Illustration — no photo of this home on file yet

Rose of Sharon Healthcare

Small home·Licensed for 6·Pittsburg, California

Licensed since 2021Licence #79201057
(925) 267-2288From the state roster · September 27, 2026Plan a visit
  • Care approvals on fileWheelchair · HospiceState licensing record · September 27, 2026
  • Estimated starting rate$4,850 a monthCovelight estimate · likely $4,000–$6,000
  • Home sizeLicensed for 6Small care home · a licensed care home (RCFE)
  • Room at the last state visit2 of 6 beds occupiedJuly 1, 2025 · not a current opening
  • Ways to payAsk the homeMedi-Cal ALW participation not on file
  • Last state visitSeptember 3, 2025CDSS inspection record

Rose of Sharon Healthcare is a small care home in Pittsburg — a licensed residential care facility for the elderly (RCFE), the licence category behind “assisted living” and “board and care.” It is licensed for 6 residents since 2021. Dementia care and bedridden care are not on file.

Built from CDSS public records · September 27, 2026. Every fact below names its source and date.

Quick answers and the state record

A citation does not make a home unsafe, and an empty file does not make a home good.

Quick answers about Rose of Sharon Healthcare

Is Rose of Sharon Healthcare licensed?

The state lists this license as “Licensed,” per CDSS records as of September 27, 2026.

How many residents is Rose of Sharon Healthcare licensed for?

6 residents — a small home, per CDSS records as of September 27, 2026.

Has Rose of Sharon Healthcare been cited?

0 Type A and 0 Type B citations since 2021, per CDSS records as of September 27, 2026. Those records count 8 state visits over the same years.

Is Rose of Sharon Healthcare still open?

This license was on the CDSS roster as of September 28, 2026.

What does Rose of Sharon Healthcare cost?

$4,850 a month to start is a Covelight estimate, likely $4,000–$6,000. This home’s own rate is not on file. Ask: “What is the all-in monthly rate, and what would push it higher?”

Covelight’s estimate starts from the rates 23 small homes and similar homes within 10 miles publish, then adjusts for this home’s size, state care approvals, Medi-Cal waiver participation, years licensed and the area’s prices. In testing, the likely range held the real rate for 6 in 10 homes. This home’s own rate is not on file.

Among 33 other homes of a similar licensed size across Contra Costa County that publish a starting rate, the middle half runs $3,500 to $5,825 a month, and the middle figure is $4,500 (n = 33 other homes publishing a starting rate).

Each of those is a home’s own published figure, gathered on its own date in September 2026 — not an average of ours, and not a survey. Similar size means small and mid-size homes counted together, and large communities counted on their own, because they are different markets.

A home outside the band is not overcharging or underpricing: a starting rate covers different things in different homes, which is the first thing to ask about.

The price is made in the phone call. Nothing here is a quote, an offer or a discount.

A starting rate is the room and the base care. California homes commonly bill care levels, medication management, supplies, transport and a second person in the room as extras. Many also charge a one-time fee at move-in. Ask for that list in writing before anything is signed.

Only prices a home put out itself count here: its own website, a listing it supplied, or a price a listing site says the home confirmed. Prices a site shows without saying where they came from are left out.

Does Rose of Sharon Healthcare take Medi-Cal?

On Medi-Cal’s Assisted Living Waiver: this home is not on the DHCS participation list dated September 23, 2026. Ask the program about current options. The waiver pays for care services, not room and board.

Who holds the license?

The license is held by Ajimatanrareje, Ayoyemi, per CDSS records as of September 27, 2026.

Can Rose of Sharon Healthcare keep a resident on hospice?

Hospice care is approved on this license, per CDSS records as of September 27, 2026.

