Peaceful Pines Senior Living

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Brian Balisi arrived at the facility unannounced to conduct a required annual visit. Upon arrival, the LPA met with staff and explained the reason for the visit. Licensee Andranik Kapikyan arrived shortly after. 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. At approx 09:40 a.m. LPA inspected the kitchen/food service area. Kitchen appliances appeared clean and to be in operable condition at the time of the visit. The facility has a sufficient supply of perishable and non-perishable food. Food labels were inspected and checked for dates and expiration dates. Knives and sharps were observed locked and inaccessible to residents in care. LPA observed five (5) resident bedrooms , which were furnished appropriately with clean linens, appropriate furnishings and sufficient lighting. The resident 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. The hot water temperature was measured between 105 - 120 degrees Fahrenheit. LPA observed personal hygiene supplies, toiletries and activities to be stored and inaccessible in a closet in the hallway bathroom. At the time of the visit, the common area furniture's were observed to be in good condition. A sufficient supply of clean linen and towels were observed stored in a hallway closet. The facility maintained a comfortable temperature of 72 degrees Fahrenheit. At approx. 10:20 a.m. LPA observed residents sitting in living room talking and watching television. All exits have functioning auditory devices and were operational at the time of the visit. The LPA observed required postings throughout the common areas. There is an attached garage observed inaccessible to residents in care. LPA observed laundry area before the garage entrance. Laundry supplies were observed inaccessible to residents in care. LPA observed garage to store, emergency food, extra incontinent supplies, linen, PPE , as well as additional furniture and medical equipment for facility use. The backyard has a covered outdoor area equipped with furniture including a table and chairs for resident use. The LPA observed one (1) self-latching gate with clear passageways clear of obstruction. LPA did not observe any bodies of water during the visit. There is gated doorway leading into the front entrance of facility. LPA observed gate to be unlocked during the visit. At approx 11:15 a.m. Administrator exited the facility due to not feeling well and stated staff will sign in their place. Records review, six (6) resident records were reviewed for, but not limited to: appraisals, medical records, admissions agreement, consent forms. At approx 11:30am , LPA did not observed the following: Resident #1 (R1) did not have a signed admissions agreement No records onsite to review for Resident #5 (R5) and Resident #6 (R6). Four (4) Personnel records were reviewed for, but not limited to: personnel records, health assessments, criminal record clearances, first aid/CPR training, and the appropriate training. Staff files were observed to be in order at this time . Last emergency disaster drill conducted 09/01/2025. At approx 01:15 p.m. LPA was unable to conduct medications review due to Centrally Stored Medication log onsite to review. Infection control: Upon entry, the facility has a central entry point for symptom screening, temperature checks, and sanitation station. At this time, the staff will continue to keep up signs that promotes good hand hygiene and symptoms of a communicable disease. 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 an infectious disease. The facility’s policies and procedures as it pertains to infection control are adequate. LPA obtained the following documents at the time of visit: Facility’s liability insurance. Interviews were conducted during the visit. Pursuant to Title 22, California Code of Regulations, the following deficiency is cited (refer to LIC 809-D). The Administrator was informed that additional civil penalties might be assessed based on Health and Safety Code 1569.49(e) and 1569.49(f). Exit interview conducted with staff along with Administrator via phone, appeal rights discussed, and a copy of this report issued.the state’s words, verbatim · CDSS document, Nov 6, 2025

Allegation investigated: Staff handled resident in a rough manor resulting in multiple bruises

