Solenza Home Care

Allegation investigated: Staff are mismanaging residents' medications. Facility staff are not treating residents with dignity and respect. Staff do not assist with transportation.

Licensing Program Analyst (LPA) Sabrina Calzada arrived unannounced to deliver investigative findings to a complaint received on October 22, 2025. LPA met with Administrator, Rahel Abebe, and stated the reason for the inspection. Also present was staff, Jannat Namale. LPA observed (1) resident present in the common area and (3) resting in their rooms. The Ombudsman arrived for an inspection at 3:20 pm. During the investigation, the Department (DSS/CCLD) interviewed the Administrator, (2) care staff, (1) hospital social worker, (2) responsible people for (R1), a friend of (R1). Additionally, (R1) was interviewed on 11/4/2025, resident (R2) who resided at the facility when (R1) did, and a family member of (R2) . Documentation was reviewed including, but not limited to, (R1’s) Admission agreement, Physician’s Report, care plan, Pre-appraisal, Centrally Stored Medication Records, and other records. The results of the investigation are as folllows: cont on 9099C-1.. Substantiated 9099C-1 (R1) moved to the care home in February 2025 with a primary diagnosis (per Physician's Report dated 1/30/2025) of CVA and Seizures, and a secondary diagnosis of GERD and pain and Mild Cognitive Impairment. (R1's) required assistance with bathing, toileting, medication administration, minimal assistance with dressing/grooming, and was not able to transfer to/from the bed. (R1's) care plan (5/15/2025) notes (R1) has a medical conditions of MCI, Major Neurocognitive Disorder (major NCD), Gl bleed, difficulty in speaking, gets confused a lot- asks if AM/PM; confusion/needs reminders to go to use toilet, practice PT exercises, tries to open door; loves reading, walking, laundry, folding/organizing clothes. Allegation: Staff are mismanaging residents' medications. The allegation states the facility told the responsible party that (R1) needed medication Trazadone refilled, but went she went to the facility, she saw there was a whole bottle there. The facility didn't start (R1)on the medication, due to not having clear instructions, until 6/21/2025. Additionally, on 9/18/2025, (R1) called the responsible person requesting more medication due to having (3) pills left; however, (R1) should have run out of medication a week before. On November 5, 2025, LPA Michael Hood conducted a medication count at the facility for residents (R1/R2) comparing residents' medication documents (Centrally Stored Medication Forms (CSMFs) and Medication Administration Records (MARs)) with medications that were centrally stored. LPA observed two (2) medications (Tamsulosin and Aspirin) for R1 to be under the amount documented and missing records for prior medication bottles when reviewing R1's CSMFs. Medication Trazadone was not reviewed during the medication count. LPA observed two (2) medications for R2 (Quetiapine and Potassium Chloride) to be over the amount documented and one (1) medication (Furosemide) to be under the amount documented. Both (S1) and (S2) stated the responsible person would drop off medications such as Tums, without a doctor's order, on file, and not tell staff. (R1) stated that they didn't know, or recognize, what medications they were taking while living at the care home, but felt were taking medications that didn't belong to them. (R1) stated that the care home ran out of Trazodone, but wasn't sure if they missed any medications. Based on information obtained, the allegation is found to be SUBSTANTIATED- A finding that the complaint is Substantiated means that the allegation is valid because the preponderance of the evidence standard has been met. *report continued on 9099C-2.. 9099A-C-1.. (S1) stated that when she called (R1's) family member, she was advised not to call 9-1-1 and that she would be right over to assist with picking (R1) up. (S1) stated that the family member helped (R1) get up off the floor with her help. (S1) stated (R1) got up her own when the family member arrived and did not sustain any injuries so was not sent to the Emergency Room. (R1's) family member stated she did not advise (S1) not to contact emergency services but did assist with picking (R1) up from the floor who sustained no injuries. This family member confirmed she was assisting (R1) with handling matters through on/around May 2025. Due to (R1) not sustaining any injuries, there was no needed medical intervention. LPA advised the facility they can contact a non-emergency ambulance provider that could assist with picking a resident up from the floor in the future. Based on information obtained, the allegation is found to be UNSUBSTANTIATED- A finding that the complaint is Unsubstantiated means that although the allegation may have happened or is valid, there is not a preponderance of the evidence to prove that the alleged violation occurred. Allegation: Facility staff are not observing the residents for changes in condition. The allegation states staff took a picture of residents’ food and sent it to to (S1) to show that resident wasn’t eating and wasting food. The allegation states (R1) has lost 30 lbs since moving in, but it wasn’t due to not eating. (R1) stated on 11/4/25 that they felt constipated and their feces was black when they resided at the care home but could not recall how long they felt constipated. (R1) stated that their bowel movements were black for several weeks, and the care home claimed it was from R1 eating candy and blamed their diet. The Administrator stated (R1) had "no problems with eating, didn't eat bell peppers but ate everything else". The Administrator confirmed (R1) lost weight, and started getting depressed when their family member separated from them and would only eat a little. The Administrator confirmed staff started giving smaller portions and (R1) "liked healthy food and we provided her healthy food", commenting (R1) wouldn't eat a lot. The administrator stated "It was my observation that I didn't think she needed to drink Ensure drinks"- she was doing well enough with the food she ate. *cont on 9099A-C-2.. 