Yannica Guest Home 1

Type of visit: Required - 1 Year

Unannounced one year required visit to the facility by Licensing Program Analyst (LPA) Jason Lund. LPA Lund was met by Administrator Maxima Martin and explained the reason for the visit. Census 4 LPA Lund & Administrator Maxima Martin toured/inspected the facility was conducted. Dining area, living area, and all other areas intended for resident use were inspected. Furniture and furnishings were observed to be sufficient and able to meet the needs of the residents at this time. Linen closet, in the hallway, was inspected and contained a sufficient supply of towels, sheets, and bedding to meet the needs of the residents. Kitchen area was inspected. Food supply for 2-day perishable and 7-day nonperishable quantities was in compliance at all times. Pantry area was inspected to have additional food storage units located in the garage area were observed to be present and functional at this time. Laundry room, located prior to the entrance for the garage, was inspected. Bleach, detergent, and all other cleaning supplies were observed to be locked and made inaccessible residents. Medication cabinet, located in the facility kitchen cabinet, was observed to be locked. First aid kit contained all of the required components. Fire extinguishers were inspected by Jorgensen Company, on 01/06/2026. Facility resident bedrooms were inspected, and furnishings were observed to meet the needs of the residents. Facility resident restrooms were inspected to have grab bars and non-skid mats. Inspection of the facility perimeter fence, side gates, and all other exits was conducted and compliance. A review of (3) facility personnel records and (2) facility resident records was conducted and in compliance. No deficiencies observed or cited during today's annual visit. Exit Interviewthe state’s words, verbatim · CDSS document, Apr 23, 2026

Type of visit: Required - 1 Year

Unannounced Annual visit made out to this facility on 05/19/2025 by Licensing Program Analysts (LPAs) Charlie Yang and Holly Williams. These LPAs were met by the facility designated Administrator, Maxima Martin, who was briefly interviewed at this time. Current census was 5 residents. It was learned that there were (4) residents under the care of hospice at this time. This facility does have an approved waiver to be able to accept and retain up to (6) residents under the care of hospice at any given time. It was learned that this facility has a program to be able to accept and retain dementia residents at any given time. It was learned that there were (3) residents diagnosed with dementia at this time. It was learned that there was (0) residents receiving services through home health at this time. It was learned that there weren't any residents deemed to be bedridden at this time. Tour of this facility was conducted. Dining area, living area, and all other areas intended for resident use were toured. Furniture and furnishings were observed to be sufficient and able to meet the needs of the residents at this time. Linen closet, located in facility hallway, was reviewed and observed to contain a sufficient supply of towels, sheets, and bedding able to meet the needs of the residents at this time. Kitchen area was toured. Kitchen drawers and cabinets were opened and reviewed. Food supply for 2-day perishable and 7-day nonperishable quantities was reviewed to make sure that they were in compliance at all times. Pantry area was toured. Additional food storage units located in the garage area were observed to be present and functional at this time. Laundry room, located prior to the entrance for the garage, was toured. Bleach, detergent, and all other cleaning supplies were observed to be locked and made inaccessible to the residents at this time. Administrator certificate, # 7032934740, for Maxima Martin was observed to have an expiration date of 08/15/2026 and in compliance at this time. Forms and documents have been completed in order to renew this Administrator certificate at this time. Medication cabinet, located in the facility kitchen cabinet, was observed to be locked and made inaccessible to the residents at this time. First aid kit, located in the medication closet, was reviewed. This LPA observed that it did contain all of the required components at this time. Fire extinguishers were located throughout this facility and observed to have been annually inspected by the local fire extinguisher company, Jorgensen Company, on 01/02/2025 and found to be in compliance at this time. Facility resident bedrooms were toured. Furniture and furnishings were observed to be sufficient and able to meet the needs of the residents at this time. Facility resident restrooms were toured. Grab bars and non skid mats were observed to be present and in good repair at this time. Hot water temperatures were taken to make sure that they were within the allowed range of 105-120 degrees. A tour of the facility exterior grounds was conducted. A review of the facility perimeter fence, side gates, and all other exits was conducted. A review of (5) facility personnel records was conducted and noted on the following LIC 859. A review of (5) facility resident records was conducted and noted on the following LIC 858. The following forms and documents were requested to be updated and submitted into CCL for review by this LPA: LIC 308 LIC 400 LIC 500 LIC 610 There were no deficiencies observed or cited during today's annual visit. Exit Interviewthe state’s words, verbatim · CDSS document, May 19, 2025

Type of visit: Case Management - Incident

Unannounced case management visit made out to this facility on 04/02/2025 by Licensing Program Analyst (LPA) Charlie Yang who was met by the facility designated Administrator, Maxima Martin, and was briefly interviewed at this time. Current census was 5 residents. The purpose of today's case management visit was to follow up on an incident, including hospitalization, that was recently submitted into CCL. The following LIC 624 was reviewed and discussed for the following resident that was in care: R1 It was learned that the above referenced resident (R1) was under the care of a hospice agency prior to being admitted into the hospital at that time. It was learned that the hospice agency was informed, as well as, any responsible family and friends were made aware of the situation and hospitalization of the resident. There were no deficiencies observed or cited during today's case management visit. Exit Interviewthe state’s words, verbatim · CDSS document, Apr 2, 2025

Type of visit: Required - 1 Year

On 03/28/2024 Licensing Program Analyst (LPA) Avelina Martinez made an unannounced visit to this facility to conduct an annual required inspection at 9:27 AM. LPA Martinez met with Maxima Martin and explained the purpose of the visit. LPA Martinez inspected the physical plant including but not limited to the kitchen, dining room, resident bedrooms; resident bathrooms, laundry room, activity room, and outside courtyards of the facility to ensure compliance with Title 22 regulations. Administrator holds current certificate. The facility is licensed for six non-ambulatory residents, which one can be bedridden The facility has a hospice waiver for 6 residents. There are currently five residents who reside at this facility. The LPA Martinez toured the facility with Maxima Martin on 03/28/2024 at 10:00 AM. LPA Martinez conducted a file review, and all files were maintained. The facility fire extinguishers are in good repair. The exterior fire emergency gate is in good repair. The facility has an adequate food supply, and the kitchen was sanitary and furnished. The resident bedrooms are furnished and sanitary. The laundry room and bathrooms are furnished and sanitary. Based on this annual inspection, the facility is in compliance with California Code of Regulations, Title 22 and Health and Safety Code. There were no deficiencies cited at this time. An exit interview was conducted, and a copy of this report was given to the facility at the end of the visit.the state’s words, verbatim · CDSS document, Mar 28, 2024