TLC Home Care 1

Type of visit: Required - 1 Year

On 01/08/2026, Licensing Program Analyst (LPA) J.Duarte and LPA S. Doucette, arrived unannounced to conduct an annual inspection. LPAs introduced self, stated the purpose of the visit, and were greeted by staff. LPAs were granted entry. Staff contacted Administrator Rodrigo Arrieta and he arrived shortly after. LPAs toured the facility with Administrator Rodrigo and Staff Teresa Reyes. The facility was observed to be at 72 degrees F, clean, in good repair, and no passageway obstructions or fire hazards were observed. The common areas were well lit with adequate seating for residents. The facility had a two-day supply of perishable and seven-day supply non-perishable food. Chemicals and sharps were observed locked in kitchen cabinets. Medications and the first aid kit were also observed in a locked kitchen cabinet. LPAs observed the door from the dining room into the laundry room was locked and the laundry room, leads to the staff office, which is a fire exit (Exit #3 on the sketch). The hot water in the restrooms measured 105.5 and 109.5 degrees F. Resident bedrooms were toured and LPAs observed a second bed in R3's room being utilized to block R3's closet, to keeep R3 from accessing their closet space. The facility conducts their own laundry and has a washer and dryer. Detergent and chemicals were observed stored in the laundry room. A second fridge was observed in the garage. LPAs observed refrigerated medication is stored in a a lock box with no lock in a fridge in the garage. The garage is also kept unlocked. Continued in LIC 809-C. Continued from LIC 809. Resident’s medications were reviewed along with the MARs. LPAs observed the start date for R1's Losartan medication was on 12/18/25. Started with 30 pills, has eight pills left. Medication Hydrochlorothiazide has the same start date of 12/18/25 and started with 30 pills; however, has nine pills left. Both medications are administered in the morning according to the MARs log. Medication Hydrochlorothiazide has one extra pill that was not administered. Facility staff did not log on the centrally stored log, R1's medication of Doxazosinmesylate.S4 stated that they ran out of R1's Doxazosin Mesylate which was supposed to be administered at 5 PM. Facility has not received medication, causing a medication error. R3 and R4 do not have hospice care plan in their files. R1 has a hospice care plan which indicates facility staff are to take R1's blood pressure; however, there is no log indicating care is being provided. Care plan states facility supposed to seek medical attention if blood pressure is high; however, facility does not have a guide to instruct staff on when to seek medical attention. A fire extinguisher was observed with a service date of 09/17/2024. The last fire drill was completed on 10/22/25, per staff records. Smoke and carbon monoxide detectors were tested and observed to be operational. Staff files were observed to be complete with criminal record statement and health screening. Resident files were observed to be complete with physician reports. A deficiency is being cited on, see LIC 809D. A Repeat civil penalty was assessed and issued for fire clearance. A repeat civil penalty was assessed and issued for not locking centrally stored medications. Community Care Licensing (CCL) is always striving to have facility files that reflect the most accurate & up to date information for your facility. In an effort to maintain your facility file, please submit the most current & complete forms &/or information as identified below: Residential Care Facility for the Elderly (RCFE): · LIC 308 Designation of Facility Responsibility · -as applicable: LIC 309 Administrative Organization · -as applicable: LIC 400 Affidavit Regarding Client/Resident Cash Resources · -as applicable: LIC 402 Surety Bond · LIC 500 Personnel Report · LIC 610E Emergency Disaster Plan For Residential Care Facilities For The Elderly · LIC 9020 Register of Facility Clients/Residents · Copy of current Liability Insurance · Copy of current Administrator Certificate · Alternate contact information including name, telephone number, & email address. Please submit the above forms/information to Fresno CCL by: 01/15/2025. An exit interview was conducted and a plan of corrections was developed with the administrator. A copy of this report and appeal rights were provided to the administrator.the state’s words, verbatim · CDSS document, Jan 8, 2026

Allegation investigated: Staff are locking resident in bedroom. Staff does not ensure resident is provided clean linen.