9099A-C-2... (R1's) had a diagnosis of a GI-bleed which can cause black stool. Charting notes reviewed show that staff were providing Activities of Daily Living (ADL's) to (R1). Based on information obtained, the allegation is found to be UNSUBSTANTIATED- A finding that the complaint is Unsubstantiated means that although the allegation may have happened or is valid, there is not a preponderance of the evidence to prove that the alleged violation occurred. Allegation: Staff threatened resident with eviction. The allegation states (R1) was threatened with eviction around October 2025. (R1) stated that they were threatened with an eviction around bedtime on October 3, 2025 but stated they never received a written eviction notice. (R1) stated that they moved to their new care home on October 9, 2025. The administrator confirmed that the rent for October 2025, was late and not received by October 4/5, 2025 when the notice was issued, but eviction was never threatened. The Administrator stated that on October 4, 2025, she issued (R1) a 30-day eviction notice and that's when the responsible person told her (R1) would be moving on/around October 11. NOTE: The facility was issued (2) citations on May 14, 2026 – (1) citation for not issuing the eviction notice for the correct reason and (1) citation for not including all the required information in the notice. Based on information obtained, the allegation is found to be UNSUBSTANTIATED- A finding that the complaint is Unsubstantiated means that although the allegation may have happened or is valid, there is not a preponderance of the evidence to prove that the alleged violation occurred. *report continued on 9099A-C-3.. 9099A-C-3 Allegation: Facility staff are not following their admission agreement. The allegation states that on July 27, 2025 (R1) was pooping black poop again and (S1) told RP that they needed to call 911. When the ambulance arrived, the facility called the resident’s family member to find out if they needed to go to the hospital, but the family member doesn’t have POA anymore. The Administrator stated she told the responsible person that the facility would be calling 9-1-1 to send (R1) to the emergency room due to possible internal bleeding, based on their diagnosis. The administrator told the family member (prior responsible person) that (R1) would be going to the emergency room and stated she contacted this family member as a courtesy and acknowledged she was not required to. LPA observed a text message sent on July 27, 2025, from the Administrator to the current responsible person at that time to state that the facility "has to call 9-1-1" due to a change in stool. The responsible person stated they were out of town and would not be back until Wednesday, and the assigned social workers atthe hospital would take over. The facility acted promptly and notified both the past and current responsible persons. Based on information obtained, the allegation is found to be UNSUBSTANTIATED- A finding that the complaint is Unsubstantiated means that although the allegation may have happened or is valid, there is not a preponderance of the evidence to prove that the alleged violation occurred. Allegation: Facility staff are not providing assistance with incontinence care. The allegation states staff was not providing incontinent assistance. (R1) stated that they had to use the bathroom and never had any incontinence accidents. (R1) stated that they were not provided any other incontinence resources but wanted to use the diapers. The administrator stated "(R1) does change themself- they can put the diaper on on their own" and added, "my caregiver noticed that (R1) was using a lot of toilet paper and would finish three rolls in a week", commenting (R1) would just roll the toilet paper around their hands and waste it- and would just throw it in the trash". LPA viewed a photo taken of what appeared to be small bunches of toilet paper in a basket. *cont on 9099A-C-4.. 9099A-C4.. (S2) stated (R1) was able to use the toilet independently and their care plan (5/15/2025) states (R1) needs “consistent reminders to use the bathroom every 30 minutes, not waste diaper, clean properly and stay on the toilet for at least a few minutes not to rush”. Two (2) family members of other residents indicated that the facility always provides care as needed, including incontinent care. (R2) stated staff will "always assist" when requested or needed. Based on information obtained, the allegation is found to be UNSUBSTANTIATED- A finding that the complaint is Unsubstantiated means that although the allegation may have happened or is valid, there is not a preponderance of the evidence to prove that the alleged violation occurred. Allegation: Staff are not ensuring the facility is clean and in good repair. The allegation states that (R1) resident had termites on their bed and curtains, which were sprayed, but the staff didn’t clean up the dead bugs and they were still there when moving out on 10/9/2025. (R1) stated that their room had termites and they used their call button regarding the termite, buty staff told them there was nothing that could be done in that moment. (R1) stated that pest control came to the care home the next day and sprayed their room once. R1 stated that there were dead termites in the room after the treatment, no one came to their room to clean them up. R1 stated that, other than the termites, the care home was pretty clean. The administrator stated that was a type of bug in (R1's) room and called a pest control company to come out. The pest control company sprayed and stated the bug was not a termite. There were no bugs anywhere else in the facility. (R2) saw a pest control truck visit once while (R1) lived here. (2) different LPA's visited the facility, and the home was observed to be clean on 11/5/25, 5/14/26, 6/302026 and on July 24, 2026. Two (2) family members of other residents stated the home is always clean and in good repair. Based on information obtained, the allegation is found to be UNSUBSTANTIATED- A finding that the complaint is Unsubstantiated means that although the allegation may have happened or is valid, there is not a preponderance of the evidence to prove that the alleged violation occurred. *continued on 9099A-C-5.. 