Sonas Home

Allegation investigated: Staff inappropriately obtained confidential information regarding resident Staff inappropriately made resident's POA pay for groceries Staff are no ensuring resident gets exercise

On February 5, 2026, Licensing Program Analyst (LPA) Murial Han conducted a visit to deliver the complaint investigation findings. LPA met with administrator, Evelyn Ryan and caregiver, Daisy Tubbs and LPA explained the purpose of today's visit. Regarding allegation of staff inappropriately obtained confidential information regarding, the reporting party stated that the licensee went to R1’s skilled nursing facility and spoke to the nurse and had the nurse provide information pertaining to R1 without the responsible party's permission. As part of the investigation, LPA interviewed the R1’s responsible party and the administrator/licensee. According to R1’s responsible party, the administrator visited R1 at the skilled nursing facility on 11/29/2025 without their consent. The responsible party stated that prior to the visit, the licensee had already issued a 30-day eviction notice, therefore, the administrator was not authorized to visit R1 as the administrator/ licensee was no longer part of R1’s care team. Unsubstantiated LPA interviewed the administrator/licensee who acknowledged that she did not obtain prior permission from R1’s responsible party to conduct an assessment of R1 at the Skilled Nursing Facility. However, the administrator/licensee stated the date of the visit was still within 30-day of the eviction notice. In addition, the administrator/licensee stated that she had provided proper introduction to the skilled nursing facility staff after she entered the facility, and she was provided with a name badge for the visit. Furthermore, She was given information by one of the Registered Nurses regarding R1’s care and she was allowed to physically assessed R1 in the room. After the investigation, this allegation is deemed to be unsubstantiated as the date of the visit was still within the 30-day eviction notice and R1’s responsible party did not express to waive the 30-day eviction process. Therefore, based on R1’s admission agreement, R1 was still under the care of the facility. Regarding the allegation of- Staff inappropriately made resident’s POA pay for groceries, the reporting party stated that R1 had a protein deficiency, so the doctor ordered more meat for R1. The reporting party stated that the facility staff brought more meat for R1 with their own money and asked R1’s responsible party for reimbursement. As part of the investigation, LPA interviewed staff (S1) and the administrator/licensee. LPA interviewed the administrator/licensee who denied the allegation and stated that the facility provided balanced meals for every resident but R1’s responsible party requested additional specific proteins such as organic yogurt, organic protein items and agreed to pay for it with R1’s income. However, R1’s income was delayed at the time, so the responsible party agreed to pay for it first. According to S1, the facility was offering balanced meals to R1 as they followed a menus for breakfast, lunch and dinner but R1’s responsible party requested additional protein items such as yogurt, bacon, fish, etc and the responsible party consented to use R1’s money income to pay for it but R1’s income was delayed so R1’s responsible party agreed to pay for it first and reimburse the money back to S1. Based on the written communication between the responsible party to the administrator/licensee, it indicated that the responsible party asked S1 to purchase additional proteins for R1 and agreed to pay S1 back with R1’s month income but the monthly income was delayed so the responsible party agreed to reimburse S1 first. After the investigation, this allegation was deemed to be unsubstantiated. Regarding the allegation of staff are not ensuring resident gets exercise, the reporting party stated that staff was not exercising R1 by taking R1 on walks. As part of the investigation, LPA interviewed the administrator/licensee, and S1. The administrator and S1 denied the allegation and both of them reported that R1 was walked outside when the weather permitted and around the house or in the backyard when the weather was bad. In addition, they stated that R1 was walked by therapists from the home health agency. Based on the written communication from R1’s responsible party and the administrator/licensee dated May 20, 2025, it indicated that the responsible party was extremely pleased with R1’s placement and facility staff have been exceptionally helpful and welcoming of R1. Based on R1’s annual face – to – face care team meeting reviewing R1’s overall stay at the facility, it indicated that R1 loved to go on walks with a staff. After the investigation, this allegation is deemed to be unsubstantiated. Although the above allegations may have happened or are valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur, therefore the allegation is UNSUBSTANTIATED. This report is reviewed and discussed with the administrator and the caregiver. A copy is provided.the state’s words, verbatim · CDSS document, Feb 5, 2026 · control 14-AS-20251208115014

Allegation investigated: Staff did not ensure client was allowed to be readmitted to the facility upon hospital discharge Staff did not properly communicate with clients responsible part

