336412449-2-5-2026-18-AS-JSRS-DQZRP6-20260205121126

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 336412449
Report Date: 02/05/2026
Date Signed: 02/05/2026 12:11:43 PM

Document Has Been Signed on 02/05/2026 12:11 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
RIVERSIDE ASC, 1650 SPRUCE ST STE 200 MS29-27
RIVERSIDE, CA 92507

FACILITY NAME:	GUIDING HANDS, RCFE		FACILITY NUMBER:	336412449
ADMINISTRATOR/ DIRECTOR:	LUCIDA JOCSON		FACILITY TYPE:	740
ADDRESS:	29238 GLENCOE LANE		TELEPHONE:	(951) 265-1749
CITY:	MENIFEE	STATE: CA	ZIP CODE:	92584
CAPACITY: 6		CENSUS: 3	DATE:	02/05/2026
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	08:20 AM
MET WITH:	Kristin Chua, 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	Licensing Program Analysts (LPAs) Jacqueline Shaw Ross and Kyle Wellington conducted an unannounced visit to the facility for the purpose of an annual inspection. LPAs was greeted by caregiver Bruna Siadto and explained the purpose of the visit. A tour of the facility was conducted inside and out. At the time of visit, there were three (3) residents home and two (2) staff present. Administrator Kristin Chua arrived shortly.The facility serves six (6) non-ambulatory elderly residents; ages 60 and above, of which two (2) may be bedridden, and is approved for a hospice waiver for six (6). The facility is a five (5) bedroom one story home. One (1) bedroom was observed to be empty, three (3) bedrooms were private occupied, one (1) bedroom was designated for staff. The facility has two and one-half bathrooms. During the tour the following was observed: Residents bedrooms had the required furnishings and were observed to be in good condition. Upon observation of one of bedroom one (1), LPAs observed the residents' private bathroom and closet being used for storage items that did not belong to resident. DEFICIENCY CITED. Bathrooms had required signage, hand rails, non-slip mats. Night-lights were observed in the hallways. Fixtures and furniture for an operational facility are present and in good repair. All passageways were free of obstructions, charged fire extinguishers and the fire alarm system was operable, medications are kept centralized and locked, hazardous chemicals are locked and inaccessible to residents. Hot water was tested and measured 117 degrees.

NAME OF LICENSING PROGRAM MANAGER: Rikesha Stamps
NAME OF LICENSING PROGRAM ANALYST: Jacqueline Shaw Ross
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 02/05/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/05/2026

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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Document Has Been Signed on 02/05/2026 12:11 PM - It Cannot Be Edited

Created By: Jacqueline Shaw Ross On 02/05/2026 at 10:56 AM

Link to Parent Document Below:

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 1650 SPRUCE ST STE 200 MS29-27
RIVERSIDE, CA 92507

FACILITY NAME: GUIDING HANDS, RCFE	FACILITY NUMBER: 336412449
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 02/05/2026

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

CCR

87307(a)

Personal Accommodations and Services

(a) Living accommodations and grounds shall be related to the facility's function. The facility shall be large enough to provide comfortable living accommodations and privacy for the residents, staff, and others who may reside in the facility. The following provisions shall apply: This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	LPAs observed facility items stored in residents private bathroom and closet that were not residents' personal belongings. Based on observation, the licensee did not comply with the section cited above in [1] out of [1] objects ] which poses a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 02/20/2026
	Plan of Correction
1 2 3 4	Facility will move items that do not belong to resident from resident's private bathroom and closet into the facility's garage, by POC Due Date of 02/20/2026.

Section Cited


	Deficient Practice Statement
1 2 3 4
	POC Due Date:
	Plan of Correction
1 2 3 4

Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.

	Rikesha Stamps
NAME OF LICENSING PROGRAM MANAGER:

	Jacqueline Shaw Ross
NAME OF LICENSING PROGRAM ANALYST:

LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 02/05/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/05/2026

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
RIVERSIDE ASC, 1650 SPRUCE ST STE 200 MS29-27
RIVERSIDE, CA 92507

FACILITY NAME: GUIDING HANDS, RCFE	FACILITY NUMBER: 336412449
	VISIT DATE: 02/05/2026

NARRATIVE

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Care & Supervision: Facility has sufficient care staff employed.

Administration: Emergency exiting plans, telephone numbers and Ombudsman information and other required signage are posted throughout the facility. Drills are conducted quarterly.

Record Review and Client/Staff Files: LPAs reviewed current staff and all staff have has Criminal Background Clearance, current CPR/First Aid certification, and trainings are current. Resident records were reviewed and contained required documents including current physician reports, admission agreements and care plans.
Medication Review: LPAs reviewed medication and medication log. Residents' medications are being dispensed according to physician's orders.

Deficiency cited per Title 22, Division 6 of the California Code of Regulations.

An exit interview was conducted and a copy of this report was provided to Administrator Kristin Chua along with Appeals Rights and LIC811.

NAME OF LICENSING PROGRAM MANAGER: Rikesha Stamps
NAME OF LICENSING PROGRAM ANALYST: Jacqueline Shaw Ross
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 02/05/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/05/2026

LIC809 (FAS) - (06/04)

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