Magnolia Garden Assisted Living

On 11/18/2025 at 9:30 AM, Licensing Program Analyst (LPA) A. Gomez arrived unannounced to conduct 1-Year Annual Required inspection. LPA met with Administrator, Heidi Yrreverre and explained the purpose of the visit. The facility’s fire clearance was approved for 36 non-ambulatory of which 4 may be bedridden in any room. LPA toured the facility with Administrator including but not limited to 5 residents apartments, bathrooms, multiple activity rooms, kitchen, common area and courtyard. There are no bodies of water observed. LPA observed lighting in all rooms are adequate for the comfort and safety of the residents. Hallway temperature was maintained at 70 degrees F. LPA observed lighting in all rooms are adequate for the comfort and safety of the residents. The hot water temperature in a sample of residents’ shared bathroom were measured at 105, 106.1, 105.7 degrees Fahrenheit. Residents’ bathrooms are equipped with grab bars and non-skid mats. There is a minimum of one week supply of nonperishable and 2-day of perishable foods. Centrally stored medications, sharps and toxic are locked and inaccessible to residents in care. Fire extinguisher was last serviced on 4/8/2025. Emergency Disaster Plan was last posted on 1/30/2025. First aid kit was observed to be complete. Emergency disaster drill was last conducted on 10/25/2025. LPA reviewed 5 residents records. LPA reviewed 5 staff records and 5 of 5 have current first aid training and associated to the facility. LPA reviewed a sample of resident’s medications. No deficiencies cited during visit. Exit interview conducted and a copy of this report provided.

An announced Pre-licensing Comp III associated with Pre-Licensing Inspection done on 12/16/2024 at 11:00 AM was conducted by Licensing Program Analyst (LPA) A Gomez. Comp III was attended by Applicant, Alphie De Guzman. LPA concluded Comp III. No citation made during this visit. Exit interview conducted and a copy of this report provided.

On 12/16/2024 at 9:00AM, Licensing Program Analyst (LPA) A. Gomez arrived unannounced to conduct a second unannounced pre-licensing visit. LPA met with Backup Administrator, Heidi Yrreverre and explained the purpose of the visit. Applicant, Alphie De Guzman arrived at 10:00AM. The facility currently has 19 residents and is approved for 4 bedridden. LPA inspected the issues that were noted during the first pre-licensing visit. All issues are corrected and observed. LPA is requesting that facility sends an updated facility sketch to reflect the rooms being utilized by staff. No Issues were noted during inspection. LPA observed that facility is ready to be licensed. This report will be submitted to the Central Applications Unit (CAU) and a final review of the application will be conducted. This facility is not yet licensed and is subject to final approval by CAU. Additional requirements may still be required. Exit interview conducted with Administrator and a copy of this report provided. COMP III will be conducted

On 11/13/2024 at 12:00PM, Licensing Program Analysts (LPAs) A. Gomez and K Nguyen arrived unannounced to conduct Pre-Licensing inspection. LPA met with Backup Administrator, Heidi Yrreverre and explained the purpose of the visit. Applicant arrived later during visit. The facility currently has 19 residents and is approved for 4 bedridden. LPAs toured the facility with the Administrator . Physical plant is consistent with the facility sketches submitted to Centralized Application Bureau (CAB). There is no body of water. Bedrooms were observed appropriately furnished with adequate lighting. Supplies of towels, bed sheets, linens were adequate. Equipment and supplies for residents' personal hygiene were available and on site. Food supplies were observed adequate for seven days of non-perishables. Facility is equipped with refrigerator, microwave, dishwasher, washer and dryer. Storage where knives and medications is centrally stored was observed. Fire extinguisher inspected April 12, 2024. Random residents bathrooms hot water temperature was tested and measured at 111.8, 110.3, 107.4, and 113 degrees Fahrenheit. Carbon monoxide and smoke detectors were observed operational. report continues on LIC 809-C 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 LPAs observed the following: Ripped screen in room 29 sliding door Room 20 needs Oxygen signs Food is not being stored properly in kitchen Kitchen staff has no indicators for residents with special diets Hot water dispenser that is dangerously hot to touch located in Activity/Dining Area Laundry room being used for other storage Outside gates and doors need to be locked Update all resident Update all staff files. Applicant to submit proof by December 2, 2024 showing all the 9 items are corrected. LPA will inform CAB analyst upon receipt of proof of corrections. Final review of application, and license to be granted by CAB analyst. Exit interview conducted and copy of this report provided.

: Component II completion: Successful Facility Type: RCFE Application Type: CHOW Capacity: 36 Census (if any clients in care):18 COMP II Participants: Joseph Oliva (administrator), Alphie De Guzman (applicant/licensee) Interview Method: Microsoft Teams On 10/24/24, 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 readiness