Celebrity Care Home

Type of visit: Required - 1 Year

On 3/23/2026, at 1:21pm, Licensing Program Analyst (LPA) Perry Scott conducted an unannounced annual required inspection visit to Celebrity Care Home. LPA was met by licensee with Maria Bautista, Designated Administrator, and explained the purpose of today’s visit. The facility is licensed to operate for four (4) non-ambulatory and two (2) bedridden elderly residents ages 60 and above. The facility is approved for (3) hospice residents. Currently the facility has (4) residents. The facility’s annual fees are due on 03/26/26 for $495.00. The facility is a single-story structure located in a residential neighborhood. It consists of the following: three (3) bedrooms, two (2) bathrooms, one (1) of which is for residents and one (1) is for visitors and staff. Additionally, there is a living room, kitchen, dining room, attached garage, washer and dryer, and an additional refrigerator for extra food storage, and an outdoor shaded area with patio and chairs. At 1:30pm, LPA and staff toured the facility. There are no bodies of water or firearm/ammunition on the premises. All resident rooms were checked. Beds and bedding were in good condition, adequate lighting provided, and adequate storage for resident personal belongings was observed. Walls and floors were in good repair. Bed linens, comforters, and bath towels were adequately stocked at the time of visit. Bathrooms were found to be within Title 22 regulations. Toilets and water faucets worked properly. The shower was free of mold/mildew, there was adequate lighting, and sufficient toiletries were accessible to clients. The water temperature measured 115.8F degrees in the bathroom. A comfortable temperature is maintained in the facility. Report Continued On LIC809-C LPA observed the facility to be clean, sanitary, and appropriately furnished at the time of visit. Storage areas for cleaning agents, toxins, and sharps were inaccessible to residents. The kitchen was inspected and there is enough perishable and non-perishable food available for the residents. All food items were stored properly. The water temperature measured 117.9F in the kitchen. Medications were centrally stored and properly locked, first aid kit was checked and fully stocked with manual. The fire extinguisher was charged, and the smoke/ carbon monoxide detectors were operable. The last fire/emergency drill was conducted on 11/05/2025. The facility’s administrator’s certificate (7000913740) was valid from 04/26/2025 through 04/25/2027. The facility’s liability insurance was valid from 12/26/2025 through 12/26/2026. LPA conducted a review of (4) resident records, (6) staff records, and reviewed the facility disaster plan. Staff and resident records were complete. The facility disaster plan was current and in compliance with Title 22 at the time of visit. LPA reviewed (4) resident medication administration records, and medication, and did not observe any discrepancies at the time of visit. During the visit, LPA observed the facility infection control practices. LPA observed screening protocols for visitors, staff, and residents. LPA observed that sanitizing stations were in common areas and restrooms. LPA observed that the facility had the required postings, posted throughout the facility. LPA advised the facility to continuously monitor the Centers for Disease Control (CDC) website and Community Care Licensing (www.cdss.ca.gov) for Provider Informational Notices (PIN) and for any updates relating to COVID-19 guidance and other related issues. No deficiencies were cited during this inspection visit. An exit interview was held, and a copy of this Facility Evaluation Report was provided to Maria Bautista, Designated Administrator.the state’s words, verbatim · CDSS document, Mar 23, 2026

Type of visit: Required - 1 Year

On 2/26/2025, at 1:21pm, Licensing Program Analyst (LPA) Perry Scott conducted an unannounced annual required visit using the new CARE Inspection Tool. LPA met with Carmelita Bautista, Licensee, and explained the purpose of today’s visit. The facility is licensed to operate for four (4) non-ambulatory and two (2) bedridden elderly residents ages 60 and above. The facility is approved for (3) hospice residents. Currently the facility has (5) residents. The facilities annual fees are due on 03/26/25 for $495.00. The facility is a single-story home and consists of the following: three (3) resident bedrooms, two (2) bathrooms one (1) of which is for residents and one (1) is for visitors and staff. Additionally, there is a living room, kitchen, dining room, attached garage, washer and dryer, and an additional refrigerator for extra food storage, and an outdoor shaded area with patio and chairs. LPA conducted a records review of four (5) residents records, four (4) staff records, and reviewed the facility disaster plan. All resident & staff records were complete. The facility disaster plan was current and in compliance with Title 22 at the time of visit. The fire/emergency drill was completed on 1/24/2025. LPA reviewed (5) resident Medication Administration Records and medication and did not observe any discrepancies at the time of visit. The facilities administrator certificate was current and expires on 4/25/2025. LPA observed that the facility has current liability insurance which expires on 12/26/2025. At 1:45pm, LPA and the administrator toured the facility. All resident rooms were checked, mattresses and box springs were in good condition, adequate lighting, plenty of dresser and closet space was observed, walls and floors were clean and in good repair, bed linens, comforters and bath towels were fully stocked. Bathrooms were found to be within Title 22 regulation, toilets, and water faucets worked properly, shower was free of mold/mildew, there is adequate lighting, and sufficient toiletries accessible to clients. The water temperature measured between 105-117.3F degrees. Facility Evaluation Report Continued On Page 2 of the LIC809-C Perishable and non-perishable food supply was checked and adequately stocked at time of visit. Carbon monoxide detector was observed and operational. Smoke detectors were working properly, two (2) fire extinguishers were fully charged, one (1) located and mounted in the hallway and one (1) located in the kitchen; toxins and knives were locked and inaccessible to clients. Medications were centrally stored and properly locked, first aid kit was checked and fully stocked, and the first aid manual was up to date. A landline telephone was observed. Outside grounds were toured and no bodies of water were observed. Exits/ Walkways around the home were free of debris and hazards. During the visit, LPA observed the facility infection control practices. LPA observed screening protocols for visitors, staff, and residents. LPA observed that sanitizing stations were in common areas and restrooms. LPA observed that the facility had the required postings, posted throughout the facility. LPA further observed the facility to have a 30-day supply of Personal Protective Equipment (PPE). LPA advised the administrator to continuously monitor the Centers for Disease Control (CDC) website and Community Care Licensing (www.cdss.ca.gov) for Provider Informational Notices (PIN) and for any updates relating to COVID-19 guidance and other related issues. During today’s visit LPA did not observe any deficiencies. An exit interview was conducted, and a copy of the Facility Evaluation Report was provided to Carmelita Bautista, Licensee.the state’s words, verbatim · CDSS document, Feb 26, 2025