Licensing Program Analyst (LPA) Brian Balisi conducted a subsequent complaint visit to deliver findings for the above allegation. LPA met with Staff and explained the reason for the visit. Administrator arrived shortly after. On 03/17/2025, the Department received a complaint alleging physical abuse of Resident #1 (R1). It was reported that R1 was observed with approximately twenty (20) bruises on different parts of R1’s body. The case was referred to the Community Care Licensing (CCL) Investigations Branch (IB) and assigned to Investigator Dennis Douglas. On 03/19/2025, from 1:50pm to 3:00pm, Licensing Program Analyst (LPA) Brian Balisi conducted an unannounced complaint visit to investigate the allegation listed above. Upon arrival LPA Balisi met with staff and explained the reason for the visit. Administrator Andranik Kapikyan was contacted and stated they could not be onsite for the visit, but staff Jessy Phiri could sign in their place. Substantiated At approximately 2:05pm, the LPA conducted a physical plant tour, interviewed staff, and reviewed and obtained copies of pertinent documentation relevant to the investigation. The LPA determined further investigation was needed before delivering the findings. On 04/10/2025, at approximately 5:20pm, Investigator Douglas conducted interviews with R1’s resident representative; on 05/07/2025, at approximately 3:30pm, with Staff #1 (S1); and on 05/09/2025, at approximately 9:20am, with the Administrator. In addition, Investigator Douglas reviewed Glendora Oaks Behavioral Health Hospital records, Adventist Health Hospital Simi Valley Hospital records, photos, and facility file documents related to R1. According to the facility file documents reviewed, R1 was admitted to Glendora Oaks Behavioral Health Hospital from 01/31/2025 to 03/07/2025, as an inpatient for a psychiatric disorder. Upon discharge from the hospital, R1 was admitted to the Peaceful Pines Senior Living Corp facility on 03/07/2025. R1’s Preplacement Appraisal Information, dated 03/05/2025, noted that upon admission to the Peaceful Pines Senior Living Corp facility, R1 had “visible bruising all over body.” R1’s Physical Disabilities were noted as lack of speech and behavioral disturbance. Mental Conditions for R1 were listed as confused, withdrawn, paranoid, and disorientated. The Preplacement Appraisal also noted R1 needed assistance with bathing, haircare and personal hygiene, as well as assistance with toileting. The review of R1’s Physician Report, dated 03/05/2025, lacked a primary or secondary diagnosis. The report indicated R1 had mild cognitive impairment (MCI), was confused/disoriented and displayed inappropriate behavior. The report noted a history of skin condition or breakdown as “rashes and bruising”. The report also indicated R1 was able to bathe and care for R1’s toileting needs, however, was not able to dress or groom themself. R1’s Resident Appraisal form, dated 03/07/2025, also indicated R1 did not require assistance with bathing or toileting. Both the Administrator and S1 acknowledged when R1 initially arrived at the facility R1 had bruising on R1’s back which were “black” in color. S1 stated they were not informed as to where R1 sustained the bruising prior to R1’s arrival. The Administrator stated the Glendora Oaks Behavioral Health hospital staff notified him of bruising on R1. The bruising was also noted on R1’s Preplacement Appraisal Information. Information obtained during the Department’s interviews revealed that sometime in the first week of R1’s stay at the facility R1 was given a shower by S1. S1 acknowledged S1 was the staff member who showered R1. S1 explained that, although R1 was deemed independent by R1’s doctor and could bathe self, R1 had only taken a total of two showers during the time R1 was at the facility. (R1 resided at the facility from 03/07/2025 to 03/24/2025). S1 explained one day, R1 urinated on self and in bed. However, R1 refused to take a shower. S1 described that day as “hell” because S1 had to physically pull R1 to the shower. S1 stated R1 did not want to change R1’s soiled clothes. S1 acknowledged S1 had to remove R1’s clothes against R1’s will. S1 also acknowledged S1 grabbed R1’s wrists to attempt to escort R1 to the shower. However, that was not effective. S1 stated S1 then used the technique of bringing S1’s arms underneath R1’s armpits from behind grabbing R1’s shoulders and pull R1 to the bathroom. S1 acknowledged that once S1 got R1 in the shower S1 was able to wash R1’s entire body including R1’s vaginal area. S1 stated the entire incident took approximately 10 minutes. S1 acknowledged R1 sustained bruising on R1’s wrists because of S1’s initial grabbing R1 to take R1 to the shower. S1 acknowledged R1’s resident representative arrived at the facility later that day and observed bruising on R1’s arm and requested they no longer give R1 any showers. S1 stated they did not inform the Administrator of the incident. During the Department’s