9099A-C-5.. Allegation: Facility staff are not ensuring that residents are free from punishment, humiliation, or intimidation. The allegation states that another resident (R2) pooped on the toilet and the floor but staff asked (R1) to clean it up. (R1) stated that there was an incident regarding staff forcing them to clean a bathroom, in which they cleaned up resident (R2's) poop off the floor. (R1) stated that (R2) hadn't had a bowel movement in four (4) days, but (R2) told staff it belonged to them after (R1) cleaned it up. Staff (S2) explained residents were at dinner and she told (R1) to "call for help" if needed in the bathroom, specifically. After dinner, (S1) stated (R1) had diarrhea and was "trying to clean up the floor and toilet seat before staff saw". (S1) provided LPA with a photo of dark, loose fecal matter on the floor that (R1) was trying to clean up. A family member of (R2) stated that (R2) is "mostly independent but sometimes needs help with BM" and she has heard staff tell (R2) to wait a minute while she was assisting another resident in the bathroom. The administrator stated that (S2) would never ask (R1) or any resident to clean up anyone's fecal matter, including their own. Staff is always cleaning up after a resident uses the bathroom and (R2) "uses the bathroom properly and never made a mess on the toilet- and never on the floor". Based on information obtained, the allegation is found to be UNSUBSTANTIATED- A finding that the complaint is Unsubstantiated means that although the allegation may have happened or is valid, there is not a preponderance of the evidence to prove that the alleged violation occurred. Exit interview. Copy of report provided. 9099C-2.. Allegation: Facility staff are not treating residents with dignity and respect. The allegation states staff (S2) walks around the facility with headphones on and ignores the residents. Resident (R1) stated they have used their call button and (S1) walked right past their door with the door open and didn't look into their room. R1 stated that they could have been in the room on the floor with a broken leg and wouldn't have received a response from staff. R1 stated that staff never responded to their call button. The Administrator stated was allowed to wear head phones after care was provided and they were doing household tasks. (S2) confirmed she wore headphones while working at the facility and it did not interfere with care provided to the residents. (S2), commented, "Most of the time, all residents were on a schedule- they would have their breakfast and then (R1) would read/write letters and (R1) would watch tv- during that space, I would wear headphones." (R1) stated that they wrote a card regarding wanting to self-harm while residing at the care home. R1 stated that they wrote the card due to being depressed. The Administrator stated she contacted the Ombudsman for assistance in talking with (R1). LPA obtained records from the Ombudsman's office confirming the Administrator reached out in July, 2025 and August 2025, requesting assistance, and the Ombudsman visited (R1) at that time. The notes indicate the Ombudsman's office was also contacted in June, 2025, July 2025, August 2025 and October 2025, when a friend/s contacted them due to (R1's) financial situation, cognitive decline and wanting to disassociate from (R1). The Department was provided with a copy of a recording where (R1) was stating an outside health care group had their monthly check for the facility, and (S1) stated that was incorrect information but instead said,"don't lie". (R1) stated they were "not lying" in response. Based on the recording provided to the Department, the allegation is found to be SUBSTANTIATED- A finding that the complaint is Substantiated means that the allegation is valid because the preponderance of the evidence standard has been met. *Report continued on 9099C-3 9099C-3.. Allegation: Staff do not assist with transportation. The allegation states that resident (R1) was taken to the hospital on July 27, 2026 and upon discharge on July 29, 2026, the facility told (R1) to call the social worker because (R1) was having to wait for transport. (R1) stated that the care home didn't provide them with transportation and that they would ask for a ride to their appointments as they couldn't go alone. (R1) stated that they missed (3) urology appointments because they couldn't get a ride. (R1) stated that their friend would take them to appointments, and their appointments were in a different city. The Administrator stated "I do not provide transportation, but I do arrange non-medical transportation" and provided the name of an outside company. The administrator commented, "For (R1), I never arranged transportation ever- nobody asked me" and confirmed she contacted (R1’s) social worker in the past to arrange transportation. LPA discussed text message conversation between the Administrator and (R1) regarding transportation from the hospital to the facility on July 29, 2025, where (R1) was told to contact her social worker. The Administrator stated that the social worker arranges transportation. The Administrator stated that (R1's) responsible person provided them with a 1-800# to contact for a free ride service; however, when the facility called, the transportation company did not recognize the phone number because the responsible person entered their contact information on the account. The administrator stated that the responsible person was not always able to reached promptly. LPA was provided with documentation written from the responsible person on/around June 2025, stating they would not be able to assist with (R1's) medical or financial needs but would continue to visit as a friend. A copy of this letter was provided to the Ombudsman's office and to (R1's) medical group. LPA spoke to the social worker stated, "the facility was not available to provide transportation or didn't want to", and confirmed she has been following (Ra) as their social worker since May 2025, and "there were multiple appointments missed and the facility advertised it provided transportation on their website which says in part, they will provide transportation and doctor appointment support, coordinate door-to door non-emergency transpiration services in partnership with other providers, ensuring residents arrive safely and punctually to medical appointments. LPA was provided with a text message dated July 29, 2025, (6:00 pm) where (R1) asks about receiving transportation and to "contact your social worker". Based on the recording provided to the Department, the allegation is found to be SUBSTANTIATED- A finding that the complaint is Substantiated means that the allegation is valid because the preponderance of the evidence standard has been met. Exit interview. Copy of report and appeal rights provided.the state’s words, verbatim · CDSS document, Jul 24, 2026 · control 59-AS-20251022093008

