Serenity Seniors Home I

Type of visit: Case Management - Incident

On 04/29/26 Licensing Program Analyst (LPA) Villegas conducted a case management visit in response to Special Incident Report submitted to CCLD on 04/28/26 for allegation made on 04/27/26; regarding Resident #1 (R1). LPA met with DeAnthony Hardiman as the purpose of the visit was explained. During case management visit LPA Villegas conducted a Health & Safety visit which consisted of the following: tour of the physical plant and obtaining copies of the following records for R1: Emergency ID form, Admission agreement dated: 11/14/24, Physicians report dated 01/28/25, Needs and service Plan dated:04/03/25, and individualized restricted health care condition care plan dated: 12/25/25. LPA also obtained copies of the staff and Resident rosters. On 04/29/26 LPA conducted interview with S1-S4 regarding the allegation above. On 04/29/26 LPA attempted to conducted interview with R1, however LPA was unsuccessful due to communication barriers. On 04/29/26 LPA conducted telephone interview with witness #1-2 (W1-W2). Due to insufficient information available at this time, the above allegations need further follow-up. No immediate Health & Safety issues were observed. Exit interview conducted, and a copy of this report was provided.the state’s words, verbatim · CDSS document, Apr 29, 2026

Type of visit: Required - 1 Year

On 12/18/2025 at 11:03am , Licensing Program Analyst (LPA) Brown conducted an unannounced annual required visit using the CARE Inspection Tool. LPA met with DeAnthony Haridman (Administrator) as the purpose of the visit was explained. The facility is licensed to serve 9 non-ambulatory and 1 bedridden developmentally disabled residents age 60 and above. The facility may accept or retain 1 resident on hospice. The residents are South Central Los Angeles Regional Center residents. The facility has a current administrator certificate 6068494740 for DeAnthony Haridman valid from 03/29/2024 - 03/28/2026. The facility fees are paid in full (as of 12/16/2025- confirmation code 989812). The facility has liability insurance with James River Insurance Company (NAIC#12203) with each occurrence at $1,000,000 and general aggregate at $3,000,000 (policy #0067943-10) effective date 08/11/2025 - 08/11/2026. The facility is a single-story structure located in a residential neighborhood. The property consists of the following: 5 bedrooms, 6 bathrooms, family room/office, living room, kitchen, dining room, indoor and outdoor activity area, a detached garage that house emergency water and food supply, and has a laundry room inside. Between the hours 11:11am - 11:34am , LPA conducted a tour of the facility with DeAnthony Haridman. All resident rooms were checked. Mattresses and box springs were in good condition, adequate lighting was observed, plenty of dresser and closet space was observed. Walls and floors were clean and in good repair. Bed linens, comforters and bath towels were adequately stocked at the time of visit. Bathrooms were found to be within Title 22 regulation. Toilets and water faucets worked properly. Shower was free of mold/mildew, there is adequate lighting, and sufficient toiletries accessible to clients. The water temperature properly measured between 105-120°F ( Bathroom #1:115 °F, Bathroom #2: 117.6 °F, Bathroom 3: 119.3 °F, Bathroom 5: 119.5 °F and Kitchen 117.6 °F). Report continues on LIC 809-C Perishable and non-perishable food supply was checked and adequately stocked at time of visit. Carbon monoxide detector is dual with smoke detectors was observed and operational. Fire extinguishers were fully charged, toxins and knifes were locked and inaccessible to clients. Posted is emergency disaster plan. Last Emergency Drill (fire and earthquake) was conducted on 12/01/2025. Medications were centrally stored and properly locked, first aid kit was checked and fully stocked. Outside grounds were toured and no bodies of water were observed. Exits/ Walkways around the home were free of debris and hazards Between the hours of 11:49am - 12:15pm, LPA conducted a records review of (2) residents records, (4) staff records, (0) Personal & Incidental Records and reviewed the facility disaster plan. All client & staff records were complete. The facility disaster plan was current and in compliance with Title 22 at the time of visit. LPA reviewed (2) Client Medication Administrations Records and did not observed any discrepancies at the time of visit. No discrepancies were observed, exit interview conducted with DeAnthony Haridman (Administrator), and a copy of this report was provided.the state’s words, verbatim · CDSS document, Dec 18, 2025

