The Hills of South Lane I

Type of visit: Case Management - Deficiencies

On 3/16/2026, Licensing Program Analyst (LPA) E. Conchas made an unannounced visit to the facility to conduct a health and safety check. LPA met with Administrator, Regina Chavez, and explained the purpose of the visit. During today's health and safety check LPA conducted an overall status of the facility. At the time of the visit there were no staff or residents present. However, LPA did observe personal belongings. Administrator revealed the facility is being occupied by care staff who work at The Hills of Stillman. The staff will be the main care staff for this facility once the facility receives residents. The facility was observed to have operable utilities (gas, water, electricity). LPA did not observe liability insurance. One deficiency was cited. An exit interview was conducted, and a copy of this report was provided to Administrator, Regina Chavezthe state’s words, verbatim · CDSS document, Mar 16, 2026

From the deficiency page — Deficiency type: Type A · Section cited: HSC 1569.605 · Plan of correction due date: Mar 17, 2026

1569.605Liability insurance; coverage requirements On and after July 1, 2015,all residential care facilities for the elderly, except those facilities that are an integral part of a continuing care retirement community, shall maintain liability insurance covering... employees. This is not met by Based on observation and interview, Licensee did not comply with the section cited above which poses an immediate health and safety risk or personal rights risk to persons in facility. LPA was informed licensee does not have a current liability insurance.the state’s words, verbatim · CDSS document, Mar 16, 2026

Plan of correction: Administrator/licensee to provide proof of liability insurance via email by POC to LPA.

Type of visit: Prelicensing

Licensing Program Analysts (LPA) Edith Conchas conducted a third announced pre-licensing visit to the facility. LPA met with Facility Administrator Regina Chavez and Chris Cerami. The pending application is for a Residential Care Facility for Elderly (RCFE). The capacity is six (6). The census is zero. The Administrator accompanied the LPA on a tour of the inside and outside of the facility. The physical plant, in general, was in good repair. The buildings and grounds are free from hazards. The indoor passageways are free of obstruction. The outdoor passageways were observed to be free of obstruction. LPA observed an in-ground pool at the facility with no water. All bedrooms are furnished with a bed, night- stand, dresser, and chair. All bedrooms have adequate lighting for resident use. Bathroom's toilet, and showers are in good repair and have non-skid mats. LPA observed two (2) of the communal shower have water stopper to allow the water to drain as intended and keeping it from widespread pooling. LPA observed both bathroom water temperatures measuring at 105 degrees Fahrenheit. LPA observed food storage and preparation areas to be clean and sanitary. LPA inspected indoor kitchen a new dual freezer and refrigerator in working condition. There is enough Emergency water supply and the required 72-hour emergency food supply for residents and staffs available at the facility. The outdoor space is suitable for residents use. LPA observed one (1) fully charged fire extinguisher present in the facility with last inspection of August 13, 2025. Smoke alarms and carbon monoxide are present and functional. Facility has a designated area (Med-cabinet) where medications are locked and stored. Continue LIC 809-C The facility had a designated area where staff and resident records are stored. Emergency disaster plans, personal rights, and complaint posters were posted in a common area. There is adequate seating in the common areas. Facility had a supply of activities for the residents. During review of records LPA's found plan of operation, admission agreement, along with an updated facility sketch. The following are things LPA observed to be completed. All mattresses have mattress covers/ pads Back yard surrounding the pool is free of debris. Back yard pool has a pad lock. Outdoor fan was replaced with lighting in working condition Staff files were observed and were complete with updated training, CPR/ First aid and jobs descriptions etc. Indoor refrigerator was replaced and in working condition. The indoor magnetic doors (2) are in working condition. Pre-licensing inspection is complete and meets the requirement to pass the inspection. Component III was completed on 8/29/2025. An exit interview was conducted, and a copy of this report was provided to Administrator Regina Chavez Chris Cerami.the state’s words, verbatim · CDSS document, Nov 17, 2025