From the deficiency page — Deficiency type: Type A · Section cited: CCR 87465(a)(4) · Plan of correction due date: Aug 27, 2026

87465 Incidental Medical and Dental Care (a) A plan for incidental medical and dental care shall be developed by each facility. The plan shall encourage routine medical and dental care and provide for assistance in obtaining such care, by compliance with the following: This requirement is not met as evidenced by: Based on record review on 11/5/2025, the facility did not ensure that medications were given to (R1) and (R2) so as to match the medication count conducted, which poses an immediate health and safety risk to residents in care.the state’s words, verbatim · CDSS document, Jul 24, 2026

Plan of correction: Licensee/Administrator agrees to conduct staff training on following proper medication protocols (7 Rights) so the count is always 100% accurate. Documentation of staff training to be completed by August 10, 2026.

From the deficiency page — Deficiency type: Type B · Section cited: CCR 87468.1(a)(1) · Plan of correction due date: Aug 10, 2026

87468.1 Personal Rights of Residents in All Facilities (a) Residents in all residential care facilities for the elderly shall have all of the following personal rights: (1) To be accorded dignity in their personal relationships with staff, residents, and other persons. This requirement is not met as evidenced by: Based on interviews conducted and a video recording, (S1) did not treat (R1) with respect by telling them "don't lie" when they were stating something inaccurate, which posed a potential health and safety check to residents in care.the state’s words, verbatim · CDSS document, Jul 24, 2026

Plan of correction: Licensee/Administrator agrees to conduct staff training on personal rights- review Reg 87468, 87468.1 and 87468.2 Documentation of staff training to be completed by August 10, 2026.

