Senior Care Records.

Facility Evaluation Report

Aging in the Bay 4, Fairfield07/06/2026Licence 486804180

Capacity6
Census6
Date signed07/06/2026 04:25:09 PM
Name of licensing program analystStar Stevenson
Name of licensing program managerBethany Moellers
The inspector’s account

At approximately 10:00 AM Licensing Program Analyst (LPA) arrived to performing a Change of Ownership inspection for AWU Home Health LLC.

During the inspection for the new license LPA observed the following:

Licensee indicated staff member S1 is very involved with day-to-day operations, but S1 is noted to not have background clearance or Guardian Association to Aging in the Bay 4, Licensee worked with Community Care Licensing to transfer Association from a sister facility. (Technical Violation Issued-See LIC9102 page)

During staff record review licensee needed to have educational records for S2 and S3 emailed during today's case management and a Technical Violation for the requirement of having all records on-site at all time was issued-See LIC9102 page)

In addition during inspection of property four (4) fence boards were observed to need to be replaced to ensure the safety of residents in care (should a small dog move next door for example), as well as, two (2) baseboards need to be replaced in a bathroom to ensure continuous good repair or facility.(Technical Violation Issued-See LIC9102 page)

Finally in observation of the Facilities Medicine Administration Record (MAR) with licensee, it was observed that five(5) of six (6) residents were missing documentation of Medicine Administration for various medicines on 07/05/2026 and a Type A Citation is being issued with a Plan of Correction due by 07/08/2026 (See LIC809-D page)

Source: California Department of Social Services, Community Care Licensing. Methodology · Report a correction