St. Daniel's Senior Care

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Gabriela Castro conducted an unannounced required annual visit using the Compliance and Regulatory Enforcement (CARE) Tool. LPA was greeted by facility staff explained the reason for the visit. Dan Davis Administrator and Deborah Davis, Licensee, arrived shortly thereafter. This home is licensed to serve 6 residents ages 60 and over, six (6) non-ambulatory of which two (2) may be bedridden. Facility has a hospice waiver for six (6) residents. There was one (1) residents under hospice care during inspection. Facility Tour & Observations: Personal Rights postings (LIC 613C and Ombudsman), Complaint Poster (PUB 475), and nondiscrimination notice were observed in a common area. Residents had access to personal space, privacy, and adequate storage. No firearms/weapons were present. “No smoking - Oxygen in Use signs” in various locations of the facility. Physical Plant The facility is located in a residential neighborhood and consists of a single-story home. The home includes six (6) resident bedrooms, one (1) caregiver bedroom, and two (2) bathrooms, one of which is designated for visitor use. The facility also contains a combined living and dining area furnished with living room furniture and a four-chair dining table, a kitchen, an attached garage/staff lounge, a front yard, and a large backyard. The front yard includes a long driveway with a walkway leading to the front entrance. Each resident bedroom was observed to contain the required furnishings, including a bed with mattress, linens, dresser, chair, and adequate lighting. Bathrooms were clean and equipped with required grab bars near the toilets and in the shower areas, as well as non-skid mats. Hot water temperatures measured within the required range of 105°F to 120°F. Cleaning supplies and other toxic substances were observed to be stored in locked cabinets and were inaccessible to residents. A Hoyer lift was available to assist residents with transfers and, according to the caregiver, is used only as needed. Extra linens and towels were available and stored in the laundry room, where a washer and dryer were also observed. (Continued on LIC809C) The facility's last fire inspection and fire safety system testing were conducted by Metro Fire Systems on 09/11/2025. Per facility staff, inspections and testing are completed annually. Fire extinguishers were observed throughout the facility and were readily accessible for emergency use. The backyard provided shaded seating areas for residents to enjoy outdoor activities. All passageways and exits were observed to be clear, safe, and unobstructed. No bodies of water were observed on the premises. Food Service: Refrigerators/freezers were maintained at proper temperatures (refrigerators maximum of 40 degrees °F and freezer 0-degree °C) with sufficient supply of 2-day perishable and 7 days non-perishable food. Fresh produce, proteins, and dry goods were stocked. Knives and were observed in a locked kitchen drawer. Health-Related Services & Records: Five (5) resident files were reviewed and contained the required current documentation, including Admission Agreements, Pre-Placement Appraisals, signed consents, Needs and Services Plans, Physician's Reports documenting TB results and ambulatory status, and signed Resident Rights acknowledgments. Three (3) residents' medications were reviewed. Medications were observed to be centrally stored in a locked hallway cabinet, and Medication Administration Records (MARs) were current and accurately reflected the prescribed medications. During record review and observation, LPA observed that Resident 1 (R1) had full bed rails installed on the bed. Facility records did not contain the required exception documentation authorizing the use of full bed rails. Based on observation and record review, the facility failed to ensure compliance with Title 22 regulations regarding the use of full bed rails. A deficiency was cited. Disaster Preparedness: Last fire/earthquake drill was conducted on July, 2026, with logs available. LIC 610D Emergency Disaster Plan was posted in the living room area. Emergency supplies (water, food, flashlights, batteries, first aid) were observed in the garage. Infection Control Plan was updated. Personnel Records & Training: Three (3) staff files were reviewed and included criminal record clearances, CPR/First Aid, required training and TB screenings. Administrator Certificate for Dan Davis was valid through June 02, 2027. Insurance: Liability insurance was in compliance with an expiration date of August 07, 2026. During the inspection, deficiencies were observed and cited on the attached LIC 809D/809C in accordance with Title 22, Division 6 regulations. Dan Davis, Administrator and Deborah Davis Licensee was advised of the nature of the deficiency, the regulatory basis, and the required Plan of Correction (POC). A copy of this report, LIC 809D/809C, and appeal rights will be provided via emailthe state’s words, verbatim · CDSS document, Aug 4, 2026

The state marks this report as 5 pages; the online copy we transcribed has 4. You can request the full file from the county licensing office.