investigation, it was disclosed that R1 was forcibly given a shower by S1. S1 acknowledged giving R1 a shower after R1 urinated on self in bed and refused to take a shower. S1 also acknowledged causing bruising to R1’s arm and wrist after forcibly grabbing R1 and pulling R1 to the bathroom to bathe R1. Information in R1’s Physician’s Report and Resident Appraisal indicated R1 was able to bathe self, and care for own toileting needs. Photos of R1’s bruises illustrated several dark bruises to R1’s wrist and arm, resembling fingerprint marks. The information obtained during the Department’s investigation provided sufficient evidence to substantiate physical abuse. Therefore, the allegation is deemed Substantiated at this time. A $500 immediate civil penalty is assessed today. The Administrator was informed that additional civil penalties might be assessed based on Health and Safety Code 1569.49(e) and 1569.49(f). Pursuant to Title 22, California Code of Regulations, the following deficiency is cited (refer to LIC 9099-D). Exit interview conducted, appeal rights discussed, and a copy of this report issued. At approximately 2:05pm, the LPA conducted a physical plant tour, interviewed staff, and reviewed and obtained copies of pertinent documentation relevant to the investigation. The LPA determined further investigation was needed before delivering the findings. On 04/10/2025, at approximately 5.20pm, Investigator Douglas conducted interviews with R1’s resident representative; on 05/07/2025, at approximately 3:30pm, with Staff #1 (S1); and on 05/09/2025, at approximately 9:20am, with the Administrator. In addition, Investigator Douglas reviewed Glendora Oaks Behavioral Health Hospital records, Adventist Health Hospital Simi Valley Hospital records, and facility file documents related to R1. According to the facility file documents reviewed, R1 was admitted to Glendora Oaks Behavioral Health Hospital from 01/31/2025 to 03/07/2025, as an inpatient for a psychiatric disorder. Upon discharge from the hospital, R1 was admitted to the Peaceful Pines Senior Living Corp facility on 03/07/2025. R1’s Preplacement Appraisal Information, dated 03/05/2025, noted that upon admission to the Peaceful Pines Senior Living Corp facility, R1 had visible bruising all over body. R1’s Physical Disabilities were noted as lack of speech and behavioral disturbance. Mental Conditions for R1 were listed as confused, withdrawn, paranoid, and disorientated. The Preplacement Appraisal Information also noted R1 needed assistance with bathing, haircare and personal hygiene, as well as assistance with toileting. The review of R1’s Physician Report, dated 03/05/2025, lacked a primary or secondary diagnosis. The report indicated R1 had mild cognitive impairment (MCI), was confused/disoriented and displayed inappropriate behavior. The report noted a history of skin condition or breakdown as “rashes and bruising”. The report also indicated R1 was able to bathe and care for R1’s toileting needs, however, was not able to dress or groom themself. R1’s Resident Appraisal form, dated 03/07/2025, also indicated R1 did not require assistance with bathing and toileting. Information obtained during the Department’s interviews revealed that sometime in the first week of their stay at the facility, R1 was given a shower by S1. S1 acknowledged S1 was the staff member who showered R1. S1 explained that, although R1 was deemed independent by R1’s doctor and could bathe self, R1 had only taken a total of two showers during the time that R1 was at the facility (R1 resided at the facility from 03/07/2025 to 03/24/2025). S1 explained one day during the first week of their stay at the facility, R1 urinated on self and in bed. However, R1 refused to take a shower. S1 described that day as “hell” because S1 had to physically pull R1 to the shower. S1 stated R1 did not want to change R1’s soiled clothes. S1 acknowledged S1 had to remove R1’s clothes against R1’s will. S1 acknowledged that once S1 got R1 in the shower S1 was able to wash R1’s entire body including R1’s vaginal area. During the course of the investigation, it was disclosed that R1 was forcibly given a shower by S1. During the process of S1 giving R1 a shower, S1 washed R1’s vaginal area. However, it was explained by S1 that S1 only gave R1 a shower after R1 urinated on self in bed and refused to take a shower afterwards. R1 reported that S1 forced R1 to shower, and S1 washed R1’s vaginal area without R1’s consent, which made R1 feel uncomfortable. Information in R1’s Physician’s Report and Resident Appraisal indicated R1 was able to bathe self, and care for own toileting needs. The information the Department obtained during the investigation did not sufficiently support the allegation of sexual abuse, therefore the allegation is deemed Unsubstantiated at this time. Exit interview conducted, copy of this report issued.the state’s words, verbatim · CDSS document, Jul 31, 2025 · control 29-AS-20250317143946