On 10/15/25, Licensing Program Analysts (LPAs) J. Duarte and M. Medina, conducted the 10-day complaint investigation visit to the facility. LPAs met with Direct Care Staff (DCS). Administrator, Rodrigo Arrieta, was contacted via telephone and he arrived shortly after. During the complaint investigation, LPAs conducted a facility tour, conducted interviews, and reviewed documentation received. Based on interviews and review of documentation, Resident One (R1) was locked in bedroom due to wandering. Per information gathered during interviews, staff stated that R1 had a mattress on the floor without linen because R1 removes all linen and bedding, and goes under the bed, so the mattress was placed on the floor to avoid potential injury. The preponderance of evidence standard has been met; therefore, the above allegations are found to be SUBSTANTIATED. Per California Code of Regulations, Title 22, Division 6, Chapter 8, a deficiency is being cited on the attached 9099-D Substantiatedthe state’s words, verbatim · CDSS document, Oct 15, 2025 · control 24-AS-20251011213720

From the deficiency page — Deficiency type: Type A · Section cited: CCR 87468.1(a)(3) · Plan of correction due date: Oct 16, 2025

87468.1 Personal Rights of Residents in All Facilities (a) Residents in all residential care facilities for the elderly shall have all of the following personal rights: (3) To be free from punishment, humiliation, intimidation, abuse, or other actions of a punitive nature, such as withholding residents’ money or interfering with daily living functions such as eating, sleeping, or elimination. This requirement was not met as evidenced by: Based on interviews, observation, and review of documentation: R1 was locked in bedroom due to wandering. In addition, R1 had a mattress on the floor without linen because R1 removes all linen and bedding, and goes under the bed, so the mattress was placed on the floor to avoid potential injury.the state’s words, verbatim · CDSS document, Oct 15, 2025

Plan of correction: LPA observed R1 to have a hospital bed and linen available. Licensee stated that the locks will be removed from R1's bedroom by POC due date of 10/16/25 and email proof to LPA.

Type of visit: Case Management - Other

On 10/15/2025, Licensing Program Analysts (LPAs) M. Medina and J. Duarte conducted a Case Management visit to document observations made during complaint visit. LPAs arrived, introduced themselves and allowed entrance by direct care staff. Licensee/Administrator, Rodrigo Arrieta contacted by telephone and arrived a short time later to conduct visit with LPAs During complaint visit, it was observed that Staff 1 (S1) has been working daily since 10/10/2025, fingerprint cleared but not associated to facility. LPA's observed that the front door auditory alarm was in place but not in the "on" position upon arrival. Four of four exit doors from resident bedrooms did not have auditory alarms, and the sliding door to back yard had an auditory alarm that was not "on" during inspection. LPA's observed a small clear bin in the kitchen with several medication bottles belonging to staff 2 (S2) in the kitchen area unsecured and accessible to residents. LPAs also observed a family member of R1 arrive and remove medication from refrigerator to administer an injection, medication was not locked and secured. LPAs also observed the cabinet beneath kitchen sink to be unlocked and accessible to residents, which contains cleaning supplies. Based on today's case management visit, and per CCR Title 22, deficiencies are being cited on the attached 809-D. Immediate civil penalties are being assessed in the amount of $500 for Caregiver transfer request, and $500 for fire clearance totalling $1000. If not corrected, the violations will have a direct and immediate risk to the health, safety, or personal rights of clients in care. Exit interview conducted. A copy of this report and appeal rights provided to Administrator during visit.the state’s words, verbatim · CDSS document, Oct 15, 2025

From the deficiency page — Deficiency type: Type A · Section cited: CCR 87202(a) · Plan of correction due date: Oct 16, 2025

(a) All facilities shall maintain a fire clearance approved by the city, county, or city and county fire department, or district providing fire protection services, or the State Fire Marshal. Prior to accepting or retaining any of the following types of persons, the applicant or licensee shall notify the licensing agency and obtain an appropriate fire clearance approved by the city, county, or city and count fire department, or district providing the fire protection services, or the State Fire Marshal. ***This was not met as evidenced by 3 of the 4 designated exits from resident rooms were locked requiring key to exit.the state’s words, verbatim · CDSS document, Oct 15, 2025

Plan of correction: Licensee to change locks to open from interior of bedrooms. Licensee to submit plan of correction to department by due date. IMMEDIATE CIVIL PENALTY ASSESSED

