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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 342701533
Report Date: 01/02/2025
Date Signed: 01/02/2025 03:06:45 PM

Document Has Been Signed on 01/02/2025 03:06 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO SOUTH ASC, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
FACILITY NAME:ALL OUR LOVE SENIOR HOME, INCFACILITY NUMBER:
342701533
ADMINISTRATOR/
DIRECTOR:		PANEN, ERICAFACILITY TYPE:
740
ADDRESS:30 TEARPAK CTTELEPHONE:
(916) 479-3916
CITY:SACRAMENTOSTATE: CAZIP CODE:
95823
CAPACITY: 6CENSUS: 0DATE:
01/02/2025
TYPE OF VISIT:PrelicensingUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
12:58 PM
MET WITH:Erica PanenTIME VISIT/
INSPECTION COMPLETED:
03:20 PM
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On 01/02/2025 at 12:58 PM, Licensing Program Analyst (LPA) Pang Lee arrived announced to conduct a Pre-Licensing Inspection of the facility to ensure compliance with Title 22 regulations. LPA Lee met with Licensee Ericia Panen and licensee’s spouse Edel Panen. Licensee assisted LPA Lee in today’s inspection. This Applicant is seeking licensure for a 6-bed non-ambulatory Residential Care Facility for the Elderly (RCFE) to accept and retain at any given time, in one of which may be bedridden in bedroom #3. The facility has a waiver granted for 2 hospice care residents. The facility will not have live in staff and provide 24/7 care and supervision at all times. There were no residents at this time.

Ericia Panen will be the Administrator of this facility. The facility administrator’s certificate # 7026719740 and will expire 11/17/25. It was learned that the applicant is pregnant and is expected to be due any day. The applicant will work on finding administrator coverage while the applicant is out on maternity leave. The facility has an infection control plan and an emergency disaster plan completed and provided to Licensing for approval. LPA Lee toured the facility with the applicant. LPA Lee observed a camera in the dining area. It was learned that the camera is not on the facility sketch and plan of operation. The applicant is requesting to have a waiver to obtain cameras in the dinning and common area. The facility interior sketch aligns with the layout of the building. LPA Lee inspected the kitchen area. Cabinets and drawers were opened and reviewed at this time. Silverware, plates, and utensils were observed to be sufficient to meet the needs of the residents at this time. Knives, cleaning agents, and bleach were observed to be locked and made inaccessible to the residents at this time. The food storage unit, facility refrigerator, was observed to be functional and in good repair at this time. Food supplies were reviewed for adequate 2-day perishables and 7-day non-perishable quantities, and they both were observed sufficient. Common area and dining area were observed to be furnished and sufficient to meet the needs of the residents. LPA Lee observed a telephone made available to residents in the common area.

Continued LIC 809-D

SUPERVISORS NAME: Czarrina A Camilon-Lee
LICENSING EVALUATOR NAME: Pang Lee
LICENSING EVALUATOR SIGNATURE: DATE: 01/02/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/02/2025
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 3
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO SOUTH ASC, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
FACILITY NAME: ALL OUR LOVE SENIOR HOME, INC
FACILITY NUMBER: 342701533
VISIT DATE: 01/02/2025
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The facility smoke detectors, carbon monoxide detectors and fire extinguisher were observed to be in good condition. The fire extinguisher was last serviced on 10/22/24. Linen closet was observed sufficient supply of sheets, bedding, pillowcases, and blankets to meet the needs of the residents at this time. Residents’ bedrooms were toured, and furniture and furnishings were observed to be sufficient and able to meet the needs of the residents.

The water temperature measured at 117.1 degrees Fahrenheit, and the facility temperature measured at 68 degrees. LPA Lee advised the applicant that the facility temperature regulations is between 68 * F to 85 * F. LPA Lee observed the centrally stored medication areas to be locked. LPA Lee inspected the first aid kit, and it was complete. LPA Lee observed supplies of hygiene items on the premises made available to residents in care. LPA lee observed facility has a designated area for residents and staff files; however, they are made accessible and not lock. LPA Lee also observed complaint poster PUB 475 posted; however, it needs to be in the size of 20” X 26” per regulation. LPA Lee did observe activity supplies made available for residents at this time. LPA Lee toured garage and the courtyard. LPA Lee observed a shed out in the courtyard. It was observed to have children play items. Per applicant the shed was used for play area for the grandchildren. LPA Lee advise the applicant that the shed cannot be used for play area or for any individual to live in. It was also learned that the shed was not on the courtyard facility sketch. Applicant stated that they are going to use the shed for storage purpose. LPA Lee observed the outdoor equipped for outdoor use. The two emergencies did not have self-closing latches. It was also observed one of the exits was unobstructed with new sliding doors leaning on the side of the wall.

The applicant will work on the following deficiencies observed:

· Licensee/Administrator will ensure that an updated plan of operation to include cameras in the dining area and common area. Plan of operation will also include the purpose of the camera, who can view the camera, how long is the recording and that there is no audio.

· Licensee/Administrator will ensure that an updated facility sketch to include the shed in the courtyard and what the shed will be used for.

Continued LIC 809-C

SUPERVISORS NAME: Czarrina A Camilon-Lee
LICENSING EVALUATOR NAME: Pang Lee
LICENSING EVALUATOR SIGNATURE:

DATE: 01/02/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/02/2025
LIC809 (FAS) - (06/04)
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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO SOUTH ASC, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
FACILITY NAME: ALL OUR LOVE SENIOR HOME, INC
FACILITY NUMBER: 342701533
VISIT DATE: 01/02/2025
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· Licensee/Administrator will ensure that the two-emergency exit has self-closing latches.

· Licensee/Administrator will ensure that the emergency exit is not obstructed and that the new sliding door leaning against the wall is removed.

· Licensee/Administrator will ensure that there is a designated area for staff file made inaccessible.

· Licensee/Administrator will ensure that a complaint poster PUB 475 in the size of 20”X26” is posted.

· Licensee/Administrator will ensure that there is an administrator coverage is in place while the applicant is on maternity leave.

The Applicant has not passed the pre-licensing component of the application process. The applicant will correct issues and inform LPA Lee when the corrections have been completed. An exit interview was conducted, and a copy of this report was provided to the applicant.

SUPERVISORS NAME: Czarrina A Camilon-Lee
LICENSING EVALUATOR NAME: Pang Lee
LICENSING EVALUATOR SIGNATURE:

DATE: 01/02/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/02/2025
LIC809 (FAS) - (06/04)
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