Rose of Sharon Healthcare license and inspection record

  • Name on the license: “ROSE OF SHARON HEALTHCARE”, per the CDSS roster as of May 25, 2025.
  • License #79201057. The state lists this license as “Licensed,” per CDSS records as of September 27, 2026.
  • Licensed for 6 residents — a small home, per CDSS records as of September 27, 2026.
  • Licensed to Ajimatanrareje, Ayoyemi, per CDSS records as of September 27, 2026.
  • First licensed in 2021, per CDSS records as of September 27, 2026.
  • 8 state inspection visits since 2021, per CDSS records as of September 27, 2026.
  • 0 Type A and 0 Type B citations on file since 2021, per CDSS records as of September 27, 2026. The same records count 8 state visits in that period.
  • 1 complaint and 0 substantiated allegations on file since 2021, per CDSS records as of September 27, 2026. One complaint can carry several allegations.
  • The most recent state visit on file is September 3, 2025, per CDSS records as of September 27, 2026.
Type A citationa violation that poses an immediate risk to health, safety or personal rights if it is not correctedType B citationa violation that could become a risk if not corrected, or one involving records, resources or required services

California writes these definitions for every licensed home, not for this one. CDSS citation definitions (PDF) ↗

See the state’s own record

Can they support the care needed?

California licenses a home for specific kinds of care. The state’s record lists what this home is approved for; the home’s own answers fill in what changes as needs change.

  • Wheelchair / non-ambulatoryApproved by the state
  • Dementia / memory careNot on file · ask the home
  • Hospice careApproved by the state
  • BedriddenNot on file · ask the home

State licensing record · September 27, 2026. An approval may cover specific rooms or residents; it does not establish an opening.

Read the state’s own wording
AGE RANGE 60 AND OVER. SIX (6) MAY BE NON-AMBULATORY. HOSPICE WAIVER APPROVED FOR TWO (2) RESIDENTS.

935 - ELDERLY

CDSS record, verbatim · September 27, 2026

As needs change

  • Staying through hospice

    Hospice waiver on file — care may continue at the end of life

    Ask: “If hospice is needed, can care continue here until the end?”

    State licensing record · September 27, 2026

4 more questions to ask the home
  • Two-person transfers or a lift

    Not on file

    Ask: “If two people or a lift are needed to transfer, can the person stay?”

  • Someone awake overnight

    Not on file

    Ask: “Who is awake overnight, and how do residents ask for help?”

  • Medicines

    Not on file

    Ask: “Who manages the medicines, and what happens when a dose is missed?”

  • If memory loss develops

    Dementia-care designation not on file

    Ask: “If memory loss develops, what would change — and when would a move be needed?”

What it costs here

Covelight estimate

$4,850a month to start

Likely $4,000–$6,000

From 23 nearby homes that publish rates · this home’s rate is not on file

Likely monthly total

$4,850a month

Likely $4,000–$6,150

With a shared room and basic help.

An estimate for planning, not a quote. The price is made in the phone call.

See the full cost breakdownRoom, care and fees · how people pay · how this estimate works
Room
Daily care
Sharing the room

Memory care is not priced here: a dementia-care designation is not on file for this home. Ask the home.

  • Starting monthly rate$4,850likely $4,000–$6,000

    Covelight’s estimate starts from the rates 23 small homes and similar homes within 10 miles publish, then adjusts for this home’s size, state care approvals, Medi-Cal waiver participation, years licensed and the area’s prices. In testing, the likely range held the real rate for 6 in 10 homes. This home’s own rate is not on file.

  • Basic help with daily careUsually includedup to $600

    Basic help is usually part of the starting rate. Homes that price care by level start around $600 a month (45 California homes publish a care-level range, seen in September 2026).

  • One-time move-in fee$2,000one time · likely $0–$4,000

    Homes that list a one-time entry or community fee charge a median of $2,000 (134 California listings; middle half $1,000–$4,000). Many homes list none — ask.

Likely monthly totalLikely $4,000–$6,150
$4,850
First monthWith a one-time move-in fee · likely $4,650–$9,250
$6,850
How people payPrivate pay, Medi-Cal waiver, SSI/SSP, veterans, insurance
  • Private payMost residents pay from savings, a home sale or family help. Ask for the rate and what it includes in writing.
  • Medi-Cal Assisted Living WaiverThis home is not on the DHCS participation list dated September 23, 2026. Ask the program about current options. The waiver pays for care services, not room and board.
  • SSI/SSPCalifornia’s 2026 standard is $1,626.07 a month; $1,444.07 of it goes to the home and $182 stays with the resident. Whether this home accepts it is not on file — ask.
  • VeteransVA Aid & Attendance can add to a veteran’s or surviving spouse’s pension. Ask whether residents here have used it.
  • Long-term care insuranceMost policies pay for licensed care homes. Ask what paperwork the home provides for claims.
  • MedicareDoes not pay for room and board in a care home. It can still cover hospice or home-health visits inside one.
If the money runs out, what Medi-Cal covers
Avoid surprises on the billWhat changes the price, and what to ask
  • The care level

    Some homes charge one all-inclusive rate. Others add levels or points as needs grow. Ask how the level is set, who decides, and what the next level costs.