Type of visit: Annual/Random

***This is an amended report to the report dated 1/21/26 the reason the report was amended was because the annual inspection report was generated incorrectly under this facility. *** Licensing Program Analyst (LPA) Gabriela Castro conducted a case management visit on January 28, 2026, for the purpose of delivering an amended annual report. LPA was greeted by Sharajhmacy Apalisok, Caregiver and the purpose of the visit was explained. No deficiencies were observed during today’s visit. A copy of the report was providedthe state’s words, verbatim · CDSS document, Jan 21, 2026

The state marks this report as 4 pages; the online copy we transcribed has 3. You can request the full file from the county licensing office.

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Sakinah Madyun conducted an unannounced Required Annual Visit. LPA met with Licensee Deborah Davis, Administrator Daniel Davis, and explained the purpose of the visit. The Residential Care Facility for the Elderly is licensed to serve six (6) Non-Ambulatory residents ages 60 and above. Facility has an approved Hospice Waiver to retain/accept six (6) residents of which two (2) may be Bedridden. Currently, there are three (3) residents in placement, one (1) Hospice, zero (0) Bedridden (0) Exceptions, and one (1) receiving Home Health Care. LPA observed (3) residents at the time of this visit. LPA Madyun requested copies of Personnel Report (LIC 500), and Resident Roster (LIC 9020) were provided. Physical Plant/Environment Safety: A tour of the single-story facility began at approximately 10:35 am that included rooms: one (1) private staff bedroom with an exiting door, one (1) staff/visitors bathroom, one (1) staff lounge (located in garaged area), five (5) bedrooms with an exiting door, one (1) resident bathroom, a living room, a dining area, a family room, and a kitchen. All resident bedrooms have the required furniture for privacy, comfort, and safety. LPA observed the carbon monoxide detectors, fire sprinklers, and inter-connected smoke detectors throughout the hallways and rooms. LPA observed required auditory devices on exits of each room. Three (3) Fire extinguishers were fully charged and located in the kitchen, garage, and directly outside the staff office and last inspected on 6/7/25. First-aid kit was fully stocked with a first-aid manual locked securely in the staff office. LPA did observe the Emergency Disaster Plan last reviewed and updated May 2025. Front Yard: Was clean and well maintained without any hazards. Continued LIC 809C Kitchen: LPA observed a sufficient number of perishables for two (2) days, and a seven (7) day supply of non-perishables. LPA observed knives and sharps locked away secured in the kitchen cabinet to be inaccessible to three (3) out of six (6) residents in care. LPA Madyun observed several bottles of cleaning solutions and disinfectants located in the bottom kitchen cabinet to be locked away secure and inaccessible to three (3) out of six (6) residents in care. Water temperature measured at 113.7 degrees F, which is within the required 105-120 degrees F under Title 22 regulations. Kitchen appliances were observed to be clean and in working order. Family room/Living room/Dining Area: Family room was observed with ample seating and lighting. Dining Area was observed to be clean and contained one table with ample seating. The living room was observed with ample seating and lighting. Linen Closet: Contained sufficient linens, towels, and hygiene products. Bathrooms: Bathrooms are clean and operational with grab bars, and skid resistance floors. Water temperatures measured at 113.5-114.8 degrees F, which is within the required 105-120 degrees F under Title 22 regulations. Both bathrooms were observed to be clean and in good condition. Centrally Stored Medications: LPA observed the medication for all residents being locked and securely stored in the staff office. Backyard: LPA observed multiple shaded seating areas. No large bodies of water were observed. Emergency Drills: LPA observed the smoke alarms tested and a Fire Drill log documenting the last fire drill conducted 7/10/25. Staff Personnel Files: LPA reviewed files for (3) staff. Resident Files: LPA reviewed files for (3) residents and medication logs. Liability Insurance & Infection Control Plan: Licensee has current Liability Insurance. Annual fees are paid in full and current. Infection Control Plan was last reviewed and updated May 2025. Exit interview was conducted with Licensee Deborah Davis and a copy of this report and appeal rights will be provided.the state’s words, verbatim · CDSS document, Aug 8, 2025