On February 5, 2026, Licensing Program Analyst (LPA) Murial Han conducted a visit to deliver the complaint investigation findings. LPA met with administrator, Evelyn Ryan and LPA explained the purpose of today's visit. Regarding allegation of – staff did not ensure client was allowed to be readmitted to the facility upon hospital discharge, the reporting party stated that resident #1 (R1) had a change in health condition resulting in hospitalization. R1 recovered well at the hospital, and according to R1's physician, R1 was ready to be discharged back to Sonas Home but Sonas Home stated that they required additional support in order to readmit R1 and it was arranged by the Golden Gate Regional Center (GGRC). However, Sonas Home declined to take R1 back and on 11/21/2025, Sonas Home officially informed GGRC that they could not take R1 back. As part of the investigation, LPA interviewed the licensee, staff, GGRC representative, Hospital Discharge Planner, R1’s responsible party and reviewed hospital records. Substantiated According to the administrator/licensee, prior to R1’s hospitalization, R1 was already requiring a higher level of care that the facility was able to provide. She stated that R1 was high risk for fall, R1 had many sessions of physical therapy and many doctor’s appointments. She stated that since R1’s hospitalization, she has visited R1 and R1 presented with medical conditions that required a higher level of care such as high risk for fall, difficulty with swallowing, and a foley catheter. In addition, the licensee stated she has visited R1 at the skilled nursing facility where she observed R1 of having a one – to – one caregiver and needed a lot more assistance than Sonas Home can provide. According to R1’s responsible party, initially the licensee stated that R1 cannot return to the facility unless R1 had a night sitter because she felt R1 was at risk for fall and R1 needed a higher level of care so the responsible party spoke with Golden Gate Regional Center and a night sitter was granted. Then, the licensee stated that the sitter needed to be trained so they can care for R1. The responsible party stated that the licensee was making excuses not to take R1 back despite R1 being back to his/her baseline upon discharge from the hospital. In addition, the responsible party stated that R1’s discharge documentation from the doctor indicated that R1 can return to the board and care home with increased caregiver support. According to the GGRC Representative, GGRC was in support of R1 returning to the facility as it was recommended by R1’s hospital discharge planner and hospital physician. GGRC has arranged for additional staffing support upon R1’s return. In addition. The licensee was informed that they would work with the facility either to provide additional staffing support to care for R1 or assist with discharge planning in a proper process. According to the hospital discharge planner, R1 required some assistance with Activities of Daily Living (ADLs) but R1 did not get up unattended at night. The discharge planner stated that the discharge plan was for R1 to return to the board and care, but the administrator did not want to take R1 back due to lack of staff at night. Subsequently, additional night staff were provided but the administrator continued not willing to take R1 back. Therefore, R1 was discharged to a skilled nursing facility despite R1 being back to baseline upon discharge. According to former staff #1 (S1) and current staff #2 (S2), R1 was able to walk with a walker with some supervision and R1 required some assistance with toileting and showering. They stated that R1 was not difficult to care for and R1 was very calm and pleasant. Based on the hospital discharge note by the physician, it indicated that once the board and care and or family arranged for increased caregiver support then R1 will return there. Based on hospital physical therapy treatment note dated 11/19/2025, R1 was making great progress, and the recommendation was returned to board and care facility with assistance from home health physical therapy. Based on GGRC annual and quarterly reviews, it indicated that the licensee and staff verbalized that R1 was easy to care for, and R1 was a sweet person. In addition, it indicated that additional help was offered to the licensee for caring for R1 but it was declined by the licensee. The documentation did not indicate that R1’s care was increasing and required additional support. After the investigation, this allegation is deemed to be substantiated as the hospital records/physician's note, the physical therapy and the physician indicated that R1 has made great progress, and they recommended R1 to return to board and care with additional staffing. GGRC was in support of R1 returning home and arranged for additional support, but the licensee continued not willing to take R1 back resulted in R1 transferring to a skilled nursing facility. Furthermore, the Facility Program stated that Sonas Home’s goal is to provide 24 hours / 7 days assistance and care with ADLs ( bathing, dressing, grooming, feeding) , however, they refused to take R1 back who required the level of care that was described in the Facility Program as per the physical therapist note dated on 11/21/25 (the day prior to R1’s discharge) that R1 was ambulating in to chair/bathroom in hallway with minimum assist with a Front Wheel Walker (FWW), safety maintained. Regarding the allegation of- staff did not properly communicate with client’s responsible party, the reporting party stated that the facility administrator/licensee informed GGRC that R1 had always been beyond their level of care. However, this concern had never been communicated to the GGRC representative and the responsible party during any of R1’s annual or quarterly meetings, nor via email or phone. As part of the investigation LPA interviewed the administrator/licensee, R1’s responsible party, GGRC representative, and reviewed documents. According to the responsible party, during R1’s stay at the facility, he/she visited R1 often and he/she was never informed that R1 was difficult to care for and R1 was above the care level that the facility was approved of by Golden Gate Regional Center (GGRC). According to GGRC representative, the administrator/licensee and staff members have not expressed that R1 required a higher level of care during the quarterly and annual face-to-face meetings. The GGRC representative stated that during the annual meeting, the licensee and the facility staff stated that R1 was very easy to care for. According to the Golden Gate Regional Center Person Center (GGRC) Individual Program Plan dated 12/9/2025 and the subsequent quarterly reviews dated 2/5/2025, 5/30/2025 and 9/9/2025, they did not indicate that R1 required a higher level of care. In fact, the quarterly review dated 5/30/2025 indicated that the facility was offered additional funding to care for R1 and it was declined by the administrator/licensee and she stated that “R1 was easy to work with”. The documentation also indicated that this funding was offered in the past and it was refused as well. According to the semi-annual meeting notes provided by the administrator/licensee, it did not indicate that R1 required a higher level of care and the facility was not able to care of R1. After the investigation, this allegation is substantiated. Based on interviews and record reviews during the investigation, the preponderance of evidence standard has been met. Therefore, these allegations were determined to be substantiated. Deficiencies of the California Code of Regulations, Title, 22 cited on the LIC9099-D. Failure to correct the deficiencies may result in civil penalties. Report was discussed with Administrator and caregiver. A copy of the report and Appeal Rights were provided. The administrator/licensee denied the allegation and stated that she has had great communication with R1’s responsible party from the date of R1’s admission. She stated that a lot of their communication was via text messages, and they even talked about personal topics that were not related to R1. The administrator stated that R1 required a higher level of care resulting in R1 not returning to the facility and it did not have anything to do with personal relationship. Based on documents provided, LPA observed communication between R1’s responsible party and the administrator/licensee and there was no proof that R1 was abandoned due to personal relationship between the administrator/licensee and the responsible party. After the investigating, this allegation is deemed to be unsubstantiated. Although the above allegations may have happened or are valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur, therefore the allegation is UNSUBSTANTIATED. This report is reviewed and discussed with the administrator and the caregiver. A copy is provided.the state’s words, verbatim · CDSS document, Feb 5, 2026 · control 14-AS-20251201104417

