Bright Eyes Retirement Home #5

Type of visit: Office

Licensing Program Analyst(LPA) Mariana Agban and Licensing Program Manager (LPM) Mary Flores conducted an Office Visit Initiated by the Licensee Norma Fabergas. During this visit Norma Fabergas Licensee and husband Francisco Fabergas met with LPA and LPM. The following was discussed during this meeting: Licensee wanted an opportunity to expressed that was not aware about the findings for complaint #31-AS-20251222153757 which were delivered on 09/04/26. Per Licensee they were not discussed during the visit. - Licensee provided appeal documents for deficiency cited on 09/04/26 for complaint #31-AS-20251222153757. LPM let licensee know that the appeal will be reviewed. Exit interview was conducted with Norma Fabergas and Francisco Fabergas Licensee and a copy of this report was provided.the state’s words, verbatim · CDSS document, Sep 15, 2026

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Mariana Agban conducted an Annual Required visit and inspection of the facility. LPA met with staff 1(S1) and explained the reason for the visit. Administrator Anna Fabergas was contacted and arrived shortly after. At approximately 09:40 am, with the assistance of S1, LPA took a tour of the physical plant. Required postings were observed in the entry area. The smoke alarms and carbon monoxide detectors were tested and appeared to function properly. The fire extinguisher is located in the kitchen. The charge date is April 23, 2025. Kitchen: The kitchen appliances and fixtures were functional. LPA found a sufficient amount of perishable and non-perishable food at the facility, properly stored. Knives were stored in a locked drawer in the kitchen. Properly labeled medications were locked in one of the dining cabinets. Bedrooms: There were five (5) bedrooms designated for residents' use. Currently, Room 3 and Room 4 are vacant. All five bedrooms, in use by residents, were properly furnished with appropriate beddings and linens with sufficient lighting. Bathrooms: There were three (3) bathrooms in the facility. Two (2) bathrooms in hallways, which are the main bathrooms, and one (1) bathroom in a private bedroom. All bathrooms were clean, properly supplied, and had functional fixtures. Water temperatures were: 106.2 and 108.5 degrees Fahrenheit. No cleaning supplies or hazardous items were present in each bathroom during the inspection. Common Areas: These included the living rooms and dining area. The common areas were properly furnished. The auditory alarms on all exit doors were on and functional at the time of the visit. The dining room table is large enough to seat the capacity of the facility. Seating, such as couches, where in good repair and seats the capacity of the facility. Surrounding Grounds: Entry/exits were free of obstruction. There was furniture appropriate for outdoor use. The outdoor area was free of hazards. The gate at the side of the home was checked to ensure no locks were installed, and that the exit and passageway were clear for emergency evacuation. (Continue on 809C) Resident Files: LPA conducted a file review of resident records to ensure compliance with licensing forms. Staff Files: LPA also conducted a file review of staff records to ensure forms and training are up to date and in compliance with licensing forms. Medications: Medications and Medication Records were reviewed for proper documentation. Temperature: The Facility maintains a comfortable temperature of 74 degrees Fahrenheit Pursuant to Title 22 Division 6 of the CA Code of Regulations, there were no deficiencies observed during the visit. Exit Interview Conducted and a Copy of the Report Issued.the state’s words, verbatim · CDSS document, Aug 22, 2025

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Mariana Agban conducted an Annual Required visit and inspection of the facility. Upon arrival, LPA was greeted by staff and explained the reason for the visit. Shortly after, LPA met with Administrator Norma Fabergas. A tour of the physical plant was conducted at 10:00 AM. Common Areas: This includes the living room dining areas were appropriately furnished and lighting was adequate. Medications are locked in the dining room cabinet. Medications observed to be locked and inaccessible to residents. The living room has a television and comfortable furniture. Bedrooms: The facility has 7 bedrooms. Six (6) bedrooms designated for residents' use and (1) bedroom designated for staff. All bedrooms were clean, properly furnished and had sufficient lighting. Residents have enough personal hygiene products provided by the licensee. LPA observed enough and clean linen available in cabinets. Kitchen: The kitchen appeared clean and the appliances and fixtures functional. Sharp objects were stored in locked drawers and cabinets. LPA observed fully stocked first aid kit in the dining room cabinet. LPA found a sufficient amount of perishable and non-perishable food at the facility; properly stored in kitchen pantry. LPA observed fire extinguisher to be full with inspection date 04/10/24. Temperature: Facility maintains a comfortable temperature of 75 degrees Fahrenheit. Bathrooms: There were three (3) bathrooms in the facility. Two (2) bathrooms in hallways which are the mains and One (1) bathroom in a private bedroom. All bathrooms were clean, properly supplied and had functional fixtures. Water temperatures were: 110.2 and 111.9 degrees Fahrenheit. All chemical cleaners were locked under the sink cabinet. Laundry Area: located through the kitchen. Appliances observed to be in good repair. All cabinets were locked and thus laundry detergents were inaccessible to residents. LPA observed another fire extinguisher to be full with inspection date 04/10/24. Smoke and Carbon Monoxide: detectors are hardwired, interconnected and observed to be operational. Outdoor Area: facility has outdoor furniture with a covered shaded area for residents and visitors. The facility does not have a swimming pool/body of water. Resident Files: LPA conducted a file review of resident records to insure compliance of licensing forms. (Continue on 809C) Staff Files: LPA also conducted a file review of staff records to insure forms and training are up to date and compliance with licensing forms. Medications: Medication and Medication Records were review for proper documentation. Pursuant to Title 22 Division 6 of the CA Code of Regulations, there were no deficiencies observed during the visit. Exit Interview Conducted and a Copy of the Report Issued.the state’s words, verbatim · CDSS document, Aug 26, 2024