Post-licensing visit·August 18, 2025

On 08/18/2025 at 1:15 PM, Licensing Program Analyst (LPA) Triel Ellen Lindstrom arrived at the facility for an unannounced post-licensing inspection. The LPA was greeted by a Caregiver. The LPA introduced herself, explained the purpose of the visit, and asked to speak to the Designated Facility Administrator. The Caregiver called the DFA, who arrived at the facility at 1:40 PM. The DFA accompanied the LPA on a tour of the facility. This facility is a three-bedroom residential house that has been cleared for six non-ambulatory residents by the City of Modesto Regional Fire Authority on 01/06/2025. The census at the time of this site inspection was four. The LPA toured the living room, dining room, kitchen, bedrooms, and bathrooms. The LPA observed that the entire facility was clean, odor-free, and pest-free. Each bedroom had the required furniture in it. The bathrooms had grab bars and non-slip surfaces. The water temperature at a bathroom sink was 105 degrees Fahrenheit. The temperature displayed on the thermostat was 76 degrees Fahrenheit. The hallway closet contained extra linens. The living and dining rooms contained enough seating for all residents. The DFA tested the smoke and carbon monoxide detectors and an alarm sounded on the interconnected system. The LPA inspected the fire extinguisher, which was last serviced on 12/20/2024 by Jorgensen Co. (Continued on LIC 809-C.) The LPA toured the kitchen, garage, and laundry room. In the kitchen, the LPA observed that sharps were locked in a kitchen drawer. The facility had a 2-day supply of perishable food and a 7-day supply of non-perishable food in the kitchen cabinets and refrigerator-freezer. The kitchen trash can had a lid on it. In the laundry room, the LPA observed a locked cabinet that contained disinfectants and cleaners. In the garage, which was locked and inaccessible to residents, the LPA observed another refrigerator-freezer with additional food, storage cabinets, and a locked cabinet with more cleaners. The LPA toured the backyard, which had a shaded seating area and concrete walkways that were free of obstructions. The LPA inspected the central medication storage. Each resident's medication was stored in a separate container, and each resident's medication bottles were original with intact labels. The LPA inspected the medications and paper-based Medication Administration Record (MAR) for two residents, and found that they matched. The LPA conducted a review of records for two staff and two residents, and found them to be well-organized and complete. Both caregivers on duty had criminal background clearances and current CPR/First Aid certifications. As a result of this inspection, the facility was in compliance with California Code of Regulations (CCR), Title 22, Division 6. Post-Licensing is complete and this facility has no deficiencies. An exit interview was conducted with the licensee, to whom a copy of this LIC809 report was provided. Their signature below confirms receipt of this document.