From the deficiency page — Deficiency type: Type A · Section cited: CCR 87224(a) · Plan of correction due date: Feb 6, 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)...This requirement is not met as evidenced by based on interviews and record reviews, R1 was hospitalized due to a change in health condition and the administrator/licensee refused to take R1 back to the facility despite additional staffing support was arranged by GGRC, hospital physician and other disciplines agreed that R1 has made good progress and shall return to the facility which posed an immediate health and safety risks to residents in care.the state’s words, verbatim · CDSS document, Feb 5, 2026

Plan of correction: The administrator will review the regulation and provide a signed and dated statement indicating of the review. After the review, the administrator will develop a plan of correction to prevent this from happening again. The administrator will provide a copy of the statement and a copy of the plan of correction to CCL by 2/6/2026.

From the deficiency page — Deficiency type: Type A · Section cited: CCR 87468.1(8) · Plan of correction due date: Feb 6, 2026

87468.1Personal Rights of Residents in All Facilities(8)To have their representatives regularly informed by the licensee of activities related to care or services, including ongoing evaluations, as appropriate to their needs. This requirement is not met as evidenced by based on interviews, and record reviews, the administrator/licensee stated that after admission, it was determined that R1 required a higher level of care but it was not communicated to R1's responsible party and GGRC which poses an immediate health and safety risk to residents in care.the state’s words, verbatim · CDSS document, Feb 5, 2026

Plan of correction: The administrator will review the regulation and provide a signed and dated statement indicating of the review. After the review, the administrator will develop a plan of correction to prevent this from happening again. The administrator will provide a copy of the statement and a copy of the plan of correction to CCL by 2/6/2026.

