Senior Care Records.

Facility Evaluation Report

Clover Home, Woodland04/09/2026Licence 577004529

Capacity14
Census9
Date signed04/09/2026 03:17:12 PM
Name of licensing program analystJill Nakagawa
Name of licensing program managerKimberley Mota
The inspector’s account

On 04/09/2026 Licensing Program Analyst (LPA) Jill Nakagawa arrived unannounced to conduct an 1-Yr Annual Inspection. LPA met with Program Director Joycelin Singh as the house manager/administrator had suddenly left their employ on 04/05/2026.

At approximately 10:45AM, LPA reviewed the Facility's Staff Roster and found that there were staff on-site who had not yet received their background clearance and/or associated to the facility per regulation.

Facility was toured both indoors and outdoors. LPA inspected the physical plant and food service. The outside of the facility was observed to be in good repair and safe for residents. The bathrooms and showers were clean but one toilet in the men's bathroom was leaking, but operational. Facility was maintained at a comfortable temperature. Required amounts of stored and perishable foods were present. Bedrooms were observed to be in good repair and bedding, storage and lighting were adequate.

LPA will return at a later date to complete the annual inspection and complete the review of staff and resident records.

The following deficiencies were observed and cited from the California Code of Regulations, Title 22, Division 6 of California Regulation. Failure to correct the deficiency and/or repeat deficiencies within a 12 month period may result in civil penalties. A civil penalty in the amount was assessed today for staff S1 not being properly cleared and for staff S2 not being properly associated to this facility.

Exit interview conducted and appeal of rights left and emailed to Licensee. M. Ibarra signed on behalf of Joycelin Singh.

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