From the deficiency page — Deficiency type: Type B · Section cited: CCR 87465(a)(2) · Plan of correction due date: Aug 10, 2026

(a) A plan for incidental medical and dental care shall be developed by each facility. The plan shall encourage routine medical and dental care and provide for assistance in obtaining such care, by compliance with the following: (2) The licensee shall provide assistance in meeting necessary medical and dental needs. This includes transportation which may be limited to the nearest available medical or dental facility which will meet the resident's need. In providing transportation the licensee shall do so directly or make arrangements for this service. Based on interviews conducted and documentation reviewed, the Licensee did not ensure that transportatation was provided to (R1) on July 29, 2025, and at other times for a medical appointment, which poses a potential health and safety risk to residents in care.the state’s words, verbatim · CDSS document, Jul 24, 2026

Plan of correction: Licensee/Administrator agrees read Reg 87465 and submit a signed statement of understanding. Administrator already updated the facilty flyer to clariy that transporation to appointments is provided at an additional charge. The facility website will be updated by 8/10/2026.

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Sabrina Calzada arrived unannounced to conduct a required annual inspection and met with staff, Jannatt Namale, stating the reason for today's inspection. LPA spoke to the Administrator by phone who had a scheduled appointment and was not able to be present. LPA observed (1) resident walking in the common area and was advised (3) residents were resting in their rooms. There are currently (4) residents. The facility is licensed for (5) non-ambulatory residents, (1) bedridden resident and has a hospice waiver for (3) residents. Currently, no residents are under hospice care. LPA and the lead caregiver toured the interior/exterior of the facility including the common areas, (3) private resident bedrooms, (2) shared resident bedrooms, (2) resident bathrooms, staff room, kitchen, and laundry area. LPA observed the facility to be clean, in good repair and without any odors. All bathrooms have the necessary grab bars, non-skid flooring, and hygiene supplies. There is sufficient 2+ day perishable, including fresh produce, and 7+day non-perishable supply of food. Sharps and medications are locked in the kitchen and toxins are locked in the laundry room. Hot water measured 114*F in the kitchen. Inside temperature measured 78*F. Fire extinguishers were last serviced on 8/12/25, and smoke/monoxide alarms are functioning. All exits have an auditory alert when opened. There are sufficient linens, towels, blankets, paper/PPE products and games/activities. There are (2) unlocked exit gates, shaded seating and no pools/fountains. LPA reviewed (4) staff and (2) resident files. Files were organized and contained current documents. Staff has completed initial training and will complete continuing training by 8/31/26. First Aid/CPR certifications are current and there is a complete First Aid kit. RCFE Administrator certificate #7030662740 (exp 6/4/27). Required posting are visible in the common area. Requested current copy of insurance by 7/7/26. There are no citations issued in this report. Exit interview. Copy of report printed.the state’s words, verbatim · CDSS document, Jun 30, 2026

Type of visit: Case Management - Deficiencies

Licensing Program Analyst (LPA) Michael Hood arrived at the care home and met with Licensee, Rahel Abebe, to conduct a case management visit to follow-up regarding documentation obtain during a separate inspection conducted on November 5, 2025. LPA reviewed an email authored by Licensee, addressed to resident (R1), and emailed to resident (R1's) responsible party, R1's Mastercare representative, and the Local Long-Term Care Ombudsman, that state's the following: "This letter serves as formal written notice that you will be evicted from Solenza Home Care effectively immediately. Pursuant to Title 22, Section 87224 of the California Code of Regulations. The reason for this eviction is: Non-payment of fees for services rendered, in violation of the signed admission agreement. Payment is due the 3rd of each month, if not additional $150 need be added each day for the payment." Interview with Licensee indicated that non-payment in notice referred to the month of October, 2025. LPA observed notice did not have information required to be included in eviction notices for residents residing in Residential Care Facilities for the Elderly per Health and Safety Code §1569.683, including resources available to assist in identifying alternative housing and care options, including public and private referral services and case management organizations, addresses of the nearest office of community care licensing and the State Ombudsman for the right to file a complaint with the department, and the following statement: "In order to evict a resident who remains in the facility after the effective date of the eviction, the residential care facility for the elderly must file an unlawful detainer action in superior court and receive a written judgment signed by a judge. If the facility pursues the unlawful detainer action, you must be served with a summons and complaint. You have the right to contest the eviction in writing and through a hearing." ** Report continued on 809-C ** As a result of today's inspection, deficiencies are being cited pursuant to California Code of Regulations, Title 22, Division 6, Chapter 8 and the Health and Safety Code. Deficiencies are listed on 809-D. Exit interview was conducted. A copy of this report and appeal rights were provided. Signature on these forms acknowledges receipt of these documents.the state’s words, verbatim · CDSS document, May 14, 2026

