Renaissance Residential Care

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Sparkle Day conducted an unannounced visit to the above facility. The purpose of today’s visit was to conduct the one-year inspection. LPA met with Imelda Pascual, Administrator and the purpose of the visit was discussed. Facility is licensed to serve 6 non- ambulatory residents age 60 and over. The facility has an approved hospice waiver for 2 residents. None of the residents are diagnosed with dementia . One (1) resident is receiving home health and no residents are receiving hospice care services. The facility handles the residents’ money. All residents are Harbor Regional Center residents This home is a single story home consisting of: (4) resident bedrooms, (1) staff room (3) bathroom, den, living room, kitchen with dining area, laundry room (located near 2nd bathroom. There is a detached garage and an outdoor shaded patio area. LPA toured the Resident bedrooms had the required furniture, bed linens and closet/drawer space to accommodate each resident comfortably. Resident bathrooms were checked. Toilets and water faucets worked properly, grab bars were secure, shower was free of mold/mildew and a non-skid mat was in place, water temperature measured between 106.1F. Resident bath towels, toiletries and personal hygiene supplies were adequately stocked. Common areas were clean and clear of hazards; doorways were free of obstructions. Kitchen was checked and observed to be within Title 22 regulations. Perishable and non-perishable food supply was checked. All cleaning solutions, hazardous items, and medications were securely locked and inaccessible to residents. Smoke detectors were working properly and fire extinguisher was fully charged. Carbon monoxide detector was operational. First Aid kit was available. Outside grounds were toured and no bodies of water were observed. Walkways around the home were clear of hazards. There are no security bars or weapons on the premises. During todays visit LPA did not observe any deficiencies. Exit interview conducted with Administrator, Maria Tavarez and a copy of this report was provided.the state’s words, verbatim · CDSS document, Feb 11, 2026

Type of visit: Case Management - Annual Continuation

On February 12, 2025, Licensing Program Analyst (LPA) Deborah Lee conducted an unannounced Case Management Continuation to complete inspection conducted on February 6, 2025 visit using the CARE Inspection Tools. LPAs met with Imelda Pascual explained the purpose of this visit. Subsequently, Administrator Maria Tavarez arrived to assist with the visit. The facility is licensed for (6) 60-year-old or older adults. May retain 1 hospice resident. Currently, there are 6 residents in the facility. The facility is a single-story home located in a residential neighborhood which consists of the following: A living room, four (4) bedrooms, two (2) bathrooms, one (1) half-bathroom, dining room, kitchen, laundry area, detached garage, shaded area, indoor/outdoor activity areas. Safety LPA observed and tested smoke/carbon monoxide combo detectors to be fully operable. LPA observed (2) fully charged fire extinguishers that was last serviced on 3/4/24 The last emergency drill was conducted on 2/11/25. LPA inspected the First Aid kit and found it contained an ample supply of required items: Scissors, tweezers, gauze, disinfectant wipes, band aids. LPA observed all exits to be clear and easily accessible. All toxins locked and inaccessible to residents in care. Medications LPA observed all centrally stored medications in their original packaging and are secured in a locked cabinet that is inaccessible to Residents in care. page 1 of 2 Files LPA reviewed ( 4 ) resident files and found that (4 ) out of (4 ) contained all the necessary documentation. LPA reviewed (4) staff files and found that (4 ) out of (4 ) contained the required documentation, certification, and training. Liability Insurance expires on 04/25/2025. LPA observed that Annual licensing fee are current at this time. LPA reviewed facility contact information to insure that the information was current and accurate. Infection Control During the visit, LPA observed the facility’s infection control practices. LPA observed a sanitizing station at the facility entrance. PPE supplies are readily available to staff. Outside area: During visit LPA observed the outside grounds (front and back) to be free of clutter, debris, and passage ways were free of obstruction. There were no deficiencies cited during today’s visit. Exit interview conducted and copy of report provided to Administratorthe state’s words, verbatim · CDSS document, Feb 12, 2025

