Serene Living Home Care

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Martha Arroyo arrived at the facility unannounced to conduct the required annual visit today. Upon arrival, the LPA was greeted by staff who then contacted the Administrator telephonically. The Administrator, Analyn Cervantes arrived at approximately 12:20pm and the reason for the visit was explained. Entrance interview conducted. Beginning at 12:25pm, 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: Bedrooms: There are five (5) bedrooms for resident use. Four (4) bedrooms are designated as private / single bedrooms, and one (1) bedroom is designated as shared / double occupancy. Bedrooms were observed to be furnished appropriately and had sufficient lighting. Additional clean linens and towels were observed in a cabinet by the hallway. Restrooms: There are two (2) restroom for resident use. Bathroom was clean and sanitary and in operating condition with non-skid surfaces and grab bars. The bathrooms were sufficiently stocked with supplies and paper towels. Starting at 12:33pm, the hot water temperature was measured in resident bathrooms, and they measured within the required range of 105 – 120 degrees Fahrenheit at the time of the visit. Personal hygiene items were observed locked and inaccessible at the time of the visit. 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 several fire extinguishers to be fully charged with a charge date of 08/11/2025. Required postings were observed throughout the common space. Report Continued on LIC 809C... Report Continued from LIC 809... There is a working telephone on premises. First aid kit was observed to be complete. The LPA observed working auditory alarms on all exits at the time of the visit. There is a fireplace in the living room; adequately screened. No hazards/obstructions observed inside or out. Garage: The garage is attached to the facility. Washer and dryer were observed inside the garage. Detergents and cleaning supplies were observed locked and inaccessible to residents in care at the time of the visit. There is a freezer with additional food in good condition. The LPA observed a sufficient amount of emergency food and water; adequately stored. Kitchen: The LPA inspected the kitchen/food service area at approximately 12:40pm. Knives and sharps were observed in a locked drawer. Cleaning supplies were observed locked and inaccessible under the kitchen sink. 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. Outdoors: The backyard has a covered patio area with adequate furniture for resident use. Emergency passageway was observed to be clear of any obstructions. There are two (2) side gates with latching mechanisms. No bodies of water noted at the time of the visit. Records: Record review began at approximately 12:50pm. Four (4) resident files were reviewed for, but not limited to, the following: signed admission agreements, current medical assessments with TB results, consent for treatment form, preplacement appraisals, appraisals, and current needs and services plan. All files were in order. Five (5) personnel files were reviewed for, but not limited to: personnel records, health assessments with negative TB test results, criminal record clearances, first aid/CPR training, and the appropriate yearly training. All personnel files were complete. The Administrator’s certificate is valid until 01/08/2027. Medications: Medication review began at approximately 02:45pm. Medications are centrally stored and kept in a locked cabinet adjacent to the living room. All medications including PRNs were labeled, stored, and locked inaccessible to residents in care. Medications appear to be administered as prescribed at the time of the visit. Report Continued on LIC 809C... Report Continued from LIC 809C... Infection Control / Emergency Disaster Planning: During today’s visit, the LPA reviewed the facility's infection control plan. The facility’s policies and procedures as they pertain to infection control are adequate. 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; last disaster drill conducted on 03/25/2026. No citations issued at this time. Exit interview conducted. A copy of the report was issued.the state’s words, verbatim · CDSS document, Jun 15, 2026