From the deficiency page — Deficiency type: Type B · Section cited: CCR 87224(a) · Plan of correction due date: May 27, 2026

87224 Eviction Procedures (a) The licensee may evict a resident for one or more of the reasons listed in Section 87224(a)(1) through (5). Thirty (30) days written notice to the resident is required except as otherwise specified in paragraph (5) (1) Nonpayment of the rate for basic services within ten days of the due date. This requirement is not met as evidenced by: Based on interviews conducted and records reviewed, the facility did not ensure that eviction notice issued to R1 complied with the reasons for eviction listed in Title 22, which poses a potential health, safety, and/or personal rights risk to the residents in care.the state’s words, verbatim · CDSS document, May 14, 2026

Plan of correction: Facility will ensure that all future eviction notices comply with the reasons for eviction listed in Title 22. Facility will complete a statement of understanding regarding regulation 87224 and submit statement to LPA by POC due date of May 27, 2026.

From the deficiency page — Deficiency type: Type B · Section cited: HSC1569.683 · Plan of correction due date: May 27, 2026

§1569.683 Eviction notices; reasons for eviction contents; service (a) In addition to complying with other applicable regulations, a licensee of a residential care facility for the elderly who sends a notice of eviction to a resident shall set forth in the notice to quit the reasons relied upon for the eviction, with specific facts to permit determination of the date, place, witnesses, and circumstances concerning those reasons. In addition, the notice to quit shall include all of the following: (...) This requirement is not met as evidenced by: Based on records reviewed, the facility did not ensure that eviction notice issued to R1 complied with the Health and Safety Code, which poses a potential health, safety, and/or personal rights risk to the residents in care.the state’s words, verbatim · CDSS document, May 14, 2026

Plan of correction: Facility will ensure that all future eviction notices comply with the Health and Safety Code. Facility will complete a statement of understanding regarding regulation 1569.683 and submit statement to LPA by POC due date of May 27, 2026.

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) K. Hiratsuka, conducted this unannounced post licensing visit. LPA toured the facility with Staff Member Jordayne Salmon. Administrator Rahel Abebe, arrived and completed visit with LPA. LPA inspected the resident rooms, bathrooms, common areas, kitchen, and dining room. LPA observed the backyard. The food supply was inspected. The medication records were reviewed. LPA verified staff have first aid and CPR cards. The following was observed during today's visit: -medications are prepared for one resident for two days and the second resident for once a week. Per the regulations all medications shall be kept in their original containers. -no infection control plan in the facility and no staff training for infection control for this facility. -staff training was all done at a previous facility. Per the regulations staff training has to be facility specific. -no emergency drills -full bed rails on a bed and the resident is not on hospice. Per regulations hospice is the only time full bed rails are allowed. -residents who cannot determine their need for PRN (as-needed) medications do not have documentation from a doctor that states they cannot -no plan for emergencies and being self-reliant for 72 hours. And no staff training. -Licensee does have a training log for a staff person but it has twelve subjects at two hours each and was completed on the same day. Deficiencies cited from the California Code of Regulations, Title 22, Division 6 of California Regulation and California Health and Safety Code. Failure to correct the deficiency and/or repeat deficiencies within a 12 month period may result in civil penalties. Appeal rights were provided.the state’s words, verbatim · CDSS document, Aug 6, 2025

Type of visit: Post Licensing

Licensing Program Analyst (LPA) K. Hiratsuka, conducted this unannounced post licensing visit. LPA toured the facility with Staff Member Getahun Tamerat. LPA inspected the resident rooms, bathrooms, common areas, kitchen, and dining room. LPA observed the backyard. The food supply was inspected. The medication records were reviewed. LPA verified staff have first aid and CPR cards. Due to a computer issue, LPA is going to return at a later date to complete the visit. No deficiencies cited during today's visit.the state’s words, verbatim · CDSS document, Apr 2, 2025