  • What is billed separately

    Medication management, incontinence supplies, transportation and a second person in the room are often extra. Ask for the list in writing.

  • Move-in costs

    A one-time community fee or deposit is common. Ask what it covers and whether any of it comes back if the stay is short.

  • Increases

    California requires at least 90 days’ written notice, with reasons, before a rate rises (Health & Safety Code §1569.655). A change in the resident’s care level is the section’s own exception and can be billed sooner.

  • What is the full monthly cost for the room and care we need, and what does it include?
  • What would the next care level cost, and who decides when it changes?
  • What is billed separately, and is there a one-time fee or deposit at move-in?
  • Is any private-pay period required before another payment program can begin?
How this estimate worksWithin 25% for 7 in 10 homes in testing

Covelight’s estimate starts from the rates 23 small homes and similar homes within 10 miles publish, then adjusts for this home’s size, state care approvals, Medi-Cal waiver participation, years licensed and the area’s prices. In testing, the likely range held the real rate for 6 in 10 homes. This home’s own rate is not on file.

23 homes like this within 10 miles publish starting rates mostly between $3,250–$5,000.

  • Only prices a home put out itself count: its own website, a listing it supplied, or a price Seniorly says the home confirmed. Prices a listing site shows without saying where they came from are left out.
  • Nearby homes are the nearest of the same size that publish a rate, widening from 3 to 40 miles until at least 8 do. The estimate starts from what they charge, then adjusts for this home’s size, state care approvals, Medi-Cal waiver participation, years licensed and the area’s prices.
  • Room, care-level, second-person and move-in lines come from what California homes publish on listing sites. Memory care uses Covelight’s researched premium over assisted living.
  • Totals add each line’s figure and combine the lines’ ranges as separate charges, because a home is rarely at the top, or the bottom, of every line at once.
  • We tested this estimate on 1,546 California homes that publish their own starting rate. It was within 10% of the real rate for 3 in 10 homes and within 25% for 7 in 10; the likely range held the real rate for 6 in 10 (September 12, 2026).
  • It cannot see this home’s specials, how it assesses care, or which rooms are open.
Show the 23 nearby homes behind this estimate

Where it is

  • 1 Kingswood Drive, Pittsburg, CA 94565Address from the public record · September 27, 2026. Confirm the entrance with the home before visiting.

Opening the neighborhood map…

The state record

California inspects every licensed home and publishes what it found. Here are the dated documents and the state’s own words, beside what is typical for homes this size.

Since 2022, the state has filed 8 documents for this home, and its records count 8 visits since 2021. The most recent is a facility evaluation report, dated September 3, 2025.

On file since
2022
State visits
8
Most recent visit
September 3, 2025
Occupied · July 1, 2025 visit
2 of 6 bedsa count on that day, not an opening

We hold 1 complaint report the state published for this home, dated July 1, 2025. 1 of the 1 carries the state's recorded outcome word: “Unfounded” (1). 1 includes the transcribed allegation the state investigated, word for word. Summary composed by computer from the 1 complaint report below — every count derives from them, and the documents themselves are the state's records, verbatim. We never grade, score, or color a record.

Beside homes the same size

  • Type A citations0typical 0
  • Type B citations0typical 0
  • Substantiated allegations0typical 0
  • Total complaints1typical 0

“Typical” is the statewide median across the 6,808 licensed small board-and-care homes (6 or fewer beds) in the state record — larger, longer-licensed homes accumulate more visits and reports, so compare like with like. One complaint can contain several allegations. Counts cover this licence since 2021.

