Palm Garden Retirement Home & Dementia Care

Type of visit: Required - 1 Year

On 06/04/2026, Licensing Program Analyst (LPA) M Vega arrived unannounced at the above facility to conduct an Annual Inspection. LPA introduced self, stated the purpose of the visit, and was granted entry to the facility. LPA toured the facility with facility staff Karlene Maitland. Administrator (AD) - Camalah Kopacz was contacted by phone however was not able to attend Annual Inspection. The facility was observed to be at a comfortable temperature, of 77 degrees F. Facility is free of debris, in good repair, and no passageway obstructions or fire hazards were observed. Common areas were properly furnished and well-lit throughout. LPA observed some residents in common area during breakfast watching television, others in their room still in bed. Department phone number and infection prevention information signs were posted thought the facility. Inspecting kitchen LPA observed the required 7-day supply of non-perishable food and 2-day supply of fresh perishables to be properly stored. An emergency disaster supply was observed. A fire extinguisher was observed with a service date of 05/27/2026. All six private residents’ bedrooms were observed to be at comfortable temperatures. The bathroom’s water temperature was tested and recorded reading of 115.7 degrees F. Medications observed to be locked in a cabinet in the common area. LPA reviewed medication records, records are observed to be properly maintained at time of inspection. Cleaning supplies were observed to be in a locked cabinet in the storage are near the front entrance of the facility. An outdoor seating area with shade was observed operational for residents in care. Report continues on attached LIC 809C Community Care Licensing (CCL) is always striving to have facility files that reflect the most accurate and up to date information for your facility. In an effort to maintain your facility file, please submit the most current and complete forms and/or information as identified below: Residential Care Facility for the Elderly (RCFE) LIC 308 Designation of Facility Responsibility LIC 309 Administrative Organization LIC 400 Affidavit Regarding Client/Resident Cash Resources LIC 402 Surety Bond LIC 500 Personnel Report LIC 610E Emergency And Disaster Plan For Residential Care Facilities For The Elderly LIC 9020 Register of Facility Clients/Residents Copy of current Liability Insurance Copy of current Administrator Certificate Alternate contact information including name, telephone number, & email address. Please submit the above forms/information to Fresno CCL by: 06/18/2026 As an operator of a Community Care Licensed facility it is your responsibility to be aware of and in compliance with all regulations, including Chaptered Legislation. Go to www.ccld.ca.gov to stay updated and informed. AD granted S1 Karlene Maitland authorization to sign report. No deficiencies issued during this inspection. An exit interview was conducted with S1. A copy of this report was given to S1 whose signature on this form confirms receipt of these reports.the state’s words, verbatim · CDSS document, Jun 4, 2026

Type of visit: Required - 1 Year

On 06/18/2025, Licensing Program Analyst (LPA) M Vega arrived unannounced at the above facility to conduct an Annual Inspection. LPA introduced self, stated the purpose of the visit, and was granted entry to the facility. LPA toured the facility with facility staff Karlene Maitland. Administrator (AD) - Camalah Kopacz was contacted by phone however was not able to attend Annual Inspection. The facility was observed to be at a comfortable temperature, of 74 degrees F. Facility is free of debris, in good repair, and no passageway obstructions or fire hazards were observed. Common areas were properly furnished and well-lit throughout. LPA observed some residents in common area during breakfast watching television, others in their room still in bed. Department phone number and infection prevention information signs were posted thought the facility. Inspecting kitchen LPA observed the required 7-day supply of non-perishable food and 2-day supply of fresh perishables to be properly stored. An emergency disaster supply was observed. A fire extinguisher was observed with a service date of 05/20/2025. All six private residents’ bedrooms were observed to be at comfortable temperatures. The bathroom’s water temperature was tested and recorded reading of 112.9 degrees F. Medications observed to be locked in a cabinet in the common area. LPA reviewed medication records, records are observed to be properly maintained at time of inspection. Cleaning supplies were observed to be in a locked cabinet in the storage are near the front entrance of the facility. An outdoor seating area with shade was observed operational for residents in care. Report continues on attached LIC 809C LPA reviewed staff and residents’ files. No deficiencies were observed and cited during this visit. AD granted Staff Karlene Maitland authorization to sign report. Exit interview conducted. A report was signed, and a copy of this report was provided for facility records.the state’s words, verbatim · CDSS document, Jun 18, 2025

Type of visit: Required - 1 Year

On 06/13/2024, Licensing Program Analyst (LPA) V. Gorban arrived unannounced at the above facility to conduct an Annual Inspection. LPA introduced self, stated the purpose of the visit, and was granted entry to the facility. LPA toured the facility with facility staff Charmen Francis. Administrator (AD) Camalah Copacz, Licence number 6044267740 and expiration date 05/11/2025 was notified of Licensing visit over the phone was able to attend the visit. The facility was observed to be at a comfortable temperature, of 74 degrees F. Facility is free of debris, in good repair, and no passageway obstructions or fire hazards were observed. Common areas were properly furnished and well-lit throughout. LPA observed some residents in common area during breakfast watching television, others in their room still in bed. Department phone number and infection prevention information signs were posted thought the facility. Inspecting kitchen LPA observed the required 7-day supply of non-perishable food and 2- day supply of fresh perishables to be properly stored. An emergency disaster supply was observed. A fire extinguisher was observed with a service date of 05/16/2024. All six private residents’ bedrooms were observed to be at comfortable temperatures. The bathroom’s water temperature was tested and recorded reading of 111 degrees F. Medications observed to be locked in a cabinet in the common area. LPA reviewed medication records appears to be administered properly. Cleaning supplies were observed to be in a locked cabinet in the storage it the laundry room. An outdoor seating area was observed operational for residents in care. Report continues on attached LIC809-C Community Care Licensing (CCL) is always striving to have facility files that reflect the most accurate & up to date information for your facility. In an effort to maintain your facility file, please submit the most current & complete forms &/or information as identified below: Residential Care Facility for the Elderly (RCFE): · LIC 308 Designation of Facility Responsibility · -as applicable: LIC 309 Administrative Organization · LIC 500 Personnel Report · LIC 610E Emergency Disaster Plan For Residential Care Facilities For The Elderly · LIC 9020 Register of Facility Clients/Residents · Copy of current Liability Insurance · Copy of current Administrator Certificate · Alternate contact information including name, telephone number, & email address. Please submit the above forms/information to Fresno CCL by: 06/20/2024 As an operator of a Community Care Licensed facility it is your responsibility to be aware of and in compliance with all regulations, including Chaptered Legislation. Go to www.ccld.ca.gov to stay updated and informed. LPA reviewed staff and residents’ files. No deficiencies were observed and cited during this visit. Advisory notes were created for Administrator to follow up by 6/20/24. Exit interview conducted. A report was signed, and a copy of this report was provided for facility records.the state’s words, verbatim · CDSS document, Jun 13, 2024