Allegation investigated: Staff abandoned resident at the hospital. Staff did not provide a 30 day notice to responsible party.

On February 5, 2026, Licensing Program Analyst (LPA) Murial Han conducted a visit to deliver the complaint investigation findings. LPA met with administrator, Evelyn Ryan and caregiver, Daisy Tubbs and LPA explained the purpose of today's visit. Regarding allegation of – staff abandoned resident at the hospital, the reporting party stated that the administrator/licensee refused to re-admit resident #1 (R1) after R1’s hospitalization resulted in R1 discharged to a skilled nursing facility. As part of the investigation, LPA interviewed the administrator/ licensee, staff, Golden Gate Regional Representative (GGRC), Hospital Discharge Planner, R1’s responsible party and reviewed hospital records. Substantiated According to the administrator/licensee, prior to R1’s hospitalization, R1 already required a higher level of care that the facility can't provide. She stated that R1 was high risk for fall, R1 had many sessions of physical therapy and many doctor’s appointments. She stated that since R1’s hospitalization, she has visited R1 and R1 presented with medical conditions that required a higher level of care such as high risk for fall, difficulty with swallowing, and a foley catheter. In addition, the administrator/ licensee stated she has visited R1 at the skilled nursing facility where she observed R1 of having a one – to – one caregiver and needed a lot more assistance than Sonas Home can provide. According to R1’s responsible party, initially the administrator/ licensee stated that R1 cannot return to the facility unless R1 had a night sitter because she felt R1 was at risk for fall and R1 needed a higher level of care so the responsible party spoke with Golden Gate Regional Center and a night sitter was granted. Then, administrator/licensee stated that the sitter needed to be trained so they can care for R1. The responsible party stated that the administrator/licensee was making excuses not to take R1 back despite R1 being back to his/her baseline upon discharge from the hospital. In addition, the responsible party stated that R1’s discharge documentation from the doctor indicated that R1 can return to the board and care home with increased caregiver support. According to the GGRC Representative, GGRC was in support of R1 returning to the facility as it was recommended by R1’s hospital discharge planner and hospital physician. GGRC has arranged for additional staffing support upon R1’s return. In addition. The licensee was informed that they would work with the facility either to provide additional staffing support to care for R1 or assist with discharge planning in a proper process. According to the hospital discharge planner, R1 required some assistance with Activities of Daily Living (ADLs) but R1 did not get up unattended at night. The discharge planner stated that the discharge plan was for R1 to return to the board and care, but the administrator did not want to take R1 back due to lack of staff at night. Subsequently, additional night staff was provided but the administrator continued not willing to take R1 back. Therefore, R1 was discharged to a skilled nursing facility despite R1 being back to baseline upon discharge. According to former staff #1 (S1) and current staff #2 (S2), R1 was able to walk with a walker with some supervision and R1 required some assistance with toileting and showering. They stated that R1 was not difficult to care for and R1 was very calm and pleasant. Based on the hospital discharge note, it indicated that once the board and care and or family arranged for increased caregiver support then R1 will return there. Based on hospital physical therapy treatment note dated 11/19/2025, R1 was making great progress, and the recommendation was returned to board and care facility with assistance from home health physical therapy. Based on GGRC annual and quarterly reviews, it indicated that the licensee and staff verbalized that R1 was easy to care for, and R1 was a sweet person. In addition, it indicated that additional help was offered to the licensee for caring for R1 but it was declined by the licensee. The documentation did not indicate that R1’s care was increasing and required additional support. After the investigation, this allegation is deemed to be substantiated as the hospital records, the physical therapy and the physician indicated that R1 has made great progress, and they recommended R1 to return to board and care with additional staffing. GGRC was in support of R1 returning home and arranged for additional support, but the licensee continued not willing to take R1 back resulted in R1 transferring to a skilled nursing facility. Furthermore, the Facility Program/Plan of Operation, it stated that Sonas Home’s goal is to provide 24 hours / 7 days assistance and care with ADLs ( bathing, dressing, grooming, feeding) , however, they refused to take R1 back who required the level of care that was described in the Facility Program as per the physical therapist note dated on 11/21/25 (the day prior to R1’s discharge) that R1 was ambulating in to chair/bathroom in hallway with minimum assist with a Front Wheel Walker (FWW), safety maintained. Regarding to allegation of – staff did not provide a 30-day notice to responsible party, the reporting party stated that the licensee denied R1’s admittance back to the facility when R1 was ready to be discharged from the hospital and the 30-day eviction notice was not provided. As part of the investigation, LPA interviewed R1’s responsible party, and the licensee. The licensee denied the allegation and stated that two written notices via email dated November 21, 2025 and November 30, 2025, were sent to varies recipients and one of them was R1’s responsible party. The licensee stated that the emails served as a 30-day notice that indicated the facility will not be able to readmit R1 as R1 required a higher level of care. LPA interviewed R1’s responsible party who acknowledged of receiving the above emails. However, the responsible party had no idea that the licensee would not allow R1 back to the facility even after additional staffing support was arranged by Golden Gate Regional Center (GGRC). Based on the documents provided, LPA observed the 30-days notice emails were provided to the responsible party and others, but it did not include all the required details based on the regulation. Therefore, the 30-day notices via email were invalid as they were not incompliance. After the investigation, this allegation is deemed to be substantiated. Based on interviews and record reviews during the investigation, the preponderance of evidence standard has been met. Therefore, these allegations were determined to be substantiated. Deficiencies of the California Code of Regulations, Title, 22 cited on the LIC9099-D. Failure to correct the deficiencies may result in civil penalties. Report was discussed with Administrator/ Licensee and caregiver. A copy of the report and Appeal Rights were provided.the state’s words, verbatim · CDSS document, Feb 5, 2026 · control 14-AS-20251121084815