From the deficiency page — Deficiency type: Type A · Section cited: CCR87355(e)(3) · Plan of correction due date: Oct 16, 2025

(e) All individuals subject to a criminal record review pursuant to Health and Safety Code Section 1569.17(b) shall prior to working, residing or volunteering in a licensed facility(3) Request a transfer of a criminal record clearance as specified in Section 87355(c) or : **This was not met as evidenced by Staff 1 (S1) is fingerprint cleared and not associated to facility. S1 has worked daily since 10/10/25 for a total of 5 days.the state’s words, verbatim · CDSS document, Oct 15, 2025

Plan of correction: Licensee to submit LIC 9182 to department and associate S1 to facility and submit plan of correction to department by due date. IMMEDIATE CIVIL PENALTY ASSESSED

From the deficiency page — Deficiency type: Type A · Section cited: CCR 87309(a) · Plan of correction due date: Oct 16, 2025

(a) Except as specified in subsection (b), the licensee shall ensure that disinfectants, cleaning solutions, poisonous substances, knives, matches, tools, sharp objects, and other similar items which could pose a danger to residents are in locked storage and are not left unattended if outside the locked storage. ***This was not met as evidenced by LPAs observed a clear bin with S2's medication in the kitchen unsecured. Medication for R1 in the refrigerator unsecured and cabinet under kitchen sink with cleaning supplies unlocked. All accessible to residents.the state’s words, verbatim · CDSS document, Oct 15, 2025

Plan of correction: S2 secured medication in locked staff room and R1's family removed medication to keep at home during visit. Staff also locked cabinet under sink. DEFICIENCY CLEARED AT TIME OF VISIT. ,

From the deficiency page — Deficiency type: Type A · Section cited: CCR87705(d) · Plan of correction due date: Oct 16, 2025

(d) The licensee shall ensure that the facility has an auditory device or other staff alert feature to monitor exits on exterior doors and perimeter fence gates accessible to those residents who may be at risk for elopement, as defined in Section 87101, Definitions. ***This was not met as evidenced by: LPA's observed that the front door auditory alarm was in place but not in the "on" position upon arrival. Four of four exit doors from resident bedrooms did not have auditory alarms, and the sliding door to back yard had an auditory alarm that was not "on" during inspection.the state’s words, verbatim · CDSS document, Oct 15, 2025

Plan of correction: Licensee/Administrator to add auditory alarms to all exit doors and keep them on. All auditory alarms must remain "on" at all times. Plan of correction to be submitted to Fresno Regional office by due date.

Type of visit: Office

On this date, an Informal Office Meeting was conducted at the Regional Office with the Licensee. The meeting was scheduled to discuss concerns observed by LPA Brown during the Annual Inspection which was conducted 1/28/25. Present during the meeting were: Sergiy Pidgirny, Licensing Program Manager I (LPM) Katie Brown, Licensing Program Analyst (LPA) Licensee/Administrators (AD) Rodrigo Arrieta & Antonia Duadico Fire Clearance change LIC200 was completed during this meeting to initiate a Fire Clearance change to add Bedridden. Technical Support Program (TSP) was discussed and offered. An exit interview was conducted and a signed copy was provided to AD.the state’s words, verbatim · CDSS document, Apr 9, 2025

Type of visit: Case Management - Other

Licensing Program Analyst (LPA) Katie Brown and Licensing Program Manager (LPM) met in the Fresno Regional Office to discuss concerns related to the operation of the facility during the Annual Inspection conducted 1/28/25. LPA and LPA met with Licensee/administrator Rodrigo Arrieta and Antonia Duadico. During this meeting, LPA and ADs discussed the following violations observed: 1.Medication Storage 2. Areas related to the facility being clean, safe and sanitary Deficiencies are being cited in accordance with California Code of Regulations on the attached LIC 809-D. Sections 87465 Incidental Medical and Dental Care and 87303 Maintenance and Operation. An exit interview was conducted and Plan of Correction (POC) developed. A signed copy of this report and Appeal Rights were provided.the state’s words, verbatim · CDSS document, Apr 9, 2025

From the deficiency page — Deficiency type: Type A · Section cited: CCR 87465(h)(2) · Plan of correction due date: Apr 10, 2025

