Raywood Villa

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Jose Tan conducted an Annual Required visit and inspection of this facility. LPA met the Administrator Ruel Deleon and explained the reason for the visit. The facility is fire cleared for non-ambulatory residents three (3) of which may be bedridden, hospice waiver for six (6) residents. LPA conducted a physical plant tour at 9:17 AM., and observed the following: Kitchen: LPA observed the kitchen to be clean and clear of clutter. Appliances and fixtures were functional. LPA also observed a 7 day supply of non-perishable amount of food and a 2 day supply amount of perishable food in the facility. Cleaning products were observed to be locked in a the laundry room. Bedrooms: LPA observed a total of five (5) bedrooms designated for residents' use. One (01) bedroom may be shared. An additional one (1) bedroom and one (1) bathroom is designated for staff use. Resident bedrooms were observed clean and free of clutter, properly furnished with appropriate beds, night stands and chairs. Doors in bedrooms leading to the outside had auditory alarms that were observed functional. LPA observed night-lights through out the facility. Bathrooms: There are two (2) bathrooms designated for residents' use. Bathrooms were properly supplied and had functional fixtures. Hot water temperature was measured between 108.3°F. and 117.1°F. Common Areas: These included living room, and the dining area. The common areas were properly furnished. The dining area has a table with chairs to sit the capacity of the facility. The living room has a television with seating that was observed in good repair. LPA observed activities and games for the residents. (continued to LIC 809-C) (continued from LIC 809) Outside/Surrounding Grounds: LPA observed that the entry/exits were free of obstruction. There is a shaded area for residents to use and furniture appropriate for outdoor use. The backyard has a enclosed patio that offers shade for residents. The patio area is sufficient in space for outdoor exercise and activities. There is a fish pond not in use closed and locked with wood and grate. Laundry/Garage: The laundry room leads to the attached garage. The door to the laundry room was observed locked. Cleaning supplies and detergents are kept locked in the garage. The garage is used for facility storage. Smoke detectors/carbon monoxide. All resident rooms are equipped with smoke detectors and the facility's smoke detectors are hard wired and interconnected. The carbon monoxide detector is located in a hallway leading to bedrooms. Detectors were tested by and were observed operational. A fire extinguisher located by the kitchen was observed fully charged and last bought on 05/16/25. Medications: LPA observed medication in the bedroom hallway cabinet and observed to be locked and inaccessible to residents. Medications are listed on the centrally stored medication and destruction record. First aids kits have complete tools and supplies. Client records: Client records are reviewed and appeared to be complete and updated. Staff records: LPA conducted a complete file review of staff record. Staff records appeared to be complete and updated. Disaster drill was last conducted on 02/17/26. Required posting are observed to be complete and current and displayed properly at the facility. Exit interview conducted and copy of this report issued.the state’s words, verbatim · CDSS document, May 16, 2026

