Regal Residence

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. The LPA was greeted by facility staff and at this time the reason for the visit was explained. The Administrator, Donald Brodt arrived shortly after. Entrance interview conducted. Starting at 09:18 a.m., 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 9:20 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. At 09:25 a.m., the hot water temperature was measured in the kitchen sink, and it measured at 110.5 degrees Fahrenheit. Bedrooms: There are five (5) resident bedrooms. Four (4) bedrooms are designated as single occupancy, and one (1) bedroom are double occupancy. The LPA observed the resident bedrooms to be furnished appropriately with clean linens, appropriate furnishings, and sufficient lighting. The LPA observed additional clean linens and towels for resident use. There is a staff bedroom on premises. Report Continued on LIC 809C... Report Continued from LIC 809... 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 the fire extinguisher to be new with a purchase date of 03/26/2025. Required postings were observed throughout the common space. Activities were observed in the living room and dining room. The LPA observed an adequate amount of emergency food and water. There is a working telephone on premises. Hardwired combination smoke and carbon monoxide detectors were tested and were functional at the time of the visit. Bathroom: There are three (3) bathrooms in the facility. Two (2) bathrooms are designated for resident use and one (1) bathroom for staff only. Bathrooms were clean and sanitary and in operating condition with grab bars and slip-resistant surfaces. The bathrooms were sufficiently stocked with supplies and paper towels. Beginning at 09:40 a.m., the LPA measured the hot water temperature in resident bathrooms, and they measured within the required range of 105 – 120 degrees Fahrenheit. Garage: The garage was locked and inaccessible to residents at the time of the visit. Laundry Room: Washer and dryer were observed inside the laundry room by the garage. The LPA observed laundry detergents locked and inaccessible at the time of the visit. Backyard: The backyard has a shaded area with patio furniture for residents’ use. All passageways were observed to be clear of any obstructions. There is one (1) side gate with latching mechanisms. There is a pool which was fully enclosed at the time of the visit. At 09:45 a.m., the LPA observed a hand saw and two (2) five gallon paints in the backyard accessible to residents in care. The Administrator moved items in locked shed during the inspection. Report Continued on LIC 809C... Report Continued from LIC 809C... Records: Beginning at 09:55 a.m., the LPA reviewed Resident Records and Personnel Records. Five (5) resident files were reviewed for, but not limited to, the following: signed admission agreements, current medical assessments with TB results, Consent for Treatment form, and current needs and services plan. All files were complete. Three (3) personnel files including the current 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. Current Administrator’s Certificate is valid until 07/21/2027. Record review and interviews revealed that Staff #1 (S1) has been working at this facility for at least thirty (30) days. The LPA reviewed the facility Guardian roster and discovered that S1 does have fingerprint clearance but is not associated with the facility. S1 left the premises immediately. Medications: Medications review began at approximately 01:50 p.m. Medications are centrally stored in a cabinet adjacent to the kitchen. All medications including PRNs were labeled, stored, and locked inaccessible to residents in care. Medications appeared to be given as prescribed at the time of the visit. Infection Control / Emergency Disaster Planning: The LPA also 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 being a fire drill which was conducted on 01/07/2026. Pursuant to Title 22, California Code of Regulations and/or CA Health and Safety Code, the following deficiencies were cited (refer to LIC 809D.) Civil penalty issued in the amount of $500. Exit interview conducted, report and appeal rights were discussed, and a copy was provided.the state’s words, verbatim · CDSS document, Jan 8, 2026

Type of visit: Prelicensing

Licensing Program Analyst (LPA), Martha Arroyo conducted a pre-licensing visit to this property at 9:00am and met with Applicant Representative, Donald Brodt. Component II was completed on 01/21/2025. During today's visit, LPA completed Component III with the Applicant Representative. The applicant has obtained a fire clearance on 12/18/2024 for six (6) bedridden residents approved for bedrooms #1 - #5. The Applicant Representative submitted a hospice waiver request for 6 (six) residents which was approved on 01/19/2025. A dementia care program will be in place. The facility is a single-story home in the Simi Valley area, which will be licensed as a Residential Care Facility for the Elderly (RCFE). Currently, there are no residents residing in the facility. The facility consists of five (5) bedroom and three (3) bathrooms. There will be a staff room on premises. Main hallway leading to resident bedrooms was observed to be equipped with fire door. Beginning at 9:07am, the LPA along with the Applicant Representative conducted a physical plant tour to ensure there are no health and safety hazards and the facility is in compliance with Title 22 Regulations. THe LPA also inspected facility for Fire Safety, Personal Accommodations and Services, and Food Service. The following was observed: Report Continued on LIC 809C... Report Continued from LIC 809... The LPA toured the kitchen area at 9:08am, and all equipment appeared to be clean and in good repair. Kitchen knives will be stored in a locked drawer. The kitchen has a sufficient supply of plates, cups, cookware and utensils. The living areas and dining areas are clean and properly furnished. All window screens and coverings are in good repair. Enough seating for six (6) residents at the same time in the dining room table. A working telephone is present. There is a fireplace present with a fireplace screen for safety at the time of visit. Night-lights were present in the main hallway and resident bathrooms. Functioning auditory alarms observed at the time of the visit. The facility has a sufficient supply of emergency food and water. Medications and facility records will be stored and locked in a cabinet adjacent to the kitchen. First aid kit was observed to have bandages, thermometer, scissors, tweezers and a current first aid manual. Flashlights were observed in case of an emergency. Garage: The garage is attached to the house and will be locked at all times. The facility has a laundry room. All detergents, disinfectants, and cleaning supplies will be stored in a locked cabinet above the washer and dryer. There will be no firearms/ammunition stored on the property. At 9:24am, all hard-wired smoke alarms and carbon monoxide detector were tested and function properly. The LPA observed a new fire extinguisher with a purchase date of 12/14/2024. Report Continued on LIC 809C... Report Continued from LIC 809C... There are five (5) bedrooms for resident use; four (4) bedrooms are designated for single occupancy and one (1) bedroom is designated for double occupancy. Bedrooms #1, #2, #4, and #5 will be private resident rooms and bedroom #3 will be a shared resident bedroom. Bedrooms # 3 and #5 have a direct exit to the outside. Each bedroom is equipped with a bed which included a mattress and bedding. Bedrooms have sufficient lighting. The facility has two (2) bathrooms for resident use, which are located by the main hallway and inside bedroom #3. The staff bathroom is located by the laundry room. Resident bathrooms contained appropriate non-skid surfaces and grab bars. Bathrooms have sufficient paper products. Hot water temperature was measured in both bathrooms and measured within the range of 105 and 120 degrees Fahrenheit. The facility has required postings, including emergency exit plan, Licensing Complaint Poster, Resident Personal Rights, Theft and Loss Policy, and Resident Council Rights. The exterior passageways were clean and clear of any obstructions. There is one (1) self-latching gate for emergency use. There is a pool which was fully enclosed at the time of the visit. Physical plant is consistent with the submitted facility sketch/floor plan. The physical plant of this facility location is in compliance with Title 22 regulations at this time. 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. Exit interview conducted. A copy of the report was reviewed and provided to Applicant Representative Daniel Brodt.the state’s words, verbatim · CDSS document, Jan 29, 2025