Ohana Care 3

Type of visit: Case Management - Other

On today's date March 10, 2026 Licensing Program Analyst (LPA) William Vanegas made an unannounced inspection for the purposes of conducting an annual inspection. Upon completion of the inspection LPA made the realization that they were at the incorrect facility. LPA amended the original report, and made administrator aware of the error that occurred. LPA met with Administrator and conducted annual visit at correct facility. An exit interview was conducted with the Administrator, and a copy of this report along with the amended report were provided to the facility.the state’s words, verbatim · CDSS document, Mar 10, 2026

Type of visit: Required - 1 Year

On today's date March 10, 2026 Licensing Program Analyst (LPA) William Vanegas conducted an unannounced visit for the purposes of conducting an annual visit. Upon arrival LPA was greeted and granted entry to the facility by Administrator (AD) LPA Began a tour of the facility accompanied with the AD and observed the following. This a one storied home with a total of 7 bedrooms, 1 of which is a staff room, four bathrooms one of which is a community bathroom, and three of which are private bathrooms. Kitchen area was observed to be clean and free of any mildew and debris. LPA observed there to be a gas stove, dishwasher, microwave, refrigerator, washer and dryer. All were observed to be in good repair and tested operational. LPA observed a two day supply of perishable food and a seven day supply of non-perishable food on hand with a sufficient amount of emergency water. LPA observed all resident rooms to have required furnishings such as a reading lamp, a bed, clean linens in good repair; meaning no strains or tares, a chair, and enough storage space to store personal belongings. LPA observed no hazards to be accessible to residents in care and rooms were large enough to move about freely. LPA Observed restrooms to be clean and free of any debris and mildew. Water faucets and toilets tested operational. Restrooms had all required furnishings such as grab bars, slip resistant floor matts, and a shower chair. Hot water temperature tested between 112.3 and 118.8 degrees Fahrenheit. CONTINUED ON LIC809C LPA toured the outside of the facility and observed the following, the backyard is large enough to participate in outdoor activities upon resident request. There is an outdoor shaded sitting area, and no debris or obstructions were noted to be along the emergency exit routes. Side exits are free of any obstructions. . LPA reviewed five resident files and two staff files. All files (staff and resident) had all required documents, and staff training was up to date and documented. LPA observed all fire extinguishers to be fully charged and up to date. LPA observed all smoke detectors and carbon monoxide detectors to be operational and in good repair. LPA reviewed all medications with AD per LPA's review all medications are being administered per physicians orders and are being documented accurately. Based on today's inspection no deficiencies will be cited per title 22 division 8 chapter 6 of the California Code Of Regulations. An exit interview was conducted with AD and a copy of this report was provided to the facility.the state’s words, verbatim · CDSS document, Mar 10, 2026

Type of visit: Required - 1 Year

On this day, Licensing Program Analyst (LPA) Kevin Saborit-Guasch made an unannounced visit to the facility to conduct the required annual inspection. LPA was greeted and granted entry by facility caregiving staff after introducing himself and stating the purpose of the visit. Administrator Brigitte Fisk was present on the premises. Ryan Fisk arrived later and also assisted with the visit. This is the facility's first annual visit with residents in place. There are currently six residents in care, two of which is receiving hospice care. LPA observed residents relaxing in their respective bedrooms and in the facility's common living areas, as well as having lunch in the facility's dining room. LPA accompanied by facility staff toured the physical plant. The facility is a one-story house with an attached garage. The facility has six private bedrooms and one staff room in use by the awake night staff. There are four en-suite bathrooms and one shared bathroom throughout the facility. Bedrooms appeared clean and sanitary. One bed is observed to be equipped with half rails. The hospice plan of care was reviewed and did not include an order for the postural supports which will be requested from the hospice provider. All resident bedrooms have the required furnishings. Bathrooms appear clean and sanitary. Bathroom are equipped with grab bars and slip mats. Hot water temperature measured at 109F and 111F in two separate bathrooms with faucets used for personal grooming. LPA observed the kitchen has a minimum two (2) day perishable and seven (7) day non-perishable food supply. Sharp items are stored in the secure laundry area, along with cleaning supplies and the medication central storage. Fire extinguishers are charged and mounted, with up-to-date maintenance documented on the attached tags. LPA tested the smoke and carbon monoxide detectors which were found to be operational. The attached garage is inaccessible to residents and is used as an administrative office by the licensee. CONTINUED ON FORM LIC809-C CONTINUED FROM FORM LIC809 LPA and facility staff toured the outside of the facility. LPA observed an shaded outdoor seating area with furniture for resident use. There is no fencing around the facility, licensee additionally operates a licensed facility next door and both houses share backyards. There is a fence along the backyard's property line. Per the stated plan of operation, the outdoor space is systematically used under staff or family supervision. None of the currently admitted residents use the outdoor space independently. Advisory notes provided. There are no bodies of water on the premises. Facility does not utilize locked perimeters or delayed egress. LPA reviewed six resident records which included all necessary components. One physician report reviewed is dated November 2023 after a resident's provider resubmitted a prior assessment. An updated assessment will be conducted. Advisory note provided. LPA reviewed resident medication records and prescription orders for all residents with no discrepancies observed. Oxygen is in use and a sign was placed accordingly during the visit. Advisory note provided. There are no bedridden residents present on the premises. LPA reviewed staff records for both caregivers present. Records were found to be complete. Training and CPR/First aid training reviewed and up-to-date. All staff are background cleared and associated to the licensed location accurately. Based on the observations made during today’s visit, no deficiencies are being cited per Title 22 Division 6 of the California Code of Regulations. An exit interview was conducted and a copy of this report was provided to a facility representative.the state’s words, verbatim · CDSS document, Mar 17, 2025

The state marks this report as 6 pages; the online copy we transcribed has 2. You can request the full file from the county licensing office.

Type of visit: Required - 1 Year

On this day, Licensing Program Analyst (LPA) Kevin Saborit-Guasch made an unannounced visit to the facility for the purpose of conducting a required annual visit. LPA called licensee Ryan Fisk who confirmed that the facility was not operating. LPA walked up to the licensed facility and was greeted and granted entry by Brigitte Fisk, Administrator after stating the purpose of the visit. During the pre-licensing visit conducted on March 28, 2022, facility administrator Ryan Fisk had informed LPA that the facility was no longer receiving residents due to a pending remodel. The remodel is observed to still be under way at this time. LPA accompanied with administrator conducted a walk-through of the physical plant and confirmed that the facility was not currently in operation. No deficiencies cited per Title 22 Division 6 of the California Code of Regulations. An exit interview was conducted and a copy of this report was provided to a facility representative.the state’s words, verbatim · CDSS document, Mar 20, 2024