Year by year
YearVisitsDocumentsSubstantiated2025330202433020231102022110

The last 36 months — 6 of 8 documents

The full record on the state’s site →
20253 state visits · 3 documents
Sep 3, 2025Facility evaluation reportReport on file

Type of visit: Required - 1 Year

On 9/3/2025 at 2:00pm, Licensing Program Analyst (LPA) L. Hall conducted an unannounced annual required inspection. LPA met with Marie Etienne, Caregiver, and explained the purpose of the visit. LPA spoke with Administrator, Endurance Ediae via telephone and was given approval for Caregiver to sign documents. Administrator holds a certificate #6070924740 expires 12/19/2026. Licensee, Aurore Ediae, arrived at 4:55pm. The facility’s fire clearance was approved for six (6) ambulatory residents. Facility has submitted all documents and made changes for updated fire clearance. LPA toured the facility with Administrator including but not limited to bedrooms, bathrooms, kitchen, common area, garage and backyard. The facility consists of five (5) bedrooms and two (2) bathrooms. One (1) bedroom occupied by staff. No bodies of water was observed. A comfortable temperature is maintained at 75 degrees Fahrenheit. LPA observed lighting in all rooms are adequate for the comfort and safety of the residents. The hot water temperature in the residents’ shared bathroom was measured at 137.3. degrees Fahrenheit. Residents’ bathrooms are equipped with grab bars and non skid mats. Smoke detectors and carbon monoxide were in operating condition during visit. Fire extinguisher was last serviced on 09/3/2024. Emergency Disaster Plan was last reviewed on 03/20/2025. Continued on LIC809. Continued from LIC809C. Smoke detectors and carbon monoxide were in operating condition during visit. Fire extinguisher was last serviced on 09/3/2024. Emergency Disaster Plan was last reviewed on 03/20/2025. LPA was not able to review staff files due to they were not at the facility. LPA reviewed both resident files and both were incomplete. LPA observed the following deficiencies: At 2:30pm, LPA observed during record review there were not any staff files to review. At 2:30pm, LPA observed during record review that both residents' files were incomplete. At 2:40pm, LPA observed during record review that the facility has not conducted a fire drill. At 2:50pm, LPA observed that medication was not in it's original containers. LPA requested the following documents to be submitted to CCLD by 9/10/2025. LIC 308 Designation of Administrative Responsibility LIC 500 Personnel Report LIC 610E Emergency Disaster Plan (Last page) Continued on LIC809C. Continued from LIC809C. Liability Insurance Deficiencies are cited from Title 22 California Code of Regulations (see 809D). Failure to submit proof of corrections by plan of correction due date, and any repeat violations within 12-month period may result in civil penalties. Exit interview conducted. A copy of appeal rights and this report provided.the state’s words, verbatim · CDSS document, Sep 3, 2025
Jul 1, 2025Complaint investigation reportUnfounded

Allegation investigated: Facility did not issue a refund to resident's responsible party.

On 7/1/2025 at 3:25pm, Licensing Program Analyst (LPA), L. Hall arrived unannounced to conduct the 10-day initial visit and deliver complaint findings for the allegation above. LPA met with Jegugimo Bode, caregiver. Administrator, Edurance Ediae, arrived at 3:55pm and explained the reason for the visit. During the course of the investigation the Department conducted interviews with staff and witness. Allegation: Facility did not issue a refund to resident's responsible party. Based on interview with W1 the facility did not issue a refund to R1’s Continued on LIC9099C. Unfounded Continued from LIC9099. responsible party after R1 expired on June 20, 2025. W1 stated that R1’s responsible party is entitled to a refund for the remainder of the month after the belongings were picked up, which was on June 21, 2025. This Department has investigated the complaint alleging a refund was not given. We have found that the complaint was UNFOUNDED, meaning that the allegation was false, could not have happened and/or is without a reasonable basis. Exit interview conducted and a copy of this report provided.the state’s words, verbatim · CDSS document, Jul 1, 2025 · control 15-AS-20250624100859
May 13, 2025Facility evaluation reportReport on file