Type of visit: Required - 1 Year

On 03/14/2024 at 11 AM, Licensing Program Analyst (LPA) Jose Calderon conducted an unannounced annual inspection visit at the Celebrity Care Home Facility. LPA Calderon was allowed entry into the facility by Administrator Carmelita Bautista. Administrator Carmelita Bautista asked infection control questions and took LPA Calderon temperature prior to entrance into the facility. The facility is licensed to operate for four (4) non-ambulatory and two (2) bedridden elderly residents ages 60 and above. The facility is approved for (3) hospice residents. Currently there is 5 residents in care living at the facility. LPA Calderon explained to Administrator Carmelita Bautista, the purpose of the one-year Annual Inspection visit, and escorted LPA Calderon on a tour of the entire inside and outside facility grounds. As part of the inspection, LPA Calderon reviewed: Five (5) client service records, five (5) client medication records, three (3) staff records, and inspected the inside facility and outside grounds. LPA Calderon interviewed four (4) clients and three (3) staff members for visit. The facilities’ last fire drill was conducted on 02/06/2024. The one-story residential home consists of three (3) client bedrooms, two (2) client bathrooms, living room, dining room, kitchen, staff room, office area, attached garage with washer and dryer/ storage area, backyard with table and chairs. No weapons are stored in the premises. Kitchen was inspected and observed to be clean and operational. A two-day supply perishable and seven-day supply of non-perishable foods are present in the facility. Emergency Water Storage is in the garage and kitchen area. LPA Calderon observed that all facility rooms are clean and in good repair. A comfortable temperature was observed, and the facility has central air and heating. LPA Calderon observed the following during inspection of client’s rooms: mattresses are in good condition, adequate lighting present, plenty of dresser/closet space is present, and all bed linens present. All bedrooms contain furniture, lighting fixtures and personal storage space as required, all beds have the required amount of linen and mattress covers, LPA Calderon observed fully stocked closet with bedding, towels, and toiletries supplies. Bathroom fixtures are clean, in good repair, and working properly and contain the required nonskid mats and grab bars. LPA Calderon observed bathrooms were found to be within Title 22 regulation. Bathroom #1 hot water temperature properly measured at 109 degrees Fahrenheit, and bathroom #2 hot water temperature properly measured at 112 degrees Fahrenheit. Kitchen hot water temperature properly measured at 113 degrees Fahrenheit. Facility (2) Carbon Monoxide and (4) Smoke Detectors hard wired and connected were tested and are working properly. The facility two (2) Fire Extinguishers was checked and found to be fully charged and accessible. All exit doors in the facility have alarm systems. All toxins and knifes are locked/secured and inaccessible to clients. Medications are centrally stored and in a locked storage cabinet. Facility first aid kit is fully stocked with manual was checked and in order. Outside grounds were toured and no bodies of water were observed. All Exits/ Walkways around the home were free of debris and hazards. Outside patio accessible to clients. Five (5) client files were reviewed and found to be complete. LPA Calderon reviewed five (5) resident medications and they were all found to be administered according to doctor's orders. Three (3) staff files were checked and have the required documents. LPA Calderon noted the Administrator Carmelita Bautista Certification # 6003738740 expiration date of 04/25/2023 was NOT valid at time of visit. Administrator Carmelita Bautista states that she applied for her renewal and is in the process of getting her updated Certification. The facility does NOT handle client's money/cash resources and a NO Surety bond is needed. Commercial General Liability Policy #01002751680 policy period from 12/26/2023 to 12/26/2024 underwritten by Kinsale Insurance Company, coverage 1,000,000/3,000,000 is valid at time of inspection. Administrator Carmelita Bautista to email LPA Calderon a full copy of the commercial insurance policy including all endorsements no later than 03/21/2024. All the required documents are posted in the facility in a clearly visible area. During the visit, LPA observed the facility infection control practices. LPA observed screening protocols for visitors, staff, and clients, sanitizing stations (Located in common areas and restrooms). LPA observed staff and clients were NOT wearing face coverings. LPA observed the facility has a 30-day supply of Personal Protective Equipment (PPE). LPA Calderon advised the Administrator Carmelita Bautista to continuously monitor the Centers for Disease Control (CDC) website and Community Care Likening Provider Informational Notices (PIN) for any updates relating to COVID-19 guidance. According to the California Code of Regulations (Title 22, Division 6, Chapter 8), LPA Calderon did not observe deficiencies therefore no citations were issued at this time. Annual Licensing Fee is CURRENT. An exit interview was conducted, and a copy of the Facility Evaluation Report was provided to Administrator Carmelita Bautista.the state’s words, verbatim · CDSS document, Mar 14, 2024