Type of visit: Required - 1 Year

On February 6, 2025, Licensing Program Analyst (LPA) Deborah Lee conducted an unannounced required annual visit using the CARE Inspection Tools. LPAs met with Administrator Maria Tavarez and explained the purpose of this visit. The facility is licensed to operate for six (6) non-ambulatory residents ages 60 and over and has an approved hospice waiver for two (2) residents. The facility is a single story, 5 bedrooms which 3 bathrooms are for residents and 1 bedroom is for live-in staff, 2 common restrooms, 1 private restroom, one (1) laundry room, dining area, living room with staff computer, kitchen, pantry, linen closet, a designated outdoor shaded area and a detached garage that stores a freezer and additional food, paper and hygiene products. Physical Plant LPA and Administrator Maria Tavarez toured the facility inside and outside. LPA observed There were no bodies of water on the premises. All rooms were inspected. Beds and bedding supplies were in operational condition, lighting was provided, and storage for the resident's personal belongings was observed. LPA observed that facility had required postings: Facility license, personal rights, ombudsman information poster, facility sketch, exit signs, infectious disease postings, Administrator certificates, an emergency disaster plan. Page 1 of 2 Bedrooms LPA inspected all (5) bedrooms All bedrooms were observed to have the required furniture including beds, dressers, night stands with lamps, chairs, and ample storage space for personal belongings. All bedrooms were observed to be clean, in good repair, and have ample lighting. Bathrooms LPA inspected the facility bathrooms. In the resident’s bathroom the toilet, faucets, and shower were fully operational. All safety handrails were securely fastened. LPA observed the showers to be clean and free of mold or mildew. The shower had a nonskid material in bottom and shower chair. Resident’s toiletries and incontinent supplies observed in resident rooms. The water temperature measured 105.4 degrees Fahrenheit. All bathrooms were observed to be clean, in good repair and within Title 22 regulations. Linens & Hygiene LPA observed all beds to have the required linens including mattress cover, fitted sheets, blanket, comforter, and pillow. LPA observed an ample supply of linens, towels, and blankets in hall closet. . Kitchen LPA inspected the kitchen and observed all appliances to be in good working repair, including stove/oven, microwave, dishwasher, refrigerator. LPA observed an ample supply of cutlery, pots, pans, and bowls to be in good repair. LPA observed knives and additional sharps to be secured in locked cabinet under the sink and are inaccessible to residents. LPA observed a 3-day supply of perishable foods and a 7-day supply of nonperishable foods. There is a laundry room where the washer and dryer are located. The detergent and other cleaning supplies are locked in a cabinet inaccessible to residents in care. Due to time restraint, LPA to complete inspection on subsequent visit. There were no deficiencies cited during this visit. Exit interviewed conducted and copy of report provided to Administrator Maria Tavarez. Page 2 of 2the state’s words, verbatim · CDSS document, Feb 6, 2025

Type of visit: Required - 1 Year

On 01/31/23, Licensing Program Analyst (LPA) Mario Leon conducted an unannounced annual required visit using the CARE Inspection Tool. LPA was met by Administrator, Maria Tavarez, to explain the purpose of today’s visit. The facility is licensed to operate for six (6) non-ambulatory residents ages 60 and over and has an approved hospice waiver for two (2) residents. The facility is a single story, 5 bedrooms which 4 bedrooms are for residents and 1 bedroom is for live-in staff, 2 common restrooms, 1 private restroom, one (1) laundry room, dining area, living room with staff computer, kitchen, pantry, linen closet, a designated outdoor shaded area and a detached garage that stores a freezer and additional food, paper and hygiene products. The facility water temperatures measured between 105 and 118 degrees F. The facility has a working landline telephone. LPA toured the physical plant. There were no bodies of water or obstructions on the premises. Resident rooms were inspected, beds and bedding supplies were in good condition and adequate lighting was provided. Adequate storage, for the client's personal belongings, was observed. Bed linens, comforters, and bath towels were adequately stocked during the visit. All bathrooms were found to be within Title 22 regulations and were clean and operational. LPA observed the facility to be mostly sanitary and appropriately furnished at the time of visit. LPA observed the Southern facing screen, located in the kitchen, is in disrepair and needs to be re-screened, see LIC809D. All storage areas for personal hygiene, toxins, and sharp objects were stored and not accessible to residents. LPA observed one cleaning product left accessible in the laundry room, see LIC9102TV. LPA reviewed Medication Administration Records (MAR) which revealed to be accurate and maintained in order. The kitchen was inspected and sufficient perishable and non-perishable food was maintained adequately. One (1) fire extinguisher was charged as of 03/09/23. Smoke detectors and carbon monoxide were in working condition and the last fire drill was conducted on 01/03/24. Report continues, see LIC809C. During the visit, LPA observed the facility's infection control practices. LPA observed there were screening protocols for visitors, staff, and residents, sanitizing stations with paper towels in common areas and restrooms. LPA observed staff wearing face coverings, LPA observed the facility has a 30-day supply of Personal Protective Equipment (PPE). All mandated inspection control posters were posted. The facility has an approved CCLD Mitigation Plan. LPA observed the facilities' Surety Bond, validated through Rimkin Co, Inc., provided on 06/30/23 which covers $2,000 per instance. LPA also observed property insurance, validated through Rimkin Co, Inc. There was one (1) deficiency cited during today's inspection and a plan of corrections were created with Administrator, Maria Tavarez. See LIC809D. There was one (1) technical violation note provided during today's inspection and a copy was provided to Administrator, Maria Tavarez. See LIC9102TV. An exit interview was conducted with Administrator, Maria Tavarez. One (1) deficiency LIC809D, one (1) LIC9102TV, and a copy of the appeal rights and this report were provided to Administrator, Maria Tavarez.the state’s words, verbatim · CDSS document, Jan 31, 2024

The state marks this report as 4 pages; the online copy we transcribed has 3. You can request the full file from the county licensing office.