Type of visit: Case Management - Health Checks

On 5/13/2025, at 10:10am, Licensing Program Analysts (LPAs) L. Hall and T. Syess-Gibson conducted an unannounced Case Management health and safety check. LPA met with Marie Etienne, Caregiver, explained the purpose of the visit. LPA received called on 5/12/2025, from Licensee, stating the property and business has been sold. New potential owners (S2 and S3) arrived at 11:00am. Facility is licensed for six (6) ambulatory residents only. LPAs observed the following deficiencies: At 10:15am, LPAs observed S1 was not fingerprinted or associated. At 10:25am, LPAs observed facility did not have a qualified administrator. At 10:30am, LPAs observed garage door unlocked with bleach, gallon of primer, gallon of paint, Fabuloso, laundry detergent, and Clorox disinfectant accessible. At 10:40am, LPAs observed facility did not have a sufficient amount of linen. LPAs observed 2 mattress pads, At 11:00am, LPAs observed S2 is not associated and S3 is not fingerprinted or associated to the facility. Continued on LIC809C. Continued from LIC809. At 11:15am, LPAs observed medication for all residents pre-poured for the week. At 11:15am, LPAs observed there was not any list of medication for the residents. At 11:20am, LPAs observed facility did not have an ambulatory fire clearance. At 11:50pm, LPAs observed facility did not have any liability insurance for the facility. At 03:00pm, LPAs observed R1 has a restricted health condition. *An immediate civil penalty in the amount of $2700.00 will be assessed on today's date* $400 x 1 for 87355(d) for fingerprint $400 x 2 = $800 for 87355(e) for association $1000 x1 for 87202(a)(1) for fire clearance $250 x 1 for 87405(a) repeat for administrator qualifications $250 x 1 for 87465(h)(6) repeat for medications not in original container Deficiencies are cited per Title 22 California Code of Regulations and listed on LIC809D. Failure to submit proof of corrections (POC) by plan of correction due date and/or any repeat deficiencies within a 12-month period may result in civil penalties. Exit interview conduct. A copy of the appeal rights, LIC421BG, LIC421IM, LIC421FC, and the report provided.the state’s words, verbatim · CDSS document, May 13, 2025

From the deficiency page — Deficiency type: Type A · Section cited: CCR 87355(d) · Plan of correction due date: May 14, 2025

(d) All individuals subject to criminal record review shall be fingerprinted and sign a Criminal Record Statement (LIC 508 [Rev. 1/03]) under penalty of perjury. This requirement was not met as evidence by: Based on record review and interview the Licensee did not comply with the section cited above in having S1 fingerprinted before being employed at the facility, which poses a potential health and safety risk to persons in care.the state’s words, verbatim · CDSS document, May 13, 2025

Plan of correction: Licensee agreed to get S1 fingerprinted and submit copy of document to CCLD by POC date.

From the deficiency page — Deficiency type: Type A · Section cited: CCR87355(e) · Plan of correction due date: May 14, 2025

(e) All individuals subject to a criminal record review pursuant to Health and Safety Code Section 1569.17(b) shall prior to working, residing or volunteering in a licensed facility: This requirement was not met as evidence by: Based on observation and interview the Licensee did not comply with the section cited above in having S2 and S3 associated to the facility, which poses an potential health and safety risk to persons in care.the state’s words, verbatim · CDSS document, May 13, 2025

Plan of correction: Licensee submtited LIC9182 and a copy of S2 and S3 identification to associate them to the facility during visit. Deficiency cleared during visit.

From the deficiency page — Deficiency type: Type A · Section cited: CCR 87309(a) · Plan of correction due date: May 14, 2025

(a... the licensee shall ensure that disinfectants, cleaning solutions, poisonous substances... and other similar items which could pose a danger to residents are in locked storage and are not left unattended... This requirement was not met as evidence by: Based on observation the Licensee did not comply with the section cited above by not having disinfectants, laundry detergents, paints accessible to residents, which poses an immediate health and safety risk to persons in care.the state’s words, verbatim · CDSS document, May 13, 2025

Plan of correction: Licensee agreed to lock garage that contained laundry detergent, Clorox, paint and other items, and submit photo to CCLD by POC date.

From the deficiency page — Deficiency type: Type A · Section cited: CCR87202(a)(1) · Plan of correction due date: May 14, 2025

(a) All facilities shall maintain a fire clearance approved by the city, county, or city and county fire department... Prior to accepting or retaining any of the following types of persons... (1) Non ambulatory persons. This requirement was not met as evidence by: Based on observation and record review the Licensee did not comply with the section cited above in having proper fire clearance for non ambulatory residents, which poses a potential health and safety risk to persons in care.the state’s words, verbatim · CDSS document, May 13, 2025

Plan of correction: Licensee agreed to submit an LIC200 and updated copy of the facility sketch to CCLD by POC date.

