Serene Richview

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Marisela Garcia-Centeno conducted an unannounced Required 1-Year Visit. LPA was greeted by, Caregiver, Jessie Chan to whom she identified herself. Currently there are no residents in care under this facility licensed as an RCFE. The licensee applied for Change of facility type to ARF, Licensed on July 24, 2025, facility # 374604916. There are no RCFE residents in care. This facility is ready for closure. During today's visit LPA Garcia-Centeno collected the RCFE license. LPA did not observed any violations during today's visit. An exit interview was conducted with Caregiver, Jessie Chan, to whom a copy of this report and the Licensee/Appeal Rights (LIC9058 03/22) were provided during the visit.the state’s words, verbatim · CDSS document, Jun 13, 2026

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Marisela Garcia-Centeno conducted an unannounced Required 1-Year Visit. LPA was greeted by, Jillian Chan daughter of Caregiver, Jessie Chan to whom she identified herself. LPA spoke with the Caregiver, Jessie Chan over the telephone and explained the reason for the visit. During the visit Chan arrived at the facility. Currently there are no residents in care. The residents in care (2) moved out on June 7, 2025 to another licensed facility, Ideal Home Care (374604611). LPA confirmed with Licensee, Josefina Hulsey that both residents were living at the facility. During today's visit, Caregiver Chan informed LPA that the Licensee, Jeffrey Chan would like to change the facility type to Adult Residential Facility. LPA explained that the application to change facility type would need to be processed by CAB. LPA explained that no clients that do not meet the current licensed criteria may be admitted to this facility until the facility is officially licensed as an Adult Residential Facility. LPA did not observed any violations during today's visit. An exit interview was conducted with Caregiver, Jessie Chan, to whom a copy of this report and the Licensee/Appeal Rights (LIC9058 03/22) were provided during the visit.the state’s words, verbatim · CDSS document, Jun 19, 2025

Type of visit: Case Management - Other

Licensing Program Analyst (LPA) Marisela Garcia-Centeno conducted a case management visit. LPA was greeted by, Caregiver, Jessie Chan to whom she identified herself and discussed the purpose of the visit. All staff present have a current criminal record clearance. During today's visit, LPA conducted case management with Staff Chan regarding the process for changing the license to a different facility type. LPA explained Title 22 regulations requiring that residents that do not meet the licensed criteria may not be admitted into the facility. No violations were observed during today’s visit. An exit interview was conducted with Caregiver, Jessie Chan, to whom a copy of this report and the Licensee/Appeal Rights (LIC9058 03/22) were provided during the visit.the state’s words, verbatim · CDSS document, Jun 19, 2025

Type of visit: Case Management - Other

Licensing Program Analyst (LPA) Marisela Garcia-Centeno conducted an unannounced Required 1-Year Visit. LPA was greeted by, Caregiver, Jessie Chan to whom she identified herself and discussed the purpose of the visit. All staff present have a current criminal record clearance. An annual inspection was not conducted during this visit because CCL conducted an annual inspection on March 18, 2024. No concerns or violations were cited during the inspection. During today's visit, LPA conducted case management to follow up regarding bathroom accommodations for one resident. No violations were observed during today’s visit. An exit interview was conducted with Caregiver, Jessie Chan, to whom a copy of this report and the Licensee/Appeal Rights (LIC9058 03/22) were provided during the visit.the state’s words, verbatim · CDSS document, Jun 7, 2024

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Marisela Garcia-Centeno conducted an unannounced Required 1-Year Visit. LPA was greeted by, Caregiver, Jessie Chan to whom she identified herself and discussed the purpose of the visit. All staff present have a current criminal record clearance. During the visit, LPA spoke with Administrator, Jeffrey Chan and explained the reason for the visit. According to the facility’s license, the facility has a maximum capacity of six (6) residents 60 and above of which may be non-ambulatory. During today’s inspection, there were a total of two (2) residents in care. The facility is approved for four (4) hospice waivers. LPA, accompanied by caregiver, Chan, toured the interior and exterior of the facility and inspected each room. The facility was clean, sanitary, and in good repair. Pathways were free of obstruction and slip hazards. Residents’ bedrooms contained the required furnishings. Doors, windows, screens, toilets, and showers were in working order. Extra linens and hygiene supplies were present, as well as Personal Protective Equipment. The facility had sufficient space and equipment to facilitate dining, laundry, visitation, meetings, and resident activities. There were at least 2 days of perishable food, and at least 7 days of non-perishable food present, all safely stored. Cooking/dining equipment and utensils were present. There were no sharp objects, toxic chemicals/poisons, or open-faced heaters accessible to clients. Medications were labeled, as required and stored in locked areas. The facility had a swimming pool, LPA observed fence height complied with Title 22 regulations, and both gates were locked. Per staff, no firearms or ammunition are kept at the facility. Smoke alarms, carbon monoxide detectors, emergency lighting, and facility telephone were all working. (Continue at LIC809) (continue from LIC809) Fire extinguisher(s) were serviced within the last 12 months. The first aid kit was available and accessible to staff. Required licensing postings were observed in visible areas of the facility. The room temperature in the facility was comfortable at 72 degrees. LPA interviewed staff and both residents. LPA reviewed multiple staff and both resident records/files. LPA interviews did not raise any licensing concerns. The files that LPA reviewed contained the required documents. Confidential records were stored in locked areas. During today’s visit, LPA observed via measurement with a thermometer device, that hot water temperature at taps accessible to residents complied with regulations. Water from the kitchen sink reached 120 F and the bathroom sink reached 115 F. No violations were observed during today's visit. An exit interview was conducted with Caregiver, Chan, to whom a copy of this report and the Licensee/Appeal Rights (LIC9058 03/22) were provided during the visit.the state’s words, verbatim · CDSS document, Mar 18, 2024