Cedars Care Home

Type of visit: Prelicensing

At approximately 10:30 AM, Licensing Program Analyst (LPA) Julie Florio arrived unannounced to conduct a pre-licensing inspection and met with Justin Herold, Prospective Licensee. This pre-licensing inspection is being conducted for a change of ownership of a Residential Care Facility for the Elderly (RCFE) with residents currently in care. Fire Clearance has been approved for 13 non-ambulatory residents. Facility has a dementia care plan and a Hospice waiver for two (2). Prospective Licensee states a Hospice waiver increase request was submitted to the Centralized Application Bureau (CAB) about five weeks ago. He will follow up with them to ensure the CCL computer system is updated and his license accurately reflects the approved Hospice waiver request. At approximately 11:30 AM, LPA initiated a tour of the facility with Prospective Licensee and observed the following: Facility is a one story building, was a comfortable temperature, and passageways were free from obstructions. Water temperature in residents' bathrooms measured about one degree above the allowable range of 105 to 120 degrees F per Title 22 regulations. Prospective Licensee agreed to either turn down the water heater or post a hot water warning in compliance with regulation. LPA observed resident showers with the required non-slip mats and grab bars in place. LPA observed a supply of clean linens, hygiene products, and paper products available for residents. Residents' bedrooms have the appropriate furnishings as outlined in regulations. Rooms, closets, and cabinets in communal areas of the facility containing cleaning supplies and other items that could pose a risk were observed locked. Facility has at least two days of perishable foods and one week of non-perishable foods and an emergency water supply. Facility has a healthy and balanced menu of food options posted in a communal area. Facility has an activity schedule and residents were observed walking about the facility and engaged in activities and conversation. Continued on LIC809-C... continued from LIC809... The facility has a land line which was tested and operational during inspection. Facility has an internet access device designated for resident use and has internet services. LPA observed a locked medication cabinet where centrally stored medications are maintained and managed. LPA observed the facility's infection control plan, first aid kits, PPE, and other emergency supplies. Facility has fully charged fire extinguishers throughout and a back up generator for emergency preparedness. Facility has the required signs posted in the front entry area. Facility staff and resident files were reviewed and two (2) of three (3) resident files reviewed were observed missing a current LIC602A Physician's Reports as required for resident's with dementia and both were also observed missing updated care plans within the last 12 months as required per regulation. Prospective Licensee agreed to get these residents scheduled for their visits and update their appraisal needs and services plan immediately to bring the facility into compliance. One (1) of three (3) staff files reviewed were observed missing proof of negative TB results. The staff member called and scheduled an appointment immediately. All staff files reviewed were observed to contain all of the remaining required documents including staff training and current first aid and CPR certifications. Prospective Licensee agrees to review all resident and staff files to ensure all contain all of the required documentation to ensure compliance with regulation. The staff and administrator will remain the same under this new license. Prospective Licensee has been informed of association and staff transfer process and agrees to ensure all staff are cleared and associated in Guardian. Prospective Licensee agrees to submit proof of liability insurance upon licensure. Residents and their families mostly coordinate medical and dental visits and transportation to and from any such appointments. Facility staff are available to assist with coordination and offer third party transportation services when needed. Component III orientation completed with Prospective Licensee. This pre-licensing evaluation has been completed. License will be granted upon completion of a final review and approval from the Licensing Program Manager. Exit interview conducted with Prospective Licensee, whose signature on this document confirms receipt.the state’s words, verbatim · CDSS document, Aug 18, 2026

Type of visit: Office

Facility Type: RCFE Application Type: CHOW Capacity: 13 Census (if any clients in care): COMP II Participants: JUSTIN HAROLD/APPLICANT-ADMINISTRATOR Interview Method: Telephone interview On 7/8/26, applicant/administrator participated in COMP II. Identification of the applicant and administrator was verified through interview questions based on photo ID and other identifying personal information. During COMP II, applicant and administrator confirmed that they have read and understand community care facility licensing laws included in the Health and Safety Codes and the California Code of Regulations Title 22. Signed LIC 809 with copy of photo ID have been obtained. 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, Jul 8, 2026