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Kimberly Ramirez conducted an unannounced required annual inspection visit on 7/28/2024. LPA Ramirez was greeted by Caregiver Elizabeth Pineda and explained the purpose of the visit. Administrator Daniel Davis Jr arrived shortly after to assist with tour of facility. The facility is located on a residential street and is a single-story dwelling. LPA Ramirez observed surveillance cameras in staff office and on the outside of the facility. LPA utilized the Compliance and Regulatory Enforcement (CARE) tools for the visit today and observed the following: Physical Plant and Environment safety: Disinfectants, cleaning solutions, poisons and other items that could pose a danger if readily available to residents, were observed to be inaccessible to residents. LPA Ramirez observed carbon monoxide detectors and smoke alarms in hallways. LPA Ramirez inspected five (5) resident rooms. Bedroom#1 was observed to contain a hospital bed with full bed rails. Resident#1 (R1) did not have a physician’s order for full bed rails or a hospice care plan that specifies need for full bed rails. LPA Ramirez will issue Type B deficiency based on this observation. All resident bedrooms contained required furniture, linens, and lighting. Water temperatures in all grooming and bathing areas were measured to be with 105 – 120 degrees F. LPA Ramirez observe postings encouraging proper handwashing etiquette in restrooms. LPA Ramirez observed grab bars near toilets and inside showers. LPA Ramirez observed no-slip mat in showers. Showers were observed to be wheelchair accessible. Food Service: LPA Ramirez observed sufficient supply of nonperishables for one week and perishable foods for a minimum of two days in the facility kitchen area. Soaps, detergents, and cleaning compounds were observed to be stored away from food supplies. Freezers and refrigerators were observed to be clean and within temperatures of 0-degree F (-17.7 degree C), and refrigerators with maximum temperature of 40-degree F. (4 degree C). LPA Ramirez observed a monthly menu posted on facility refrigerator. Planned Activities: LPA Ramirez observed several adult coloring books, magazines and board games in facility living room area. LPA Ramirez observed three (3) out of the six (6) residents sitting in living room area watching the 2024 Olympics on TV. SEE 809-C Residents Rights-Information: LPA Ramirez observed the following postings in common areas throughout the facility: Complaint Poster (PUB 475), personal rights, and nondiscrimination notice. LPA Ramirez observed a facility land line. Disaster Preparedness: The facility has the Emergency Disaster Plan (LIC610D) in place. LPA Ramirez observed facility sketches with exits and emergency exits routes throughout various locations of the facility. LPA Ramirez observed emergency food supply. LPA Ramirez observed several fully charged fire extinguishers. Residents with Special Needs: No large bodies of water were observed. LPA Ramirez observed signs posted indicating “No smoking - Oxygen in Use” in various locations of the facility. LPA Ramirez observed several oxygen tanks in resident rooms secured in stands. Knives, sharps or other items that could pose a danger to residents with dementia, were observed to be inaccessible. Auditory devices were observed to be in working order. Health Related Services/Incidental Medical Services: The medications are centrally stored in staff office and in bubble packs and/or original containers. The facility uses the Medication Administration Record (MAR) log to document medications given. The facility provides incidental medical services. Staffing: Administrator Certificate for Daniel Davis Jr expires 06/02/2025. Staff employed are over the age of 18 and are fingerprint cleared and associated to the facility. Personnel Records Training: Staff files are maintained at the facility. LPA Ramirez observed required annual training, CPR and First Aid for three (3) out of the three (3) personnel records reviewed. LPA Ramirez observed TB testing results, Health screening, fingerprint clearance and job application for three (3) out of the three (3) personnel records reviewed. Infection Control: There are using appropriate hand hygiene and wearing gloves while assisting clients. Staff are cleaning and disinfecting often for high touched surfaces. Facility has an Infection Control Plan in place. Operational Requirements: The fire clearance is approved for six (6) non-ambulatory of which two (2) may be bedridden. All bedrooms are approved for bedridden. This facility may retain no more than six (6) hospice residents. There were one (1) resident under hospice care during time of inspection. Resident Records/Incident Reports: LPA reviewed six (6) resident files. Resident files are maintained at the facility. Admission Agreement, Physician's Report (including T.B and Ambulatory Status), Consent for Medical Treatment, Preplacement Appraisal Information, Resident Pre-Appraisal, Care Plan/Appraisal/Needs and Services Plan, Resident Rights were observed. One (1) deficiency was cited. A copy of this report, 809-D and appeals rights was provided. Exit interview was conducted.the state’s words, verbatim · CDSS document, Jul 28, 2024