From the deficiency page — Deficiency type: Type A · Section cited: CCR 87224(a) · Plan of correction due date: Feb 6, 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)...This requirement is not met as evidenced by based on interviews and record reviews, R1 was hospitalized due to a change in health condition and the administrator/licensee refused to take R1 back to the facility despite additional staffing support was arranged by GGRC, hospital physician and other disciplines agreed that R1 has made good progress and shall return to the facility which posed an immediate health and safety risks to residents in care.the state’s words, verbatim · CDSS document, Feb 5, 2026

Plan of correction: The administrator will review the regulation and provide a signed and dated statement indicating of the review. After the review, the administrator will develop a plan of correction to prevent this from happening again. The administrator will provide a copy of the statement and a copy of the plan of correction to CCL by 2/6/2026.

From the deficiency page — Deficiency type: Type A · Section cited: CCR 87224(d)(1)(B)1.2 · Plan of correction due date: Feb 6, 2026

87224 Eviction Procedures (d) The licensee shall set forth in the notice to quit the reasons..(1) The notice to quit shall include the following information: (B) Resources available to assist in identifying alternative housing.. but are not limited to, the following:1.Referral services..2. Case management organizations This requirement is not met as evidenced by based on interviews, observations and record reviews, the administrator/licensee provided two 30-day eviction notices to R1's responsible party and both notices did not contain the required information which posed an immediate health and safety risks to residents in care.the state’s words, verbatim · CDSS document, Feb 5, 2026

Plan of correction: The administrator will review the regulation and provide a signed and dated statement indicating of the review. After the review, the administrator will develop a plan of correction to prevent this from happening again. The administrator will provide a copy of the statement and a copy of the plan of correction to CCL by 2/6/2026.

Type of visit: Required - 1 Year

On October 14, 2025, Licensing Program Analyst(LPA) Murial Han conducted an unannounced annual inspection. LPA was greeted by caregivers, Jeffrey Medina and Marc Medina. LPA explained the purpose of today's visit. LPA toured the facility inside out and inspected the living room, dining area, kitchen, bedrooms, bathrooms, garage and backyard. This is a single story home with 5 resident bedrooms(4 private and 1 semi-private), 2 full bathrooms, and 1 staff room. The indoor and outdoor passageways were free of obstruction. The facility observed to clean, tidy and in good repair. Bedrooms were equipped with the required furniture for residents to use. Bathrooms are equipped with grab bars, and nonskid mats. Facility temperature is comfortable. Hot water temperature was measured at 106-110 degrees F. Central stored medication were observed to be locked and inaccessible to residents. Food supplies were observed to be adequate, Facility is equipped with smoke detectors and carbon monoxide detectors. Fire extinguisher was last serviced Oct 8, 2024. Fire drill records were reviewed to be adequate. A review of (5) resident files was conducted and noted on the LIC 858. A review of (2) staff files was conducted and noted on the LIC 859. The following document is requested to be submitted to CCL by 10/16/2025 Administrator Certification, LIC 400, LIC 500, LIC 402 (Surety bond) LIC 308, and LIC 309. No deficiency is cited today. This report is reviewed and discussed with the caregivers.the state’s words, verbatim · CDSS document, Oct 14, 2025