From the deficiency page — Deficiency type: Type A · Section cited: CCR 87468.1(a)(3) · Plan of correction due date: Aug 1, 2025

To be free from punishment, humiliation, intimidation, abuse, or other actions of a punitive nature, such as withholding residents’ money or interfering with daily living functions such as eating, sleeping, or elimination. This requirement is not met as evidenced by: Based on interviews, the licensee did not comply with the section cited above when S1 caused bruising to R1’s arm and wrist after forcibly grabbing R1, which posed an immediate health and safety risk to residents in care.the state’s words, verbatim · CDSS document, Jul 31, 2025

Plan of correction: Licensee agreed to review section cited with staff and provide a written plan on how they will ensure future compliance with the regulation and provide document to LPA via email by COB 08/01/2025.

Type of visit: Post Licensing

Licensing Program Analyst (LPA) Brian Balisi arrived at the facility unannounced to conduct a required annual visit. Upon arrival, the LPA met with staff and explained the reason for the visit. Licensee Andranik Kapikyan arrived shortly after. 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. At approx 10:45 a.m. LPA observed five (5) resident bedrooms , which were furnished appropriately with clean linens, appropriate furnishings and sufficient lighting. The resident 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. The hot water temperature was measured between 105 - 120 degrees Fahrenheit. LPA observed personal hygiene supplies, toiletries and activities to be be stored and inaccessible in an entry closets by the front door. The LPA inspected the kitchen/food service area. Kitchen appliances appeared clean and to be in operable condition at the time of the visit. At approx 10:55 a.m. LPA observed staff cleaning common areas. The facility has a sufficient supply of perishable and non-perishable food. Food labels were inspected and checked for dates and expiration dates. Knives and sharps were observed locked and inaccessible to residents in care. At the time of the visit, the common area furniture's were observed to be in good condition. A sufficient supply of clean linen and towels were observed stored in a hallway closet. The facility maintained a comfortable temperature of 72 degrees Fahrenheit. Smoke detector(s) and carbon monoxide detector were operational at the time of the visit. LPA observed fire extinguishers to be fully charged and last serviced on 12/16/2024. There is an office located next to the front entrance. LPA observed facility and resident files to be stored inaccessible to residents in care. All exits have functioning auditory devices and were operational at the time of the visit. The LPA observed required postings throughout the common areas. There is an attached garage observed inaccessible to residents in care. LPA observed laundry area before the garage entrance. Laundry supplies were observed inaccessible to residents in care. LPA observed garage to store, emergency food, extra incontinent supplies, linen, PPE , as well as additional furniture and medical equipment for facility use. The backyard has a covered outdoor area equipped with furniture including a table and chairs for resident use. The LPA observed one (1) self-latching gate with clear passageways clear of obstruction. LPA did not observe any bodies of water during the visit. There is gated doorway leading into the front entrance of facility. LPA observed gate to be unlocked during the visit. Records review, five (5) resident records were reviewed for, but not limited to: appraisals, medical records, admissions agreement, consent forms. Four (4) Personnel records were reviewed for, but not limited to: personnel records, health assessments, criminal record clearances, first aid/CPR training, and the appropriate training. All files were observed to be in order at this time . Medications review, all medications including PRNs were labeled, stored and inaccessible to residents in care in a hallway closet. Medications appeared to to be administered as prescribed at this time. First Aid kit was observed in this closet as well. Infection control: Upon entry, the facility has a central entry point for symptom screening, temperature checks, and sanitation station. At this time, the staff will continue to keep up signs that promotes good hand hygiene and symptoms of a communicable disease. 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 an infectious disease. The facility’s policies and procedures as it pertains to infection control are adequate. LPA obtained the following documents at the time of visit: Facility’s liability insurance. Interviews were conducted during the visit. Administrator had to leave during the visit, but stated staff can sign in their place. Exit interview conducted with staff and copy of report issued.the state’s words, verbatim · CDSS document, Jul 31, 2025

Allegation investigated: Staff wrongfully evicted resident.

