306006155-6-30-2026-22-AS-WVAS-DVJQE8-20260630120555

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 306006155
Report Date: 06/30/2026
Date Signed: 06/30/2026 12:06:07 PM

Document Has Been Signed on 06/30/2026 12:06 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
ORANGE COUNTY RO, 770 THE CITY DR., SUITE 7100
ORANGE, CA 92868

FACILITY NAME:	COTTAGES AT ARTESIA ANAHEIM, THE		FACILITY NUMBER:	306006155
ADMINISTRATOR/ DIRECTOR:	RODGERS, NORA		FACILITY TYPE:	740
ADDRESS:	8792 CERRITOS AVENUE		TELEPHONE:	(657) 256-1062
CITY:	ANAHEIM	STATE: CA	ZIP CODE:	92804
CAPACITY: 38		CENSUS: 36	DATE:	06/30/2026
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	08:00 AM
MET WITH:	Nora Rodgers (Administrator)		TIME VISIT/ INSPECTION COMPLETED:	12:20 PM

NARRATIVE
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	On today's date Licensing Program Analyst (PA) William Vanegas made an unannounced inspection for the purposes of conducting an annual inspection. Upon arrival LPA was greeted and granted entry to the facility by care giving staff. Administrator was available to assist with the annual inspection. LPA explained the purposes of the visit and began to conduct a tour of the facility, and observed the following. Administrator (AD) Nora Rodgers has a valid administrator certificate valid from February 25, 2025 through January 12, 2027. The facility consists of one large two storied building that is equipped with nineteen resident bedrooms that are all shared. Resident bedrooms are equipped with jack and jill restrooms, and shared restrooms. The second floor of the building is occupied the facility owner and their family. Additionally the facility is equipped with a laundry room, staff office, dinning room, kitchen, medication room, storage rooms, and a shaded courtyard to participate in outdoor activities upon resident request. At the time of the inspection the facility presented to be clean and sanitary. No debris or mildew were noted in resident restrooms, kitchen area, or dining room area. Medications, hazards, and sharps were all locked away and inaccessible to residents in care. LPA observed resident bedrooms to be free of any hazards, mildew and debris. Bedrooms were observed to be large enough to walk about freely, and accommodate all required furnishings. Bedrooms were observed to be equipped with required furnishings including: A bed, clean linens in good repair; meaning no strains or tears, a reading lamp, a chair, a chest of drawers, and enough storage space to store personal belongings. CONTINUED ON LIC809-C

NAME OF LICENSING PROGRAM MANAGER: Kevin Saborit-Guasch
NAME OF LICENSING PROGRAM ANALYST: William Vanegas
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 06/30/2026

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/30/2026

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)

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California Health & Human Services Agency

California Department of Social Services

FACILITY EVALUATION REPORT California law requires a public report of each licensing visit/inspection. This report is a record for the facility and the licensing agency. This report is available for public review; therefore, care is taken not to disclose personal or confidential information. Inquiries concerning the location, maintenance, and contents of these reports may be directed to the Licensing Program Analyst or Regional Office whose address and telephone number are listed on the front of this form.

DEFICIENCIES A deficiency is an instance of noncompliance with licensing requirements, including applicable statutes, regulations, interim licensing standards, operating standards, and written directives. Applicants/ licensees must be notified in writing of all licensing deficiencies. Deficiencies are listed on the left side of this form, and the applicable licensing requirement upon which the deficiency is identified. There are two types of deficiencies:

Type A deficiencies are violations of licensing requirements that, if not corrected, have a direct and immediate risk to the health, safety, or personal rights of persons in care.

Type B deficiencies are violations of licensing requirements that, without correction, could become a risk to the health, safety, or personal rights of persons in care, a recordkeeping violation that could impact the care of said persons and/or protection of their resources, or a violation that could impact those services required to meet the needs of persons in care.

PLANS OF CORRECTION (POCs) The licensing agency is required to establish a reasonable length of time to correct a deficiency. In order to set the time, the licensing agency must take into consideration the seriousness of the violation, the number of persons in care involved, and the availability of equipment and personnel necessary to correct the violation. Applicants/licensees are requested to provide a specific plan for each violation on the right side of the form across from each deficiency. The more specific the plan, the less chance exists for any misunderstanding in setting time limits and reviewing corrections. The applicant/licensee who encounters problems beyond their control in completing the corrections within the specified time frame may request and may be granted an extension of the correction due date by the licensing agency.

