Eugenia's House

Type of visit: Office

On January 27, 2026, An office meeting was held by Regional Manager Benita Yates, and Licensing Program Analyst (LPA) Deborah Lee to obtain requested documents for an Emergency Notice to Operate Eugenia's House. In attendance was the deceased owner’s daughter Rejean Ragas Documents received: --Residential Lease Agreement --Memorial Arrangement Agreement/Proof of death --Valid ID (Rejean Ragas) --LIC 200 --LIC 215 Regional Manager reviewed the above document. and issued Emergency Approval to Operate--LIC 9117. Licensee, Rejean Ragas, was informed that by February 28,2026, she would have to submit an application to the department or surrender the license.the state’s words, verbatim · CDSS document, Jan 27, 2026

Type of visit: Office

On January 26, 2026, An office meeting was held by Regional Manager Benita Yates ,and Licensing Program Analyst (LPA) Deborah Lee to discuss a request for an Emergency Notice to Operate Eugenia's House. In attendance were the deceased owner’s daughters, Rejean Ragas and Marissa Botsacos. The following documents were presented and reviewed: --2024 Family Trust --Appointment of and acceptance by successor trust --Tax form 1041 Daughter will bring in control of property for Emergency Notice to Operate and verification of death. LIC 200 and LIC 215 in addition a valid ID. Copy of this report was provided.the state’s words, verbatim · CDSS document, Jan 26, 2026

Type of visit: Required - 1 Year

On 11/23/24, Licensing Program Analyst (LPA) Ernand Dabuet conducted an unannounced annual required visit using the CARE Inspection Tool. LPA met with administrator Ivy Jane Bertulfo and explained the purpose of today’s visit. The facility is licensed to operate for five (5) non-ambulatory of which one (1) may be bedridden elderly adults ages 60 and above. The facility is a single-story structure located in a residential neighborhood. It consists of the following: four (4) resident's rooms, two (3) common bathrooms, a living area, a dining area, a kitchen, and an outside patio area. LPA and administrator toured the physical plant. There were no bodies of water or obstructions on the premises. All rooms were inspected. Beds and bedding supplies were in good condition, adequate lighting was provided, storage for resident personal belongings was observed. Bed linens, comforters, and bath towels were adequately stocked at the time of visit. Bathrooms were found to be within Title 22 regulations and were clean and operational. The water temperature measured 107.5 degree F. A comfortable temperature of 71 degree was maintained in the facility. LPA observed the facility to be sanitary and appropriately furnished at the time of visit. Storage areas for personal hygiene were stored and not accessible to residents. The kitchen was inspected and there is sufficient perishable and non-perishable food available maintained properly. Fire extinguisher was charged, smoke detectors and carbon monoxide were operable. A landline telephone was in working condition. A review of staff CPR/First Aid training is current. Evaluation Report Continues LIC 809-C During the visit, LPA observed the facility's infection control practices. LPA observed screening protocols for visitors, staff, and residents, and sanitizing stations in common areas and restrooms. All mandated inspection control posters were posted. LPA observed First Aid Kit was maintained. The facility has current liability insurance on file effective 01/31/24 - 01/31/25. The facility is not current on Community Care Licensing annual dues with an open balance of $1237.00. An audit of residents #1-#6 (R1-R6) service files and staff #1-#7 (S1-S7) personnel files revealed to be maintained in order. The facility has the current administrator's certification on file for Ivy Jane Bertulfo #605680740 - Expiration 02/16/25. Deficiencies: Facility has not conducted quarterly fire drills. Facility staff #1-#6 all did not have hoyer lift training. Hazardous materials, cleaning disinfectant, sharp object, and prescribed medications not stored in locked storage. Resident #6 a fall risk was restrained with an authorized material while in a wheelchair without a physicians order. Facility staff #4 and #5 did not have complete training on file. Facility did not maintained documentation Medication Administration Records for prescribed and PRN medications. Facility did not supply a LIC 500 Personnel Report, unclear if an "awake" staff is scheduled for NOC shift. Facility has not conducted annual medical and appraisal for resident #2, #3 and #6 diagnosed with dementia. An exit interview was conducted with Ivy Jane Bertulfo, and a copy of the report was provided.the state’s words, verbatim · CDSS document, Nov 23, 2024

Type of visit: Required - 1 Year

On 01/22/2023 at 08:30 AM, Licensing Program Analyst (LPA) Mario Leon conducted an unannounced annual inspection visit at the Eugenia’s House Adult Residential Facility. LPA Leon was allowed entry into the facility by Licensee, Ophelia Aplicador (S1). The facility is licensed for six (6) adult clients 59 year or older. Currently, there are six (6) residents residing in the facility 59 years or older. LPA explained the purpose of the one-year (1) Annual Inspection visit, and LPA and S1 took a tour of the inside and outside of the facility grounds. LPA reviewed: six (6) resident records, six (6) resident medication records, two (2) staff records, and inspected the inside facility and outside grounds. The facilities’ last fire drill was conducted on 12/20/2023. The one-story residential home consists of four (4) resident bedrooms, three (3) resident bathrooms, living room, dining room, family room, kitchen, office area, attached garage with washer and dryer area, backyard with table and chairs. No weapons are stored in the premises. Kitchen was inspected and LPA observed the stove top to be in disrepair, see LIC809D. A two-day (2) supply perishable and seven-day (7) supply of non-perishable foods are present in the facility. Emergency Water seven-day (7) supply is found in the garage. LPA 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 observed the following during inspection of resident’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 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 observed bathrooms were found to be within Title 22 regulation. Bathroom #1 hot water temperature properly measured at 117.1 degrees F, #2 hot water temperature properly measured at 117.7 degrees F and #3 hot water temperature properly measured at 118.6 degrees Fahrenheit. Report Continues, see LIC809C. Kitchen hot water temperature properly measured at 115 degrees F. Facilities' nine (9) Smoke Detectors were tested, two (2) of which also contain carbon Monoxide detection, are inter-connected and all are working properly. The facility (2) Fire Extinguishers were 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 residents. Medications are centrally stored and in a locked storage cabinet in the kitchen, inaccessible to residents. Facility's two (2) first aid kits are fully stocked, one (1) 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 is accessible to residents. Six (6) resident files were reviewed and were found to be complete. LPA reviewed six (6) resident medications and they were all found to be administered according to doctor's orders. Two (2) staff files were checked and have the required documents. Licensee was not able to provide updated liability insurance. An exit interview was conducted, and a copy of the Facility Evaluation Report was provided to Licensee, Ophelia Aplicador (S1).the state’s words, verbatim · CDSS document, Jan 22, 2024

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.