Type of visit: Post Licensing

Licensing Program Analyst (LPA) Martha Arroyo arrived at the facility unannounced to conduct a post licensing visit. Upon arrival, the LPA was greeted by staff who then contacted the Administrator telephonically. The Administrator, Analyn Cervantes arrived during the inspection and the reason for the visit was explained. Entrance interview. The LPA and 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. Kitchen: The LPA inspected the kitchen/food service area at approximately 10:05 a.m. Knives and sharps were observed in a locked drawer. Cleaning supplies and other chemicals are kept locked under the sink area. Kitchen appliances were in operable condition. The facility has a sufficient supply of two (2) day perishable and seven (7) day non-perishable food. Refrigerator and food pantry were checked for proper labels and expiration dates. The kitchen faucet was measured for hot water temperature, and it measured 115 degrees Fahrenheit at 10:07 a.m. Bedrooms: There are six (6) total bedrooms in the facility; Five (5) bedrooms are designated for resident use, and one (1) bedroom is designated for staff use only. Four (4) resident bedrooms are designated as private, single occupancy, resident rooms and one (1) resident bedroom is designated as double, shared occupancy, resident room. Bedrooms #2, #4, and #5 have access to the exterior. All passageways were observed to be clear of obstructions. All resident rooms were observed to be furnished appropriately with clean linens, appropriate furnishings, and sufficient lighting. Additional clean linens and towels are available for resident use. Report Continued on LIC 809C... Report Continued from LIC 809... Restrooms: There are two (2) total restrooms in the facility. One (1) bathroom is designated for resident use, and one (1) bathroom is designated for staff / visitor use only. Resident restroom was observed to be clean and in sanitary condition. Grab bars and slip resistant floor were observed. The restroom was sufficiently stocked with supplies and paper towels. The hot water temperature was measured at 113.7 degrees Fahrenheit, which is between the required range. Garage: The LPA observed the garage which is kept inaccessible to residents in acre. There is a washer and dryer. Toxins and detergents were observed locked and inaccessible at the time of the visit. The LPA observed a sufficient supply of emergency food and water. Common Areas: This includes the living room, family room, and a dining room. 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 hardwire combination of smoke / carbon monoxide detectors and fire doors were tested and operational at the time of the visit. The fire extinguisher was observed and fully charged on 08/11/2025. The LPA observed required postings throughout the common space including emergency exiting plans / sketch, emergency telephone numbers, and facility license. Activities were observed in the common areas. There is a functioning telephone on the premises. Outdoors: The backyard has a covered patio area with shade, patio furniture including tables and chairs for resident use. All passageways were observed to be clear. The LPA observed two (2) self-latching gates. No bodies of water noted at the time of the visit. Records Review: The LPA conducted a record review of four (4) resident files and four (4) personnel files beginning at 11:30 a.m. Resident files were reviewed for, but not limited to, the following: signed admission agreements, current medical assessments with TB results, LIC627(c) Consent for Treatment form, PRN authorization letters, and current needs and services plan. Files were complete. Report Continued on LIC 809C... Report Continued from LIC 809C... Personnel files including the Administrator’s file were reviewed for, but not limited to: personnel records, health assessments, criminal record clearances, first aid/CPR training, and the appropriate training. The LPA was unable to verify training hours for staff during the visit. Infection Control / Emergency Disaster Planning: During today’s visit the LPA reviewed the facility’s infection control practices and the facilities emergency disaster plan. The facilities policies and procedures, as they pertain to infection control and emergency planning, adhere to the standard. Medications Review: Medications are centrally stored in a cabinet adjacent to the living room. Medications are labeled and checked for expiration dates. All medications including PRNs were labeled, stored, and locked inaccessible to residents in care. Medications appear to be administered as prescribed at the time of the visit. The following deficiencies were observed (See LIC 809-D) and cited from the California Code of Regulations, Title 22 and/or California Health and Safety Code. Failure to correct the deficiencies may result in additional civil penalties. Exit interview conducted. Copy of report reviewed and provided.the state’s words, verbatim · CDSS document, Oct 28, 2025