87465 Incidental Medical and Dental Care (h) The following requirements shall apply to medications which are centrally stored: (2) Centrally stored medicines shall be kept in a safe and locked place that is not accessible to persons other than employees responsible for the supervision of the centrally stored medication. Licensee did not ensure resident medications were stored as required. Medication box was observed on a kitchen table and Insulin was found to be refrigerated when orders state at room temp after opening. This poses a potential health and safety risk to residents in care.the state’s words, verbatim · CDSS document, Apr 9, 2025

Plan of correction: AD has agreed to submit a written statement which will include the staff training plan related to medication storage. A in-service sign in sheet and copy of training materials will be sumbmitted after completion of training. Statement will be submitted via email to CCL by POC date.

From the deficiency page — Deficiency type: Type B · Section cited: CCR87303(a) · Plan of correction due date: Apr 16, 2025

87303 Maintenance and Operation (a) The facility shall be clean, safe, sanitary and in good repair at all times..... Maintenance shall include provision of maintenance services and procedures for the safety and well-being of residents, employees and visitors This requirement was not met as evidenced by: Licensee did not ensure: Patio area was unsafe and cluttered, side yard storage which stores tools was unlocked, multiple piles of trash and construction materials in the yard, shower mat was not clean, sharps storage was unsafe for staff. This poses a potential health & safety risk to residents in care.the state’s words, verbatim · CDSS document, Apr 9, 2025

Plan of correction: AD has agreed to schedule a video call with LPA to show that the items listed have been adressed, cleaned or replaced as required. The video call will be scheduled and completed prior to POC date.

Type of visit: Required - 1 Year

LPA Katie Brown arrived at the facility unannounced to conduct the Annual Inspection, Upon arrival, LPA was informed by Staff (S1) Teresa Reyes that Administrator (AD) was available by phone. AD, Rodrigo Arrieta was contacted. LPA spoke to AD on the phone who authorized S1 to meet with LPA and sign the reports. AD was available during the visit for questions. During this visit, LPA toured the facility inside & out. Resident rooms and common areas were clean, in good repair and contained required equipment, furnishings and lighting. LPA observed required items in bathrooms which were clean. LPA observed hygiene items, paper products, towels, extra bedding, and linens which were stored and available for use. The kitchen was found to be clean, in good repair with necessary items and appliances. LPA observed required food supply and paper products. Knives, cleaning/disinfecting supplies and chemicals were locked are stored separate from food. Medications are centrally stored in a locked kitchen cabinet. Overflow medications and medication refrigerator are kept in a locked area. First Aid kit contained required items. Fire extinguishers were found to be charged and were serviced 9/17/24 by Independent Fire & Safety Co. Smoke detectors were observed and tested. Deficiencies are being cited in accordance with California Code of Regulations on the attached LIC 809-D in the areas of: Fire Clearance and Incidental Medical & Dental Care Services. An Immediate $500 Civil penalty is being assessed on the attached LIC421IM An exit interview was conducted and Plan of Correction (POC) developed with AD via phone call. A signed copy of this report and Appeal Rights were provided.the state’s words, verbatim · CDSS document, Jan 28, 2025

Type of visit: Required - 1 Year

Today, Licensing Program Analyst L. Xiong arrived at the facility unannounced to conduct the Annual Inspection. LPA met with Administrator Rodrigo Arrieta and inform him the purpose of the visit. LPAs observed a central entry point with a supply of hand sanitizer and a sign in policy that includes documented routine symptom screening for resident's, staff and visitors. LPA introduced self and allowed entrance by staff. All COVID-19 guidelines are in place. Visitor log-in/temperature check was observed upon entry. LPA toured facility. Facility appeared clean with no obstruction or fire clearance issues. All common areas have adequate seating and lighting. Resident bedrooms toured, rooms observed to have all required accommodations. Kitchen toured, LPA observed a 2-day supply of perishable and a 7-day supply of non-perishable food available for residents. Smoke detector and carbon monoxide detectors observed operational during inspection. Fire extinguisher present with a service date of 2/2023. Water temperature observed to measure at 105 degrees F. No deficiencies were observed.the state’s words, verbatim · CDSS document, Jan 22, 2024