M. Yang arrived unannounced to conduct an annual visit. LPA introduce self, stated the purpose of the visit and requested to meet with Administrator. LPA met Staff Pacinta Mangunay and Staff Enrico Mangunay. Administrator Phoeun Marez was called and arrived later during inspection. LPA toured the facility with staff. All six residents were present during inspection. One resident was present sitting in the dining area, two residents observed in the common area and three residents observed in the bedroom. Two residents left to the day program during inspection. Upon entry, audio surveillance camera observed in entryway. The facility was observed to be at a comfortable temperature, clean, in good repair, and no passageway obstructions or fire hazards were observed inside. An adequate supply of perishable and non-perishable food was observed. Refrigerator temperature is maintained at 28 degrees F and freezer at -2 degrees F. Fire extinguisher was observed. Last fire drill completed on 06/19/25. Medications were observed locked in kitchen closet. LPA reviewed MARS and checked medication. Knives observed locked in kitchen shelf. Audio surveillance camera observed on kitchen counter. Extra linens and towels were observed. All bedrooms were observed to have the required furnishings and with adequate lightning. Bathrooms were toured and observed operational during inspection. Non-skid mats and grabbed bars was observed in bathrooms. Hot water temperature was tested 119.9 degrees F in hall bathroom and 117.1 and 107.9 degrees F in master bathroom. Chemicals observed locked in facility office. Outside of the facility toured. Adequate outdoor seating is available for residents. Both side gates observed self-latching and self-closing free of debris. Sample of residents’ and staff files were reviewed. Carbon monoxide and smoke detectors observed operational during inspection. A deficiency is being cited on the attached Lic 809D in accordance to California Code of Regulations, Title 22, Division 6. Exit Interview conducted. The following documents are requested and submitted to Fresno CCL by: 08/28/25. Forms requested: Lic 308, Lic 500, Lic 610E, current Administrator Certificate, control of property, and current liability insurance. A copy of this report and appeal rights was provided to the Administrator, whose signature on this form confirms receipt of this report.the state’s words, verbatim · CDSS document, Aug 22, 2025

The state marks this report as 5 pages; the online copy we transcribed has 4. You can request the full file from the county licensing office.

Type of visit: POC

On this day Licensing Program Analysts (LPA) M. Yang and R. Bruce arrived unannounced to conduct a POC visit. LPAs met with Staff Enrico Mangunay Yabut. Administrator MaDivina “Grace” Petil was called and arrived shortly. LPAs received copy of S1 First Aid/ CPR certification with completion date of 08/26/24. LPAs was informed Administrator schedule appointment for R1 and R2 for TB testing to be completed on 08/29/24. TB result for R1 and R2 shall be submitted to the department by 9/16/24. LPAs observed the following: 1. Non-skid mat in the bathroom tub and shower. 2. Fire extinguisher delivered to the facility on 08/28/24. An exit interview was conducted. A copy of this report was provided to Administrator, whose signature confirm receipt of report.the state’s words, verbatim · CDSS document, Aug 29, 2024

Type of visit: Required - 1 Year

On 08/26/24, Licensing Program Analyst (LPA) M. Yang arrived unannounced to conduct an annual visit. LPA introduce self, stated the purpose of the visit and requested to meet with Administrator. LPA met Staff Inggrit Lousye and Staff Enrico Mangunay Yabut and Josie Yabut. Administrator MaDivina “Grace” Petil was called and arrived shortly. LPA toured facility with staff and Administrator. Four residents were present in the common area during inspection. The facility was observed to be at a comfortable temperature, clean, in good repair, and no passageway obstructions or fire hazards were observed inside. An adequate supply of perishable and non-perishable food was observed. Refrigerator temperature is maintained at 40 degrees F and freezer at 0 degrees F. Fire extinguisher was observed with a service date of 07/20/22. Medications were observed locked in kitchen closet. LPA reviewed MARS and checked medication. Chemicals were observed locked under kitchen sink, bathroom sink, and laundry room sink. . Extra linens were observed. All bedrooms were observed to have the required furnishings and with adequate lightening. Carbon monoxide and smoke detector observed operational during inspection.The bathrooms were toured and observed operational during inspection. Molded non-skid mat observed in master bathroom. Non-skid mat was not observed in hall bathroom. Grabbed bars were observed in all bathrooms. Hot water temperature was tested 109.9 degrees F in master bathroom and 10110.8 degrees F in hall bathroom. Outside of facility toured. Adequate outdoor seatings available for residents. Both side gate observed self-latching and self-closing with free of debris. All residents’ and staff files were reviewed. A deficiency and an immediate Civil Penalty were assessed. See Lic 421BG and Lic 421IM is being cited on the attached Lic 809D in accordance to California Code of Regulations, Title 22, Division 6. Exit Interview conducted. The following documents are requested and submitted to Fresno CCL by: 08/30/24. Forms requested: Lic 308, Lic 500, Lic 610E, current Administrator Certificate, control of property, and current liability insurance. A copy of this report and appeal rights was provided to the Administrator, whose signature on this form confirms receipt of this report.the state’s words, verbatim · CDSS document, Aug 26, 2024