From the deficiency page — Deficiency type: Type B · Section cited: CCR 87307(a)(3)(c) · Plan of correction due date: May 20, 2025

(a) ... The following provisions shall apply: (3) Equipment and supplies necessary for personal care and maintenance... shall be ...readily available to each resident. (C) Clean linen... towels, hand towels and wash cloths. The quantity shall be sufficient to permit changing at least once per week or more often... This requirement was not met as evidence by: Based on observation the Licensee did not comply with the section cited above in having a sufficient amount of bedding and towels available for residents, which poses a potential health and safety risk to persons in care.the state’s words, verbatim · CDSS document, May 13, 2025

Plan of correction: License agreed to purchase bedding and linen and submit a photo to CCLD by POC date.

From the deficiency page — Deficiency type: Type B · Section cited: HSC1569.605 · Plan of correction due date: May 20, 2025

... all residential care facilities for the elderly... shall maintain liability insurance covering injury to residents and guests in the amount of at least ($1,000,000) per occurrence and ($3,000,000) in the total annual aggregate, caused by the negligent acts or omissions to act of, or neglect by, the licensee or its employees. This requirement was not met as evidence by: Based on record review and interview the Licensee did not comply with the section above in having liability insurance for the facility which poses a potential health and safety risk to persons in care.the state’s words, verbatim · CDSS document, May 13, 2025

Plan of correction: Licensee agreed to purchase liability insurance and submit a copy to CCLD by POC date.

From the deficiency page — Deficiency type: Type B · Section cited: CCR 87405(a) · Plan of correction due date: May 20, 2025

(a) All facilities shall have a qualified and currently certified administrator.... The administrator shall... on the premises a sufficient number of hours... When the administrator is not in the facility, there shall be coverage by a designated substitute who shall have qualifications.... This requirement was not met as evidence by: Based on observation and interview the Licensee did not comply with the section cited above in having an administratorthe state’s words, verbatim · CDSS document, May 13, 2025

Plan of correction: Licensee agreed to hire a qualified administrator and submit all documentation to CCLD by POC date.

From the deficiency page — Deficiency type: Type B · Section cited: HSC1569.191(a)(1) · Plan of correction due date: May 20, 2025

(a) Notwithstanding Section 1569.19, in the event of a sale of a licensed facility where the sale will result in a new license being issued, the sale and transfer of property and business shall be subject to both of the following: (1) The licensee shall provide written notice to the department and to each resident or his or her legal representative of the licensee's intent to sell the facility at least 30 days prior to the transfer of the property or business, or at the time that a bona fide offer is made, whichever period is longer. This requirement was not met as evidence by: Based on interview the Licensee did not comply with the section cited above in notifying CCLD and representatives of sale of business, which poses a potential health and safety risk to persons in care.the state’s words, verbatim · CDSS document, May 13, 2025

Plan of correction: Licensee agreed to submit letter given to resident or residents representative to CCLD by POC date.

From the deficiency page — Deficiency type: Type B · Section cited: CCR 87465(h)(5) · Plan of correction due date: May 20, 2025

(h) The following requirements shall apply to medications which are centrally stored: (5) Each resident's medication shall be stored in its originally received container. No medications shall be transferred between containers. This requirement was not met as evidence by: Based on observation the Licensee did not comply with the section cited in maintaining medication in it's original container, which poses a potential health and safety risk to persons in care.the state’s words, verbatim · CDSS document, May 13, 2025

Plan of correction: Licensee agreed to review regulation 87465 and submit self-certification that the facility will abide by regulation going forward to CCLD by POC date.

From the deficiency page — Deficiency type: Type B · Section cited: CCR87465(h)(6) · Plan of correction due date: May 20, 2025

(h) The following requirements shall apply to medications which are centrally stored: (6) The licensee shall be responsible for assuring that a record of centrally stored prescription medications for each resident is maintained for at least one year and includes: This requirement was not met as evidence by: Based on observation and record review the Licensee did not comply with the section cited above in having records of medication for all 3 residents, which poses a potential health and safety risk to persons in care.the state’s words, verbatim · CDSS document, May 13, 2025

Plan of correction: Licensee agreed to obtain records for medication for all 3 residents and submit records to CCLD by POC date.

From the deficiency page — Deficiency type: Type B · Section cited: CCR 87623(b) · Plan of correction due date: May 20, 2025

(b) In addition to Section 87611, General Requirements for Allowable Health Conditions, the licensee shall be responsible for the following: This requirement was not met as evidence by: Based on observation the Licensee did not comply with the section cited above in having documentation for R1's catheter/home health which poses a potential health and safety risk to persons in care.the state’s words, verbatim · CDSS document, May 13, 2025

Plan of correction: Licensee agreed to obtain care plan from home health for R1 and submit plan to CCLD by POC date.