Licensing Program Analyst (LPA) Brian Balisi conducted a subsequent complaint visit to deliver final findings for the allegations listed above. During today’s visit, LPA met with Staff and explained the reason for the visit. Licensee Andranik Kapikyan was contacted and stated they could not be onsite for the visit. Kapikyan stated Staff Jessy Phiri can sign in their place. On 02/27/2025, the initial complaint visit was conducted by LPA between approximately 02:10 p.m. - 03:00 p.m. During the visit, LPA’s conducted physical plant, interviewed staff, residents, as well as, reviewed and obtained copies of pertinent documentation relevant to the investigation. It was reported that "Staff wrongfully evicted resident" as it was alleged that staff evicted Resident #1 (R1) from the facility. LPA's records review revealed, no eviction notice was ever submitted to the Department for review. R1’s physician’s report dated 01/18/2025, indicated R1 is able to leave facility unassisted and is able to communicate needs. Unsubstantiated Continued from 9099 Additionally, interviews conducted with staff, Administrator and R1 stated no eviction notice was ever provided to R1. On 02/20/2025 at approx. 07:30 p.m. R1 requested assistance from staff to relocate R1's personal belongings to front of the facility as R1 stated they were going to be picked up. R1 did not disclose to the staff who or where they were going. R1 exited the facility with assistance from staff, waited in the driveway then R1 contacted the local police department who arrived at approx. 07:55 p.m. which resulted in R1 returning to the facility. Based on the information obtained during the investigation, the Department does not have sufficient evidence to corroborate the allegation. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur, therefore the above allegation, “Staff wrongfully evicted resident” is deemed Unsubstantiated at this time. Exit interview conducted and a copy of report issued.the state’s words, verbatim · CDSS document, Apr 17, 2025 · control 29-AS-20250224090712

Type of visit: Case Management - Deficiencies

Licensing Program Analysts (LPA) Brian Balisi conducted an unannounced Case Management - Deficiencies visit in conjunction with a complaint visit (Complaint control # 29-AS-20250224090712). LPA met with staff ane explained the reason for the visit. Licensee Andranik Kapikyan was contacted and stated they could not be onsite at this time. Kapikyan stated staff Jessy Phiri can sign in their place. The purpose of this visit is to issue citations for deficiencies observed during the complaint investigation which were not related to the complaint. Upon arriving to the facility LPA was unable to access front door due to locked perimeter gate. LPA pressed doorbell on the gate and was greeted by staff and allowed entry to front entrance. LPA’s records review revealed there is no approved fire clearance for a locked perimeter. During the investigation, records review and interviews conducted revealed on 02/20/2025 at approx. 07:30 p.m. Resident #1 (R1) was brought to the front of the facility at R1’s request when they stated they were being picked up by a family member, however staff did not make any attempts to contact the family / responsible party of R1 to ensure proper arrangements were made for R1 to vacate the facility safely and in a timely manner. R1 was outside of the facility for an extended period of time until police arrived, which resulted in R1 returning to the facility. The following deficiencies were observed (See LIC 809-D) and cited from the California Code of Regulations, Title 22 and California Health and Safety Code. An immediate Civil Penalty for a fire clearance violation is assessed in the amount $500. Administrator was informed that additional civil penalties might be assessed based on Health and Safety Code 1569.49(e) and 1569.49(f). Exit interview conducted, appeal rights discussed and copy of reports issued.the state’s words, verbatim · CDSS document, Apr 17, 2025

From the deficiency page — Deficiency type: Type A · Section cited: CCR 87705(f)(2) · Plan of correction due date: Apr 18, 2025

The licensee shall ensure that the fire clearance includes approval of locked exterior doors or perimeter fence gates... to unlock exterior doors or perimeter fence gates. This requirement was not met as evidenced by: Based on observation and records review, the licensee did not comply with the section cited above as LPA observed a locked gate and no approved fire clearance on file, which poses an immediate health, safety and personal rights risk to residents in care.the state’s words, verbatim · CDSS document, Apr 17, 2025

Plan of correction: Licensee agreed to have key lock replaced and provide a photo to LPA via email by COB 04/18/2025.

From the deficiency page — Deficiency type: Type B · Section cited: CCR87468.1(a)(2) · Plan of correction due date: Apr 25, 2025

To be accorded safe, healthful and comfortable accommodations, furnishings and equipment. This requirement was not met as evidenced by: Based on interviews and records review, the licensee did not comply with the section cited above as R1 was moved to the exterior of the facility along with their belongings for an extended period of time, which poses a potential health, safety and personal rights risk to residents in care.the state’s words, verbatim · CDSS document, Apr 17, 2025

Plan of correction: Licensee agreed review section cited and provide a statement of understanding to LPA via email by COB 04/25/2025.