Type of visit: Case Management - Other

On December 26, 2024, Licensing Program Analyst (LPA) Cassie Yang arrived at the facility to conduct a case management visit to complete COMP III. LPA met with Administrator and explained the purpose of the visit. As requested, Comp III was conducted with Administrator. LPA provided Administrator a copy of LIC 311F and CCR 87632 Hospice Waiver. Interview interview, a copy of report was provided.the state’s words, verbatim · CDSS document, Dec 26, 2024

Type of visit: Case Management - Other

Licensing Program Analyst (LPA) Cassie Yang arrived at the facility to conduct a case management visit to complete COMP III. LPA met with Licensee, Rahel Abebe, and explained the purpose of the visit. Comp III was conducted. LPA and Licensee discussed that facility is pending construction for a change of ambulatory status. LPA will be notified once construction has been completed, new LIC 200 and facility sketch will be provided to LPA for a new ambulatory status request. Interview interview, a copy of report will be emailed to Licensee.the state’s words, verbatim · CDSS document, Sep 10, 2024

Type of visit: Prelicensing

On 8/2/2024, Licensing Program Analyst (LPA) Cassie Yang arrived at the facility to conduct a pre-licensing inspection. This is a joint visit with Sacramento Metro Fire. LPA met with Applicant, Rahel Abebe, and explained the purpose of the visit. During today's visit, fire clearance for 6 non-ambulatory residents was denied. Sacramento Metro discussed facility needing a second hardwired smoke alarm in the living room. Additionally, Sacramento Metro discussed with Applicant regarding the needed construction for the non-ambulatory clearance. At this time, Applicant informed LPA that they wished to hold on licensure until construction is complete and non-ambulatory cleared. LPA informed Applicant to submit a new LIC 200, facility sketch to LPA and/or CAB analyst once ready for new inspection. Exit interview conducted and a copy provided.the state’s words, verbatim · CDSS document, Aug 2, 2024

Type of visit: Prelicensing

Licensing Program Analyst (LPA) Cassie Yang arrived announced at the facility to conduct a pre-licensing inspection utilizing the inspection tool. LPA met with applicant, Rahel Abebe, and explained the purpose of the visit. During today's inspection, LPA observed chemicals were left in the laundry area with no locked access. LPA and Applicant addressed that all chemicals are to be stored and locked. Applicant stated chemicals will be moved to the garage in a lock cabinet. LPA and Applicant continued tour in the kitchen and observed knives to be in the cabinet with no locks. LPA informed Applicant all sharps are to be locked and inaccessible to residents in care. LPA inspected five bedrooms total, four will be used as residents room and one will be staff room. LPA observed two bedrooms to be complete furnished. LPA observed the common areas to have couches. LPA informed Applicant that facility should have activities available for resident to accessible. LPA provided Applicant a copy of PUB 475 and informed Applicant it needs to be 20"x26" and posted in the common areas. LPA and Applicant discussed facility LIC 200 to be for six ambulatory. Applicant stated she has completed the required criteria from Sac Metro Fire for non-ambulatory clearance. Applicant stated she will submit a new LIC 200 for non-ambulatory status. During today's visit, LPA provided Applicant a copy of 22 CCR 87211, HSC 1569.605, HSC 1659.625, LIC 200, LIC 311F, LIC 603, LIC 603A, LIC 625, LIC 601, LIC 602, LIC 604A, LIC 613C, LIC 621, LIC 622, LIC 624, LIC 9020 and LIC 9060. Comp III has not been completed as today's inspection is not approved for licensure. Applicant will make corrections. Additionally, Applicant will resubmit LIC 200 and facility sketch to the Department. Exit interview and a copy provided.the state’s words, verbatim · CDSS document, Jul 3, 2024

Type of visit: Office

COMP II by CAB successfully completed Facility Type: RCFE Application Type: Initial Capacity: 6 Census (if any clients in care): 0 Method: Telephone call with CAB COMP II Participants: Rahel Abebe, Administrator/Owner; Shannon Betker, analyst. Applicant/administrator participated in COMP II at CAB via telephone call with analyst at CAB. Identification of the applicant and administrator was verified by confirming driver’s license number. During COMP II, applicant and administrator confirmed the understanding of Title 22. Component II was successfully completed. Applicant and administrator were advised to email/fax signed LIC 809 with copy of photo ID to CAB. 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 21, 2024