Type of visit: Prelicensing

Licensing Program Analyst (LPA), Martha Arroyo conducted a pre-licensing visit to this property at 10:00am. Upon arrival, the LPA met with Applicant Representative’s, Analyn Cervantes and Leilani Millera. During today's visit, the LPA completed Component III with the Applicant Representatives. Component II was completed on 04/24/2025. The facility is one story. At approximately 10:10am, a physical plant tour was conducted inside and out. The LPA inspected facility for Fire Safety, Personal Accommodations and Services, and Food Service. The applicant has obtained fire clearance for a total capacity of six (6) residents, five (5) non-ambulatory residents in bedrooms # 1 - #5 and one (1) bedridden resident in bedroom #2. There are no fire sprinklers in the facility. Main hallway leading to resident bedrooms from the living room was observed to be equipped with a fire door. The smoke alarms and carbon monoxide detectors are wired and function properly when tested. The LPA observed two (2) fire extinguishers fully charged with a date of 08/09/2024. The facility has four (4) private resident bedrooms and one (1) shared resident bedroom. Bedrooms #1, #2, #3, and #5 will be single occupancy and bedroom #4 will be used for double occupancy. Each bedroom is equipped with a bed, nightstands, chests of drawers, chairs and closet space. The beds are furnished with comfortable mattress and clean linen, which includes, a mattress pad, top and bottom linens, pillowcases, blanket and a bedspread. Lighting in the rooms appeared adequate. Report Continued on LIC 809C... Report Continued from LIC 809... In addition, no bedroom was used as a passageway to another room, bath or toilet. Bedrooms #2, #4, and #5 have direct access to the outside perimeter. All rooms were free of odors. All window screens were clean and maintained in good repair. There is a closet located in the main hallway that stored an adequate supply of extra bed and bath linens. Facility will have a staff room which will be kept locked and inaccessible to residents. The facility has two (2) bathrooms for resident use. Resident bathrooms contained appropriate non-skid mats and grab bars. Bathrooms have sufficient paper products. The LPA observed trash cans with tight fitting lids at the time of the visit. Hot water temperature in both bathrooms measured within the required range of 105 and 120 degrees Fahrenheit. Medications will be stored and locked in a cabinet adjacent to the living room. First aid kit was observed to have bandages, thermometer, scissors, tweezers and a current first aid manual. Facility records will be maintained locked and inaccessible in a file cabinet adjacent to the kitchen. The facility has at least seven (7) day supply of non-perishable food. The kitchen has a sufficient supply of plates, cups, cookware, and utensils. Enough seating for six (6) residents at the same time in the dining room table. Appliances in the kitchen were clean and all appeared functional at the time of the visit. There are no pesticides (poisons) or toxins stored in any food storage area or preparation area with utensils. Kitchen knives and sharps were observed in a locked drawer next to the kitchen sink. Soaps and cleaning supplies will be locked and inaccessible under the kitchen sink. Trash cans had tight fitting lids. No flies or other vermin were observed. The common areas were appropriately furnished, and the lighting was adequate. All window screens and coverings are in good repair. A working telephone is present. There is a television and other entertainment equipment, games and/or activity supplies in the living room. Report Continued on LIC 809C... Report Continued from LIC 809C... There is sufficient space to accommodate both indoor and outdoor activities. Night lights were observed in hallways and bathrooms. There is a fireplace in the living room that was observed to be adequately covered/screened. All doors had functioning auditory alarms at the time of the visit. The facility has required postings, including Licensing Complaint Poster, Resident Personal Rights, Theft and Loss Policy, and Resident Council Rights. No obstructions were observed inside or out. The garage is attached to the house and will be kept inaccessible to residents in care. The washer and dryer was observed inside the garage. Cleaning supplies and personal hygiene items were observed in a locked cabinet at the time of the visit. There is a sufficient supply of emergency food and water. There will be no firearms/ammunition stored on the property. Facility has a generator for emergency purposes. The exterior passageways were clean and clear of any obstructions. There are two (2) self-latching gates for emergency use. The LPA observed the backyard, which has a covered outdoor area and appropriate furniture for outdoor use. The outside area was observed to be large enough to conduct outdoor activities. There are no bodies of water noted at the time of the visit. 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. No corrections needed at this time. Exit interview conducted. The report was reviewed, and a copy was provided.the state’s words, verbatim · CDSS document, Jun 5, 2025

Type of visit: Office

Facility Type: RCFE Application Type: Initial Capacity: 6 Census (if any clients in care): N/A COMP II Participants: licensee/administrator Analyn Cervantes Interview Method: Telephone interview On 5/20/2025, applicant/administrator participated in COMP II. Identification of the applicant and administrator was verified through interview questions based on photo ID and other identifying personal information. During COMP II, applicant and administrator confirmed that they have read and understand community care facility licensing laws included in the Health and Safety Codes and the California Code of Regulations Title 22. Signed LIC 809 with copy of photo ID have been obtained. During COMP II, CAB analyst confirmed Applicant/Administrator’s understanding of following areas: 1. Facility operation: License type, client/resident populations, and program 2. Admission Policies 3. Staffing requirements & Training 4. Restrictive/Prohibited Health Conditions 5. General provisions 6. Emergency Preparedness 7. Complaints & Reporting 8. Pre-licensing readinessthe state’s words, verbatim · CDSS document, May 20, 2025