Type of visit: Required - 1 Year

On 12/03/24, Licensing Program Analyst (LPA) Villegas conducted an unannounced annual required visit using the CARE Inspection Tool. LPA met with Licensee Maya Astier as the purpose of the visit was explained. Licensee was provided with upcoming fees info. Facility is licensed to serve 9 non-ambulatory and 1 bedridden developmentally disabled residents age 60 and above. Facility may accept or retain 1 resident on hospice. Residents are linked to the South Central Los Angeles Regional center. Facility has active liability Insurance with expiration date of 03/24/2025. The facility is a single-story structure located in a residential neighborhood. It consists of the following: 5 bedrooms, 6 bathrooms, family room/office, living room, kitchen, dining room, indoor and outdoor activity area, a detached garage that house emergency water and food supply, and has a laundry room inside. Bedrooms were checked, mattresses and box springs were in good condition, adequate lighting, plenty of dresser and closet space was observed. Bathroom toilets and water faucets worked properly, shower was free of mold/mildew, and there are sufficient toiletries accessible to clients. The water temperature properly measured between 105-120 F.. A supply of perishable and non-perishable food was observed, toxins and knifes were stored and inaccessible to clients, no weapons nor bodies of water on the premises, exits and walkways are free of debris/hazards. LPA conducted a records review of 2 staff records, 4 resident records, and 4 medication administration records, no discrepancies observed. Medications were centrally stored and properly locked, first aid kit was checked and fully stocked. The last fire was conducted on 10/01/24, fire extinguisher fully charged, carbon monoxide and smoke detectors are operational. No discrepancies were observed, exit interview conducted, and a copy of this report was provided.the state’s words, verbatim · CDSS document, Dec 3, 2024

Type of visit: Required - 1 Year

On 12/02/2023 at 12:15PM, Licensing Program Analyst (LPA) Regina Cloyd conducted an unannounced Required – Annual Inspection and met with Licensee Maya Astier. Five (5) residents and three (3) staff were present during this inspection. Facility is licensed to serve 9 non-ambulatory and 1 bedridden elderly residents age 60 and above. Facility may accept or retain 1 resident on hospice. The facility currently has five residents. The facility is a single-story structure located in a residential neighborhood. It consists of the following: 5 bedrooms, 6 bathrooms, family room/office, living room, kitchen, dining room, shaded area, indoor and outdoor activity area, laundry room and detached garage. Staff accompanied LPA inside and outside the facility during this inspection. Outside grounds were toured and no bodies of water were observed. Walkways around the home were clear of hazards. Resident bedrooms had the required furniture, bed linens and closet/drawer space to accommodate each resident comfortably. There are no security bars or weapons on the premises. Resident bathrooms were checked. Toilets and water faucets worked properly, grab bars were secure, shower was free of mold/mildew and a non-skid mat was in place, hot water temperature properly measured at 119F. Resident bath towels, toiletries and personal hygiene supplies were adequately stocked. Common areas were clean and clear of hazards, doorways were free of obstructions. Continue to LIC809-C LPA toured the kitchen area and observed a two-day supply of perishable and a seven-day supply of non-perishable food. Knives and toxics were kept in locked storage cabinet. First Aid kit was available. Fire extinguisher, last serviced July 23, 2023 was observed in the kitchen area. LPA tested all carbon monoxide detectors and smoke detector located in the facility. Both devices were functional. 5 staff records were reviewed, 5 out of 5 staff records had current first aid certificates and had required criminal record clearances or criminal record exemptions. Two staff interviews were conducted. 5 resident records were reviewed and, 5 out of 5 client records had, Medical Assessments. Two residents’ medications was reviewed. Two residents were interviewed. No deficiencies are being cited. An exit interview was conducted, and technical assistance provided. A copy of this report was discussed and left with Maya Astier.the state’s words, verbatim · CDSS document, Dec 2, 2023

The state marks this report as 3 pages; the online copy we transcribed has 2. You can request the full file from the county licensing office.