Wildwood Court

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Michelle Echeverria arrived unannounced to conduct the required annual visit to the facility. LPA met with Caregiver, Erika Dominguez and introduced self and stated purpose of the visit. LPA was informed that there are currently 6 residents in care who are in the facility. Licensee, Jahmaal Willis was called and notified about the visit and stated that he would arrive shortly. The facility is a one story house with (5) resident bedrooms, (2) bathrooms, living room, (2) dining areas, kitchen, family room, laundry room, backyard, and attached garage. LPA completed a walk through of facility, review of records and medication audit with Licensees, Jahmaal Willis and Tanya Willis. Physical Plant: The facility is operating in the capacity approved by Community Care Licensing (CCL). There are no obstructions to indoor and outdoor passageways. The facility is maintained at a comfortable temperature of 72 degrees Fahrenheit. LPA inspected resident bedrooms; they are equipped with required furniture such as: mattresses, night stands, storage space, chairs and sufficient lighting. LPA inspected resident bathrooms; bathrooms were clean and appliances were found functional. Water temperatures tested at 106.5 degrees Fahrenheit. The facility is equipped with operational smoke detectors, carbon monoxide alarms, fire extinguisher and first aid kit. Posters such as; the personal rights, ombudsman, CCL complaint poster and emergency contacts were posted in a common area. LPA also observed cleaning supplies, toxins, sharps, and other dangerous items locked in cabinets made inaccessible to residents. There was a designated storage space for resident/staff files. Medications were observed secured and inaccessible to residents. There is no swimming pool, bodies of water, firearms or ammunition in the facility. Overall, the facility is clean, in good repair, and operating in safe conditions for residents in care. Food Service: Non-perishable and perishable food supply is sufficient for number of residents in care. Facility has a wide variety of food available.. Dishes, cups, and utensils were also stored properly. Yards/Outside: A shaded covered patio with seating areas and a self-latching handle gate on the left side of the house that leads into the backyard were observed. All outdoor pathways were free of obstructions. Care & Supervision: Facility has sufficient care staff for coverage 24 hours a day, 7 days a week. All staff members working in the facility have criminal record clearance through the department. Record Review: LPA reviewed all resident files for admission agreements, updated physician reports, and needs and services plans. LPA also reviewed personnel and administrator files for First Aid/CPR certification, criminal record clearance, trainings, and health screenings. LPA reviewed the facility's insurance coverage, emergency disaster plan, and infection control plan. No deficiencies were cited during this visit. An exit interview was conducted where this report LIC809 and LIC809C were discussed and copies were provided to the Licensees, Jahmaal Willis and Tanya Willis.the state’s words, verbatim · CDSS document, Jul 7, 2026

Type of visit: Case Management - Other

Licensing Program Analyst (LPA) Michelle Echeverria conducted an announced visit to the facility for the purpose of a room conversion. LPA was greeted and granted entrance by the Licensees, Tanya Willis and Jahmaal Willis. Per the LIC200, the licensees requested for the capacity to remain the same (5) nonambulatory and (1) bedridden on 11/25/2024. The fire clearance request was approved on 02/19/2025 for (5) nonambulatory and (1) bedridden. Bedrooms #1,#2, and #3 are private bedrooms and occupy (1) nonambulatory resident per room. Bedroom #4 is a private (1) bedridden bedroom. Bedroom #5 is a semiprivate bedroom which occupies (2) nonambulatory residents. There is a facility sketch on file with designation of capacity for each room. The licensees were advised that the noted designated capacity for each room is to remain in compliance. LPA observed that the resident bedrooms were appropriately furnished and had functional lighting. The physical plant is ready for an updated license. LPA will update the facility's file and issue a new license stating the change in bedrooms. There are (5) residents in care who are in their bedrooms. An exit interview was conducted where this report LIC809 was discussed and provided to the Licensees, Tanya Willis and Jahmaal Willis.the state’s words, verbatim · CDSS document, Feb 21, 2025

Type of visit: Prelicensing

Licensing Program Analysts (LPAs) Michelle Echeverria and Lavette Farlow , arrived at Wildwood Court LLC, to conduct an announced Pre-Licensing visit for licensure. LPAs were greeted by licensees, Tanya Willis and Jahmaal Willis. LPAs introduced self and stated purpose of the visit. LIC200 application was submitted on 04/19/24 for (5) non-ambulatory residents and (1) bedridden resident. Fire Safety Inspection clearance was granted for (5) non-ambulatory residents and (1) bedridden resident on 06/26/24. LPAs toured the facility inside and outside and observed the following: Structure: Facility is a one story house with (4) resident bedrooms, (2) bathrooms, office, living room, (2) dining areas, kitchen, family room, laundry room, backyard, and attached garage. Heating/Cooling System: Central heating and air conditioning system installed with a central panel located in the hallway to control entire house. Bedrooms: Two bedrooms accommodates two non-ambulatory residents in each room, and one bedroom accommodates one non-ambulatory resident and one bedroom accommodates one bedridden resident. Bathrooms: The bathrooms have a working toilet, wash basin, and shower with an adequate supply of toilet paper and soap. Kitchen/Laundry: An adequate supply of dishes, glasses, utensils, pots, and pans were observed. Knives, sharps, detergent, and chemicals are stored in locked compartments. There was a pantry stocked with non-perishable food and perishable food found in the refrigerator. LPAs observed the stove to be operational. Refrigerator/freezer were in working condition. Water tested in the bathroom faucet measured at 107 degrees fahrenheit. A functional washer and dryer are located inside the laundry room. Living/Family room: There was a furnished living room with books and games observed. There was a family room with a tv and an inaccessible fireplace observed. Linens and Hygiene Supplies: An adequate supply of linens and hygiene supplies stored in a closet. Yards/Outside: A shaded covered patio with (2) seating areas and a self-latching handle gate on the left side of the house that leads into the backyard were observed. There are no firearms, ammunition, swimming pool or bodies of water observed. All outdoor pathways were free of obstructions. Emergency Phone Numbers, and Exit Plan: Facility sketch, CCL complaint poster, visitors policy, long-term ombudsman and personal rights were observed posted by the entrance. General items: The smoke and carbon monoxide detectors were tested and are operable. There was a fully charged fire extinguisher observed. Resident/Staff records stored inside the locked filing cabinets in the office. First Aid kit with required components, and a locked compartment for medication storage was observed. The facility has a functioning telephone and line. The facility was evaluated in accordance with the California Code of Regulations (CCR), Title 22. Based on the observations and evaluation of the facility this date, the facility is ready for licensure. LPAs completed COMP III with the Licensees at the conclusion of the inspection. Licensees will be notified once facility is licensed. An exit interview was conducted, and this report was discussed and provided to licensees Tanya Willis and Jahmaal Willis.the state’s words, verbatim · CDSS document, Aug 1, 2024

Type of visit: Office

Facility Type: Residential Care Facility for the Elderly Application Type: Initial Capacity: 6 Census (if any clients in care): 0 COMP II Participants: TANYA WILLIS, JAHMAAL WILLIS Interview Method: Telephone interview On July 22, 2024, 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 the understanding of the California Code Title 22 Regulations. 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. Restricted/Prohibited Health Conditions 5. General provisions 6. Emergency Preparedness 7. Complaints & Reporting 8. Pre-licensing readinessthe state’s words, verbatim · CDSS document, Jul 22, 2024