Type of visit: Prelicensing

Licensing Program Analyst (LPA) Brian Balisi conducted a pre-licensing visit to the above noted facility. The LPA met with applicant Andranik Kapikyan. This is a new facility. A dementia program was included in the plan of operation. A Hospice Waiver has been requested. The current capacity is for six (6) clients, the facility doesn't have any clients at this time. The fire clearance was granted for (6) bedridden clients. The facility is one story. At approx. 11:05 am, a physical plant tour was conducted inside and out. The facility has four (4) private resident bedrooms. Each bedroom has a direct exit to the outside. There are fire sprinklers in the facility. There are no fire doors in the facility. All client rooms are set up with beds, nightstands, lamps, chests of drawers, chairs and closet space. The beds are furnished with box springs, comfortable mattress and clean linen; which includes, a mattress pad, top and bottom linens, pillowcases, blanket (if needed) and a bedspread. Lighting in the rooms appeared adequate. In addition, no bedroom was used as a passageway to another room, bath or toilet. There is no staff room at the facility. For NOC , there will be awake night staff only. All rooms were free of odors. All window screens were clean and maintained in good repair. There are three (3) bathrooms total. The resident bathroom(s) have a shower with non-skid materials. The toilet and shower have grab bars. The hot water temperature was tested in the bathrooms and the kitchen and was found to be within the range of 105*F and 120*F. Resident and staff records are to be stored inaccessible in the office area, which is currently located next to the front entrance and only accessible from the exterior of the home. Medications are to be centrally stored in a locked hallway closet across from bedroom #1. Continued from 809 The first aid supplies were complete , including a thermometer and a current version of a first aid manual. First aid was observed stored inaccessible in the hallway closet as well. Kitchen knives are stored in accessible in a drawer to the right of the sink. Stove burners are rendered inaccessible to the residents by removing the knobs when not in use. The supply of dishes, utensils, pots, pans and drinkware is adequate. The freezer was maintained at zero degrees Fahrenheit (0*F) and the refrigerator was maintained at 40*F. The supply of nonperishable food is adequate. There are no pesticides (poisons) or toxins stored in any food storage area or preparation area with utensils. Appliances in the kitchen were clean and all appeared functional at the time of the visit. Trash cans had tight fitting lids. No flies or other vermin were observed. The common areas were appropriately furnished, and the lighting was adequate. There is a television in the living room. Entertainment equipment, games and/or activity supplies was observed on a shelf in the dining room. There was sufficient space to accommodate both indoor and outdoor activities. Night lights were maintained in hallways and passageways to non private bathrooms. There is no fireplace in the facility. There is a storage room located next to the front entrance. LPA observed it to be empty at this time. The facility has emergency exit signs . The facility has a furnace, which is able to heat rooms that residents occupy to a minimum of 68 degrees Fahrenheit; and, they have central air conditioning and are able to cool rooms to a comfortable range, not to exceed 85 degrees Fahrenheit. The facility smoke alarm system is hard-wired. The smoke detector and carbon monoxide detectors were tested and functioned properly during the time of visit. Fire extinguishers were observed fully charged and serviced in September 14, 2024. The laundry room is located at the garage entrance. Cleaning supplies and toxins were observed stored here and the room will be inaccessible to residents in care. The garage is attached to the home and only accessible to staff. LPA observed extra facility supplies emergency food supplies, extra non-perishable food, and facility equipment, tools and décor. Continued from 809 There is closet located in the main entrance that stored an adequate supply of extra bed and bath linens. Cabinets inside the bathroom #1 were observed to store personal hygiene items (shampoos, soaps) and other supplies for facility use. Cabinets are to be locked and inaccessible to residents in care. There is a functioning telephone on the premises. The emergency exiting plans/sketch are posted at the entrance, in the main hallway and in the bedrooms. The emergency telephone numbers are posted on the bulletin board near the front entry way. Other required postings are posted on the bulletin board as well. The exterior passageways were clean and clear of any obstructions. There is a covered patio area in the rear of the home. LPA observed appropriate furniture for outdoor use. The outside area was observed to be large enough to conduct outdoor activities. LPA observed a variety of fruit trees and a gardening area enclosed by a locked gate. The entire property is not fenced. There is no body of water observed at this time. Component III was conducted in conjunction with the visit. No corrections required on a pre-licensing visit at this time. Exit interview conducted. Report issued and provided to Licensee. This report will be sent to the Centralized Application Bureau (CAB). You will be notified by the CAB Analyst when your license has been approved. You are not allowed to begin operating until you have been notified that your license has been approved by the CAB Analyst. Failure to comply could affect approval of your license.the state’s words, verbatim · CDSS document, Nov 25, 2024