Type of visit: Required - 1 Year

On September 17, 2024 Licensing Program Analyst(LPA) Murial Han conducted an unannounced annual inspection. LPA was greeted by caregiver, Criselda Bautista and LPA explained the purpose of the visit. Lead caregiver, Phillip Elera arrived shortly thereafter and assisted with the visit. LPA toured the facility inside out and inspected the living room, dining area, kitchen, bedrooms, bathrooms, garage and backyard. This is a single story home with 5 resident bedrooms(4 private and 1 semi-private), 2 full bathrooms, and 1 staff room. The indoor and outdoor passageways were free of obstruction. The facility observed to clean, tidy and in good repair. Bedrooms were equipped with the required furniture for residents to use. Bathrooms are equipped with grab bars, and nonskid mats. Facility temperature is comfortable. Hot water temperature was measured at 108-112 degrees F. Central stored medication were observed to be locked and inaccessible to residents. Food supplies were observed to be adequate, Facility is equipped with smoke detectors and carbon monoxide detectors. Fire extinguisher was last serviced Oct 26, 2023. Fire drill was last conducted on August 2024. A review of (4) resident files was conducted and noted on the LIC 858. A review of (2) staff files was conducted and noted on the LIC 859. The following document is requested submitted to CCL by 9/18/2024 - Administrator Certification Based on observation, deficiency is cited under California Code of Regulations, Title, 22 cited on the LIC 809D. Failure to correct the deficiencies may result in civil penalties. . This report is reviewed and discussed with the lead caregiver. A copy of this report and the appeal rights were provided.the state’s words, verbatim · CDSS document, Sep 17, 2024

Type of visit: Required - 1 Year

On October 10, 2023 Licensing Program Analyst(LPA) Murial Han conducted an unannounced annual inspection. LPA was greeted by caregivers, Rhealynne Cabarlez and Phillip Elera and LPA explained the purpose of the visit. Caregiver Rhealynne contacted the administrator via phone of LPA's visit and administrator arrived shortly thereafter and assisted with the inspection. LPAs toured the facility inside and outside including the bedrooms (4 private rooms, 1 semi-private room and 1 staff room), 2 full- bathrooms, kitchen, and common areas. The facility observed to clean, tidy and in good repair. Bedrooms were equipped with the required furniture for residents to use. Bathrooms are equipped with grab bars, and nonskid mats. Facility temperature is comfortable. Hot water temperature was measured at 102- 105 degrees F. Central stored medication were observed to be locked and inaccessible to residents. Food supplies were observed to be adequate, At 11:08 am, LPA observed toxins and sharps objects in the kitchen were unlocked. LPA reviewed 3 staff training records and observed 2 out of 3 were adequate, and staff #1(S1) was missing some records. According to administrator that S1 has completed all the required training but some of the records are kept at the administrator's residence. Facility is equipped with smoke detectors and carbon monoxide detectors. Fire extinguisher was last serviced Oct 13, 2022. Fire drill was last conducted on August 2023. Staff members at the facility were fingerprint cleared and associated to the facility. LPA reviewed residents and staff records. Resident records contained admission agreement, medical assessment, LIC 602 (Physician Order), Appraisal Needs and Service Plan, GGRC/IPP, etc. Staff files contained personnel records, health screening, COVID-19 vaccination card, Abuse Statement, First Aide and CPR, Criminal Record Statement. LPA reviewed P & I records and observed Record of Client's/ Resident's Safeguarded Case Resources (LIC 405) and receipts for 3 residents. During today's inspection, there were 2 residents present and 2 were attending the adult day program. Based on observation, deficiency is cited under California Code of Regulations, Title, 22 cited on the LIC 809D. Failure to correct the deficiencies may result in civil penalties. This report is reviewed and discussed with caregiver, Phillip Elera. A copy of this report and Appeal Rights were provided.the state’s words, verbatim · CDSS document, Oct 10, 2023