20243 state visits · 3 documents
Oct 1, 2024Facility evaluation reportReport on file

Type of visit: Case Management - Other

On 10/1/2024, Licensing Program Analysts (LPAs), L. Hall and D. Doidge arrived unannounced to conduct a case management visit. LPAs met with Caregiver, Rizalina Hutchko. House manager, Arvin Franco, arrived at 12:10pm, and LPAs explained the purpose of the visit. Case management visit was for a follow-up for an annual inspection completed on 8/20/2024. During visit LPAs reviewed the three (3) resident records and five (5). All resident and staff records are incomplete. LPAs toured facility and observed three (3) residents. During record review LPAs observed two (2) of three (3) residents are non-ambulatory. Facility fire clearance for the facility is for six (6) ambulatory residents only. The following deficiencies were observed: At 11:45am, LPAs observed facility did not have supplies of nonperishable foods for a minimum of one week and perishable foods for a minimum of two days shall be maintained on the premises At 12:40pm, LPAs observed during record review that the facility have two (2) non-ambulatory residents but does not have a non-ambulatory fire clearance. Continued on LIC809C. Continued from LIC809. *An immediate civil penalty will be assessed on today's date for $500.00 for fire clearance* Deficiencies are cited per Title 22 California Code of Regulations and listed on LIC809D. Failure to submit proof of corrections (POC) by plan of correction due date and/or any repeat deficiencies within a 12-month period may result in civil penalties. Exit interview conducted. A copy of the appeal rights, LIC421M, and this report provided.the state’s words, verbatim · CDSS document, Oct 1, 2024

From the deficiency page — Deficiency type: Type A · Section cited: CCR 87202(a)(1) · Plan of correction due date: Oct 2, 2024

87202 (a) All facilities shall maintain a fire clearance approved by the city, county... fire protection services... Prior to accepting... persons, the applicant or licensee shall notify the licensing agency and obtain an appropriate fire clearance...(1) Nonambulatory persons. This requirement was not met as evidence by: Based on observation and record review the Licensee did not comply with the section cited above in have an approved fire clearance for non-ambulatory residents, which poses a potential health and safety risk for persons in care.the state’s words, verbatim · CDSS document, Oct 1, 2024

Plan of correction: House manager agreed to sumbit a LIC200 and updated facility sketch to CCLD by POC date. *An immediate $500 civil penalty fire fire clearance*

From the deficiency page — Deficiency type: Type B · Section cited: CCR87555(26 · Plan of correction due date: Oct 4, 2024

87555 General Food Service Requirements (26) Supplies of nonperishable foods for a minimum of one week and perishable foods for a minimum of two days shall be maintained on the premises. This requirement was not met as evidence by: Based on observation the Licensee did not comply with the section cited above in having 7 day supply of non-perishable and 2-day perishable foods for residents, which poses a potential health and safety risk to persons in care.the state’s words, verbatim · CDSS document, Oct 1, 2024

Plan of correction: House Manager agreed to purchase food and submit photos of food and receipts to CCLD by POC date.

Aug 29, 2024Facility evaluation reportReport on file

Type of visit: POC

On 8/29/2024, at 1:35PM, Licensing Program Analyst (LPA) L. Hall arrived unannounced to conduct a proof of correction (POC) visit. LPA met with Eva Bode, Caregiver, and explained the purpose of the visit. LPA conducted an annual inspection on 8/20/2024 and cited for the following deficiencies that has not been corrected. 87555(26), LPA observed facility does not have a 7-day supply of non -perishables and 2-day of perishables foods. 87405(a) LPA observed facility have not implemented a plan to hire or recertify an Administrator. 87203 - LPA observed fire extinguisher has not been services and facility has not purchased a new fire extinguisher. 87211(a)(1) - LPA observed facility did not report incident for R1. 87307(d)(6) - LPA observed couch, loveseat, freezer, shovel, and rake in backyard. 87506(d) - LPA observed resident records still not at facility available for review. Continued on LIC809C. Continued from LIC809. 87412(f) - LPA observed staff records still not at facility available for review. 87705(l)(8) - LPA observed facility still have not conducted a fire drill. 87465(8) - LPA observed facility has not bought a first aid kit. 87411(a) - LPA observed facility does not have sufficient staffing to meet residents needs. 87465(h)(6) - LPA observed records for medication is not accurate. LPA conducted an annual inspection on 8/20/2024, and cited for the following deficiency have been corrected. 87705(f)(2) - Caregiver removed medication next to R1's bed and locked medication in cabinet. Each uncorrected deficiency is $100.00 x 2 = $2200.00. Civil Penalties in the total amount of $2200.00 is assessed today for failure to meet POC date for deficiencies. Facility is subject to ongoing civil penalties until deficiencies are corrected. Exit interview conducted. A copy of this report, LIC421FC, and appeal rights provided.the state’s words, verbatim · CDSS document, Aug 29, 2024
Aug 20, 2024Facility evaluation reportReport on file