Type of visit: Required - 1 Year

On 05/30/2025 Licensing Program Analyst (LPA) Evelin Rios conducted an Annual Required visit and inspection of the facility. The inspection tool was used for todays visit. LPA arrived to the facility and was greeted by staff #1 (S1) who granted access. LPA met the administrator shortly after and explained the reason for the visit. LPA conducted a physical plant tour at 1:17 p.m., and LPA observed the following: At entry LPA observed appropriate postings on the wall near the front door and the hallway leading to residents' bedrooms. Kitchen: In the kitchen LPA observed the kitchen to be clean and clear of clutter. Appliances and fixtures were functional. LPA also observed a 7 day supply of non-perishable amount of food and a 2 day supply amount of perishable food in the facility. LPA observed a second staff, staff#2 (S2) in the facility. LPA observed cleaning products locked in a cabinet under the kitchen sink. Bedrooms: LPA observed a total of five (5) bedrooms designated for residents' use. One (01) bedroom may be shared. Resident bedrooms were observed clean and clear of clutter, properly furnished with appropriate beds, night stands and chairs. Doors in bedrooms leading to the outside had auditory alarms that were observed functional. LPA observed night-lights through out the facility. Bathrooms: There are three (03) bathrooms designated for residents' use. Bathrooms were properly supplied and had functional fixtures. From 1:32 p.m. to 1:35 p.m. LPA took the hot water temperature from two (02) out of three (03) bathrooms and they measured between 114.6 and 118.1 degrees Fahrenheit, within regulation. (Continue on LIC809-C) Common Areas: These included living room, and the dining area. The common areas were properly furnished. The dining area has a table with chairs to sit the capacity of the facility. The living room has a television with seating that was observed in good repair. LPA observed activities and games for the residents. Outside/Surrounding Grounds: LPA observed that the entry/exits were free of obstruction. There is a shaded area for residents to use and furniture appropriate for outdoor use. The backyard has a enclosed patio that offers shade for residents. The patio area is sufficient in space for outdoor exercise and activities. There is a fish pond not in use closed and locked with wood and grate. Laundry/Garage: The laundry room leads to the attached garage. The door to the laundry room was observed locked. Cleaning supplies and detergents are kept locked in the garage. The garage is used for facility storage. Smoke detectors/carbon monoxide. All resident rooms are equipped with smoke detectors and the facility's smoke detectors are hard wired and interconnected. The carbon monoxide detector is located in a hallway leading to bedrooms. Detectors were tested by licensee at 1:35 p.m., and were observed operational. A fire extinguisher located by the kitchen was observed fully charged with service date 04/10/25. From 1:37 p.m. to 2:30 p.m., LPA reviewed three (03) of three (03) resident records and (3) staff records. Records were observed locked in the medication cabinet. Two (02) out of three (03) staff records reviewed did not have health screenings completed with TB test conducted prior to providing care in the facility. LPA collected a copy of the Certificate of Liability Insurance. LPA reviewed administrator certificate, infection control plan and LIC610E. LPA reviewed residents' centrally stored medication and medication records. LPA observed medications are centrally stored and locked in a closet. LPA observed a complete first aid kit in the closet. One (01) out of the (03) residents medication records reviewed did not have a signed, dated written order for PRN medications from a physician on file. Deficiency cited during today’s visit (refer to LIC809-D). Exit interview conducted. Licensee was unable to stay for the duration of the visit and designated Arlina Jarin to sign todays report. Copy of appeal rights and report provided to .the state’s words, verbatim · CDSS document, May 30, 2025

Type of visit: Required - 1 Year

At 10:25 AM Licensing Program Analyst (LPA), Huma Rahimi, conducted an unannounced annual inspection at the facility mentioned above. LPA met with the Licensee Therese Fonseca, and explained the reason for the visit. Physical tour was conducted with the Licensee and LPA observed the following: Census: 0 Kitchen: At approximately, 10:55 AM LPA toured the kitchen area and observed enough supplies of staple non-perishable for minimum one (1) week and perishable for two (2) days at the facility. All knives and sharps observed to be locked in a the kitchen cabinet by the sink. All chemicals and toxins were locked in a cabinet under the sink. LPA observed three fire extinguishers, one in the kitchen area, one in the hallway and one in the garage to be fully charged. Medications: At approximately, 10:59 AM LPA observed medications are centrally stored and locked in a closet in the hallway. Bedrooms: The facility is fire cleared for six (6) non-ambulatory residents. LPA observed total of five (5) bedrooms designated for resident's use. There is no staff room. Bedroom # five (5) is shared and all other bedrooms are private. All bedrooms are properly furnished, clean and have appropriate bedding and linens. Facility has awake staff. Bathrooms: LPA observed three (3) bathrooms and both appeared to be clean and in good repair. Properly supplied with toilet papers, soap and paper towels. LPA observed appropriate grab bar and resident's bathroom had non-skid mat. LPA observed appropriate hand washing signs posted in each bathroom. Hot water temperature measured at 113.9°F. Continue on LIC809-C Common Areas: The facility maintains a comfortable temperature at 76°F. The living room and dining area appeared clean and were properly furnished. The living room has a television, comfortable furniture. No obstructions and or tripping hazards throughout the facility. Laundry Room: The laundry room is next to the bedroom # three (3) in the hallway. LPA observed the laundry room locked and inaccessible to residents. The laundry detergents are observed to be locked in the bathroom cabinet next to the laundry room. The garage is next to the laundry is currently used as a storage. Smoke detectors/carbon monoxide. Smoke detectors were located throughout the facility, and at 11:10 AM they were tested and observed to be operational. Carbon monoxide was located in the kitchen and was also tested and observed to be operational. Outside areas: At approximately, 10:15 AM LPA toured the outside area of the facility. LPA observed appropriate outdoor furniture, with a covered shaded area for residents. LPA observed a fish pond and inaccessible to residents. The fish pond was fenced and locked. There is no swimming pool. The facility has no residents and staff; therefore, no record review for staff or residents completed on today's visit. Administrative: LPA collected Certificate of Liability Insurance. No deficiency cited during today’s visit. Exit interview conducted and copy of this report signed and delivered.the state’s words, verbatim · CDSS document, May 16, 2024