The state marks this report as 9 pages; the online copy we transcribed has 5. You can request the full file from the county licensing office.

Type of visit: Required - 1 Year

On 9/28/2023, Licensing Program Analysts (LPAs) K. Kaur and L.Padgett arrived unannounced at the above facility to conduct an Annual Inspection. LPAs introduced themselves, stated the purpose of the visit and met with Administrator MaDavina (Grace) Petil (AD). LPAs conducted facility tour with AD and Staff Tirso Petil (S1). LPAs toured kitchen and dining areas. The kitchen was observed clean, in good repair with necessary items and appliances. LPA observed non-perishable and perishable foods. Carbon monoxide detector in the kitchen was tested operational. Smoke detectors were observed in all bedrooms and the hallways, tested, observed operational. Office is in converted garage space. In the laundry room, detergent and cleaning supplies are kept in locked cabinets. LPAs observed facility common areas which were furnished with sufficient seating. LPAs toured five resident rooms which were observed to be furnished with required furniture and adequate lighting. At 9:05am LPAs observed some dust debris in resident bedrooms. LPAs observed one cracked tile and slight lift on the transition floorboard at the entrance of bedroom 5. Bathrooms were properly equipped with non-slip mats and grab bars. At 9:43 AM Padgett tested water temperature in the hallway bathroom sink at 92.8°F and the bathroom in bedroom 5 91.4°F. At 9:41am LPA Kaur observed 5 out of 5 stove knobs accessible to residents while no staff were present in the kitchen and or cooking. Bedroom 5 has door that leads to the backyard. LPA Kaur attempted to open this door, but it was stuck and difficult to open. S1 was able to open the door. Once this door was open, LPA’s observed what appears to be water damage and rot at the inner right corner of the door at the base. This exit opens to covered patio area with sufficient seating and shade for recreational purposes. There was visible rot and damage to the fascia and roof of the patio. On the patio roof area just above the Bedroom 5 exterior door is a gap between the home fascia and the patio fascia. Continued to next Page There, the roof area appears to be rotting. R2 stated that when it rains the covered patio area floods. Backyard gate was self-closing and self-latching. At 2:35pm LPA Kaur observed Fire extinguisher in kitchen was expired with a service date of July 20, 2022. Medications are kept in locked pantry in the kitchen. Resident's records contained signed Admission Agreement, Personal Rights, and current Physician's Report. AD stated that she and S1 are the only employees. Staff files were reviewed for health screening and first aid/CPR certified. Last fire drill conducted on 8/7/2023. At 1:20 PM LPA’s reviewed resident's medication, MARS, and Centrally Stored Medication and Destruction Record (CSMDR) and observed (R1) and (R4) did not have a Centrally Stored Medication and Destruction Record. During Resident records review 2 of the 5 residents were observed to be without TB clearance. Deficiencies are being cited on the attached 809D in accordance with California Code of Regulations, Title 22, Division 6. LPA is requesting the following documents be submitted to the Fresno CCL office by 10/5/2023: Current copy of Administrator Certificate, Designation of Facility Responsibility (LIC308), Administrator Organization (LIC 309), Affidavit regarding Client/Resident Cash Resources (LIC 400), Emergency and Disaster Plan, Personnel Report (LIC500), Register of Facility Clients/Residents LIC9020. An exit interview was conducted with Administrator. Report signed on-site; a copy of this report, 809D with appeal rights were provided.the state’s words, verbatim · CDSS document, Sep 28, 2023