Type of visit: Required - 1 Year

On 8/20/2024 at 1:30pm, Licensing Program Analyst (LPA) L. Hall conducted an unannounced annual Required inspection. LPA met with Rizalina Hutchko, Caregiver, and explained the purpose of the visit. LPA spoke with listed Administrator, Ojo Akognon via telephone and was given approval for Caregiver to sign documents. The facility’s fire clearance was approved for six (6) ambulatory residents. LPA toured the facility with Administrator including but not limited to bedrooms, bathrooms, kitchen, common area, garage and backyard. The facility consists of five (5) bedrooms and two (2) bathrooms. One (1) bedroom occupied by staff. No bodies of water was observed. A comfortable temperature is maintained at 75 degrees Fahrenheit. LPA observed lighting in all rooms are adequate for the comfort and safety of the residents. The hot water temperature in the residents’ shared bathroom was measured at 105. degrees Fahrenheit. Residents’ bathrooms are equipped with grab bars and non skid mats. Smoke detectors and carbon monoxide were in operating condition during visit. Fire extinguisher was last serviced on 2/2/2022. Emergency Disaster Plan was last posted on 06/27/2024. Fire drill was last conducted on 03/4/2024. Continued on LIC809. Continued from LIC809. LPA was not able to review staff or residents records due to they were not at the facility. LPA received medication LPA observed the following deficiencies: At 1:40pm, LPA observed facility did not have a certified administrator. At 1:45pm, LPA observed during record review that resident files were not present at facility and available to inspect. At 1:55pm, LPA observed scissors and knives in unlocked kitchen drawer. LPA also observed a pair of scissors drying in dish rack. At 2:00pm, LPA observed fire extinguisher expired. Last services 2/22/2022. At 2:10pm, LPA observed facility does not have a 7-day supply of non perishables and 2-day perishables. LPA also observed 21 cans of expired food. At 2:15pm, LPA observed 2 bottles and 1 box of melatonin sitting next to R2's bed. At 2:20pm, LPA observed a couch, loveseat, recliner, freezer, shovel, and rack in back yard on right hand side of house. At 2:45pm, LPA observed R1's after summary visit, but staff did not report to CLLD. At 3:00pm, LPA observed during record review records are not maintained for medication. R1, R2, and R3 have medication that is not listed on medication administrator record (MAR). Continued on LIC809C. Continued from LIC809C. LPA requested the following documents to be submitted to CCLD by 8/27/2024. LIC 308 Designation of Administrative Responsibility LIC 309 Administrative Organization LIC 500 Personnel Report LIC 610E Emergency Disaster Plan (Last page) Liability Insurance Deficiencies are cited from Title 22 California Code of Regulations (see 809D). Failure to submit proof of corrections by plan of correction due date, and any repeat violations within 12-month period may result in civil penalties. Exit interview conducted. A copy of appeal rights and this report provided.the state’s words, verbatim · CDSS document, Aug 20, 2024
What the state’s words mean
Substantiatedthe state found the allegation more likely true than notUnsubstantiatedthere was not enough evidence to prove a violation occurred — not a finding of wrongdoingUnfoundedthe evidence showed the allegation was false, could not have happened, or had no reasonable basisType A citationa violation that poses an immediate risk to health, safety or personal rights if it is not correctedType B citationa violation that could become a risk if not corrected, or one involving records, resources or required services

CDSS citation definitions (PDF) ↗ · CDSS complaint outcomes ↗

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