Type of visit: Prelicensing

Licensing Program Analysts (LPA’s) Edith Conchas and LaVette Farlow conducted a second announced pre-licensing visit to the facility. LPA met with Facility Administrator Regina Chavez. The pending application is for a Residential Care Facility for Elderly (RCFE). The capacity is six (6). The census is zero. The Administrator accompanied LPA’s on a tour of the inside and outside of the facility. The physical plant, in general, was in good repair. LPA observed two (2) indoor magnetic doors that were not in functioning condition. A chair and table were propping the doors open.The buildings and grounds are free from hazards. The indoor passageways are free of obstruction. The outdoor passageways need to be free of obstruction. LPA observed an in-ground pool at the facility, the perimeter of the pool requires a pad lock. All bedrooms are furnished with a bed, night- stand, dresser, and chair. All bedrooms have adequate lighting for resident use. LPA observed mattresses did not have required protective covers. Bathroom's toilet, and showers are in good repair and have non-skid mats. LPA observed two (2) of the communal shower have water stopper to allow the water to drain as intended and keeping it from widespread pooling. LPA observed water temperature measured at 115 and 116 degrees Fahrenheit. LPA observed food storage and preparation areas to be clean and sanitary. LPA inspected indoor kitchens freezer and refrigerator not in working condition. However observed a second one in the garage with appropriate temperatures according to Title 22 regulation. There is enough Emergency water supply and the required 72-hour emergency food supply for residents and staffs available at the facility. The outdoor space is suitable for residents use. LPA observed two (2) fully charged fire extinguishers present in the facility with last inspection October 2nd, 2024, and August 13, 2025. Smoke alarms and carbon monoxide are present and functional. Facility has a designated area (Med-cabinet) where medications are locked and stored. Continue LIC 809-C The facility had a designated area where staff and resident records are stored. Emergency disaster plans, personal rights, and complaint posters were posted in a common area. There is adequate seating in the common areas. Facility had a supply of activities for the residents. During review of records LPAs found plan of operation, admission agreement, along with an updated facility sketch. The following are things that need to be completed. All mattresses needs mattress covers/ pads Back yard surrounding the pool needs to be free of debris. Back yard pool needs to have a pad lock. Outdoor fan needs to be in working condition Staff files were observed and were incomplete. Review and update training, CPR/ First aid and jobs descriptions etc. Indoor refrigerator need to be in working condition. The indoor magnetic doors (2) need to be in working condition. The administrator will provide proof of correction/status prior to pre-licensing approval. Pre-licensing inspection is not complete and doesn't meet the requirement to pass the inspection. LPA will initiate a third inspection when the facility completes the necessary requirements as stated. Component III was completed on 8/29/2025. An exit interview was conducted, and a copy of this report was provided to Administrator Regina Chavez.the state’s words, verbatim · CDSS document, Oct 7, 2025

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: Prelicensing

Licensing Program Analysts (LPA’s) Edith Conchas and Paola Guerrero conducted an announced pre-licensing visit to the facility. LPA met with Facility License Maricel Nepomuceno and Administrator Regina Chavez. The pending application is for a Residential Care Facility for Elderly (RCFE). The capacity is six (6). The census is zero. The Licensee and Administrator accompanied LPA’s on a tour of the inside and outside of the facility. The physical plant, in general, was in good repair. The buildings and grounds are free from hazards. The indoor and outdoor passageways are free of obstruction. LPA observed an in-ground pool at the facility, the perimeter of the pool was gated and locked. All bedrooms are furnished with a bed, nightstand, dresser, and chair. All bedrooms have adequate lighting for resident use. Bathroom's toilet, an tubs are in good repair and have non-skid mats. LPA observed one (1) of the communal shower water failed to drain as intended and instead migrated toward the main bathroom floor, causing widespread pooling. LPA observed food storage and preparation areas to be clean and sanitary. LPA inspected facilities freezer and Refrigerator with appropriate temperatures according to Title 22 regulation.There is enough Emergency water supply and the required 72-hour emergency food supply for residents and staffs available at the facility. All appliances are clean and operating. The outdoor space is suitable for residents use. LPA observed two (2) fully charged fire extinguishers present in the facility. Smoke alarms and carbon monoxide are present and functional. Facility has a designated area (Med-cabinet) where medications are locked and stored. Continue LIC 809-C The facility had a designated area where staff and resident records are stored. Emergency disaster plans, personal rights, and complaint posters were posted in a common area. There is adequate seating in the common areas. Facility had a supply of activities for the residents. During review of records LPAs found plan of operation, admission agreement, along with an updated facility sketch. Pre-licensing inspection is not complete and doesn't meet the requirement to pass the inspection. LPA will initiate a second inspection when the facility completes the necessary requirements as stated. Component III was completed on this day as well. An exit interview was conducted, and a copy of this report was provided to Licensee Maricel Nepomuceno and Facility Administrator Regina Chavez.the state’s words, verbatim · CDSS document, Aug 29, 2025

Type of visit: Office

Facility Type: RCFE Application Type: Initial Capacity: 6 Interview Method: Telephone interview On 2/26/2025, 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 Pre-licensing readinessthe state’s words, verbatim · CDSS document, Feb 26, 2025