CORRECTION NOTIFICATION The applicant/licensee is responsible for completing all corrections and promptly notifying the licensing agency of corrections. Applicants/licensees are advised to keep a dated copy of any correspondence sent to the licensing agency concerning corrections, or if corrections are telephoned to the licensing agency, the date, person contacted, and information given.

CIVIL PENALTIES The licensing agency is required by law to issue a Penalty Notice, when applicable, to all facilities holding a license issued by the licensing agency, or subject to licensure, except Certified Family Homes, Resource Families, and Foster Family Homes, or any governmental entity.

PENALTY NOTICE GIVEN The statement concerning civil penalties serves as a penalty notice on this Licensing Report and failure to correct cited licensing deficiencies will result in civil penalties. Applicants/ licensees are required to pay civil penalties when administrative appeals have been exhausted and in accordance with any payment arrangements made with the licensing agency.

APPEAL RIGHTS The applicant/licensee has a right without prejudice to discuss any disagreement in this report with the licensing agency concerning the proper application of licensing requirements. The applicant/ licensee may request a formal review by the licensing agency to amend or dismiss the notice of deficiency and/ or civil penalty. Requests for review shall be made in writing within 15 business days of receipt of a deficiency notification or civil penalty assessment. Licensing deficiencies may be appealed pursuant to the procedures in the LIC 9058 Applicant/Licensee Rights.

AGENCY REVIEW The licensing agency review of an appeal may be conducted based upon information provided in writing by the applicant/licensee. The applicant/licensee may request an office meeting to provide additional information. The applicant/licensee will be notified in writing of the results of the agency review within 60 business days of the date when all necessary information has been provided to the licensing agency.

EMAIL REQUIREMENT Adult Community Care Facilities, Residential Care Facilities for the Chronically Ill, and Residential Care Facilities for the Elderly are required to provide and maintain an active email address of record with the licensing agency.

LIC809 (FAS) - (09/23)

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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
ORANGE COUNTY RO, 770 THE CITY DR., SUITE 7100
ORANGE, CA 92868

FACILITY NAME: COTTAGES AT ARTESIA ANAHEIM, THE	FACILITY NUMBER: 306006155
	VISIT DATE: 06/30/2026

NARRATIVE

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LPA observed resident restrooms to be clean and sanitary. Water faucets and toilets tested operational, and restrooms had all required furnishings such as: A shower chair, slip resistant floor matts, and grab bars. Hot water temperature tested between 105.8 and 106.1 degrees Fahrenheit. LPA reviewed smoke detector and carbon monoxide detector test log. Test conducted on November 25, 2025 by Sphinx Alarm & Communications Systems. Test log indicates that test conducted on this date passed and smoke detectors and carbon monoxide detectors tested operational. LPA observed all fire extinguishers to be fully charged and have an updated service tag on them.

LPA observed the facility to have a two day supply of perishable food and seven day supply of non-perishable food on hand; along with a sufficient amount of emergency water. LPA reviewed first aid kit and observed for it to have all required items such as: Adhesive tape, scissors, tweezers, bandages, thermometer, and a first aid manual. LPA conducted a tour of the exterior of the facility and observed the following: Exterior of the facility presented to be clean and free of any obstructions a long exit routes. Exterior is equipped with an outdoor shaded sitting area, and side doors were observed to be self latching and unlocked.

LPA reviewed four staff files and four resident files. All files (Staff and Resident) Had all required documents. Staff training was up to date and documented correctly. LPA reviewed medications with AD. Per LPA review medications reviewed are being documented correctly and being administered per physicians orders. Based on observations made during today's inspection no deficiencies will be issued per title 22 chapter 6 division 8 of the California Code of Regulations. An exit interview was conducted with AD Nora Rodgers, and a copy of this report was provided to the facility.

NAME OF LICENSING PROGRAM MANAGER: Kevin Saborit-Guasch
NAME OF LICENSING PROGRAM ANALYST: William Vanegas
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 06/30/2026

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/30/2026

LIC809 (FAS) - (06/04)

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