Green Villa

Type of visit: Required - 1 Year

On 2/19/26 Licensing Program Analyst (LPA) J. Leffall arrived unannounced to conduct an Annual Inspection. LPA introduced self, stated the purpose of the visit, and was greet by Staff (S1) Ralph Valencia, LPA was granted entry. 6 residents were present during inspection. House Manager (HM) Mary Magpili and Administrator (A1) Carlo Santos arrived shortly after LPA’s arrival. LPA toured facility with HM. The facility was observed to be at a comfortable temperature, clean, in good repair, and no passageway obstructions or fire hazards were observed inside. An adequate supply of perishable and non-perishable food was observed. Samples of resident’s medications were checked and observed locked in kitchen drawer and cabinet. Clients’ MARS was reviewed. One medication was administered per staff but not initialed by staff after administering on 2/18/26. Samples of medications reviewed. Fire extinguisher reviewed with a service date of: 2/4/26. Fire drill completed on 1/20/26. Clients' bedrooms were toured and reviewed. Cleaning chemicals were observed stored and locked in closet. Residents bedrooms observed to be adequately furnished with bed, dresser, and adequate lighting. All bathrooms are toured and observed to be operational. Hot water temperature was tested at a range of 105.2 to 110.4 degrees in 2 bathrooms. Outside of facility toured. Outside observed free of debris. Side gate was self-closing and self-latching. Outside was observed with adequate outdoor seatings available for clients. Freezer temperature observed at 0 degrees F and refrigerator temperature maintained at 40 degrees F. Smoke detectors and carbon monoxide were tested and observed to be operational. All clients’ files and staff’s files reviewed to have all the required documents. Report continued on LIC 809-C............... The following deficiencies are being cited on the attached 809D in accordance with California Code of Regulations, Title 22, Division 6. Exit Interview conducted. LPA is requesting the following documents be submitted to the Fresno CCL office by 3/5/26: Current copy of Administrator Certificate, Designation of Facility Responsibility (LIC308), Administrator Organization (LIC 309), Affidavit regarding Client/Resident Cash Resources (LIC 400), Liability Insurance-RCFE, Emergency and Disaster Plan (LIC 610E), Personnel Report (LIC500), Register of Facility Clients/Residents for (LIC9020A) A copy of this report with Appeal Rights were provided to Administrator, whose signature on this form confirms receipt of these report.the state’s words, verbatim · CDSS document, Feb 19, 2026

Type of visit: Case Management - Deficiencies

On 12/15/25 at 9:30 am Licensing Program Analyst (LPA) J. Leffall conducted a case management regarding an Incident report received by the Department. LPA met with House Manager (HM) Mary Magpili and stated purpose of visit. Administrator Carlo Santos was contacted by phone call. The department conducted interviews and reviewed records. Based on information staff failed to seek timely medical attention for R1. The following deficiency is being cited on the attached 809D in accordance with California Code of Regulations, Title 22, Division 6. Exit interview conducted. A copy of this report along with appeal rights was provided to Administrator whose signature confirms receipt of this report.the state’s words, verbatim · CDSS document, Dec 15, 2025

From the deficiency page — Deficiency type: Type B · Section cited: CCR 8741(d)(5) · Plan of correction due date: Dec 29, 2025

(d) All personnel shall be given on the job training or have related experience in the job assigned to them. This training and/or related experience shall provide knowledge of and skill in the following, as appropriate for the job assigned and as evidenced by safe and effective job performance: (5) Knowledge necessary in order to recognize early signs of illness and the need for professional help. Based on observation, record review and interview, the licensee did not comply with the section cited above. Staff did not seek timely medical attention which poses a potential health, safety or personal rights risk to persons in care.the state’s words, verbatim · CDSS document, Dec 15, 2025

Plan of correction: Licensee will exercise appeal rights and submit to CCLD RO office.

Type of visit: Required - 1 Year

On 2/19/25 Licensing Program Analyst (LPA) J. Leffall arrived unannounced to conduct an Annual Inspection. LPA introduced self, stated the purpose of the visit, and was greet by Staff (S1) Nicandro Sunga, LPA was granted entry. 5 residents were present during inspection. Administrator (A1) Carlo Santos arrived shortly after LPA’s arrival. LPA toured facility with S1. The facility was observed to be at a comfortable temperature, clean, in good repair, and no passageway obstructions or fire hazards were observed inside. An adequate supply of perishable and non-perishable food was observed. Samples of resident’s medications were checked and observed unlocked in kitchen drawer and cabinet. Clients’ MARS was reviewed. Samples of medications reviewed. Fire extinguisher reviewed with a service date of: 2/18/25. Fire drill completed on 1/11/25. Clients' bedrooms were toured and reviewed. Cleaning chemicals were observed stored and locked in closet. Residents bedrooms observed to be adequately furnished with bed, dresser, and adequate lighting. All bathrooms are toured and observed to be operational. Hot water temperature was tested at a range of 112.8 to 119.6 degrees in 3 bathrooms. Outside of facility toured. Outside observed free of debris. Side gate was self-closing and self-latching. Outside was observed with adequate outdoor seatings available for clients. Freezer temperature observed at 10 degrees F and refrigerator temperature maintained at 42 degrees F. Smoke detectors and carbon monoxide were tested and observed to be operational. All clients’ files and staff’s files reviewed to have all the required documents. No deficiencies issued during this inspection. Exit Interview conducted. LPA is requesting the following documents be submitted to the Fresno CCL office by 3/5/25: Current copy of Administrator Certificate, Designation of Facility Responsibility (LIC308), Administrator Organization (LIC 309), Affidavit regarding Client/Resident Cash Resources (LIC 400), Liability Insurance-RCFE, Emergency and Disaster Plan (LIC 610E), Personnel Report (LIC500), Register of Facility Clients/Residents for (LIC9020A) A copy of this report and LIC-9102 were provided to A1, whose signature on this form confirms receipt of these report.the state’s words, verbatim · CDSS document, Feb 19, 2025

The state marks this report as 5 pages; the online copy we transcribed has 2. You can request the full file from the county licensing office.

Allegation investigated: Resident sustained unexplained injuries and bruises due to staff neglect

The Department conducted interviews and reviewed records. Based on records reviewed, R1 unwitnessed fall and was transported to the hospital. Interviews conducted indicated R1’s skin condition/skin tears were consistent with her behaviors. The allegation is Unfounded and we have therefore dismissed the complaint. Exit interview was conducted. Unfoundedthe state’s words, verbatim · CDSS document, Mar 6, 2024 · control 24-AS-20231205081924

Type of visit: Required - 1 Year

On 2/20/204, Licensing Program Analyst (LPA) M. Medina conducted an unannounced Annual Required Inspection. LPA arrived, introduced self, and allowed entrance by Administrator, Carlo Santos. All residents were present during today's inspection. Facility toured with Administrator. Facility observed to be clean, odor free, and a comfortable temperature. All resident bedrooms are private, rooms observed to have required furnishings. Bathrooms observed to have grab bars near toilet, and showers observed to have shower chairs, non-skid mats, and grab bars. Water temperature measured at 119 degrees F. Additional linen observed in hallway closet. Living room and dining room have adequate seating for residents. Kitchen toured, knives observed to be locked and secured in drawer near kitchen sink. Facility observed to have a 2-day supply of perishable food and a 7-day supply of non-perishable food available. Pantry is located in hallway. Medications are locked and secured in small cabinet near refrigerator and inaccessible to residents. All medications observed to have original labels and to be administered as prescribed. Carbon monoxide and smoke detectors present and observed operational during today's inspection. Fire extinguisher present with a service date of 2/20/24. Last fire drill was conducted 1/11/24 according to facility records. Outside of facility toured. Perimeter is secured with self-latching gate. There are two sheds in the backyard and observed to be locked and inaccessible to residents. Staff and resident files reviewed. No deficiencies observed during inspection.the state’s words, verbatim · CDSS document, Feb 20, 2024

Type of visit: Office

On 12/13/2023 an Office Meeting was held. Present at the meeting was: Regional Office Manager, Brenda White Licensing Program Manager, See Moua Licensing Program Analyst, Mary Garza Administrator, Marlene Galvez Administrator, Delia Galvez Administrator, Carlo Santos Direct Care Staff, Maricris "Mari" Magpili Direct Care Staff, Nicandrosunga Sungh The purpose of the meeting was to discuss what occurred when the LPA visited the facility on 12/5/2023 to open a complaint. During the meeting, LPM and RM discussed: - the expectation and professional conduct of the Department’s LPAs - the reason why complaints are opened under Personal Rights - how inspections are conducted Licensees, Administrators, and staff were informed that: - at no time should LPAs be deny entry - LPAs can take photos to assist in inspections Licensees, Administrators, and staff communicated their concerns with the LPA and what happened during LPA’s inspection to the facility and how they felt in their interactions with the LPA. RM, LPM, and LPA communicated that the intent of the Department is to remain professional and to continue to work with all parties. Exit interview completed. A copy of this report was provided.the state’s words, verbatim · CDSS document, Dec 13, 2023