Carindale Residential Care

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Blanca Gonzalez conducted an unannounced required annual visit. LPA was met by caregiver Jessica Torres and the purpose of the visit was explained. Administrator Angela Gavilanes was advised telephonically. The facility is a two-story home located in a residential area of Glendora. It is licensed to serve residents age range 60 and over, six (6) non-ambulatory of which one (1) may be bedridden and has a hospice waiver approved for 2. The home consists of a living room, kitchen, dining room, (6) resident bedrooms, (1) staff room located upstairs, (2) bathrooms, (1) staff/visitor bathroom, laundry area, a shaded patio in the backyard with seating, and a detached garage. LPA utilized the Compliance and Regulatory Enforcement (CARE) tools for the visit today and observed the following: The front and backyard are well maintained and there are no pools or large bodies of water. The backyard does contain a fenced in waterfall/water feature. Passageways and exits are free of obstructions. Carbon monoxide and smoke detectors were observed in resident bedrooms and are operable. There five (5) fire extinguishers located throughout the facility and were last serviced 10/02/25. Emergency drills conducted quarterly, last drill was 10/06/2025. continued on LIC 809C continued from LIC809 Kitchen appliances are clean and were operating at the time of the visit. Sharps are secured in a kitchen drawer and are inaccessible to residents. Kitchen area was observed to be clean and free of litter, rodents, vermin and insects. The food supplies were observed to be the required 2-day perishables and 7-day non-perishables. Cleaning supplies, disinfectants and toxins are secured in a locked hall closet, inaccessible to residents in care. Dining room and living room are clean and free of obstructions and have sufficient seating for residents in care. Fireplace located in the living room was inaccessible with a covered screen. The facility has cameras in common areas. According to staff, cameras do not record, they are only used for surveillance. Resident bedrooms have the required furniture and have sufficient closet and storage space. Resident beds have the required linen and the linen is in good repair. Hallway closet contained clean linens and towels. Water temperature tested in all three (3) bathroom and measured within the required 105°-120°F. Washing machine and dryer were clean and operable at the time of visit. Medications are centrally stored in a locked filing cabinet in the kitchen. Medications are documented properly and given as prescribed. Six (6) resident and four (4) staff files were reviewed and were observed to contain required documentation. R2 facility file and medical assessment did not contain TB clearance. Deficiency cited. Per California Code of Regulations, Title 22, and California Health and Safety Code, the deficiencies observed during the visit are documented on the LIC809D. Exit interview held and a copy of the report along with appeal rights were provided Caregiver Jessica Torres.the state’s words, verbatim · CDSS document, Nov 13, 2025

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA)S Vaid made an unannounced visit to the facility for the purpose of conducting the required annual inspection, using the CARE tool to evaluate the facility. LPA Vaid met with Caregiver Angela Gavilanes and explained the purpose for the visit. Angela called the administrator/licensee Ralph Estanislao arrived shortly after and helped with the visit. LPA conducted a tour of the physical plant with Ralph observed the food supplies, COVID-19 procedures, and reviewed client and staff files, and client's medications. The facility has an approved mitigation plan on file. The facility is a two-story home located in a residential area. It is licensed to serve (6) elderly residents, ages 60 and over, of which all may be non-ambulatory and (1) may be bedridden and has a hospice waiver approved for 2. The home consists of a living room, kitchen, dining room, (6) resident bedrooms, (1) staff room located upstairs, (2) bathrooms, (1) staff/visitor bathroom, a shaded patio in the backyard with seating, and a detached garage. LPA observed all resident bedrooms to have the required furniture, bedding, linens, sufficient lighting, closet space, and additional storage space. (2) resident bathrooms were observed to have a shower, toilet, and wash basin. LPA observed cleaning supplies and toxins locked and inaccessible to residents. The showers accommodate non-ambulatory clients and have the required grab-bars and non-skid mats. The water temperature was tested and measured are in-compliance. The food supplies were observed to be the required 2-day perishables and 7-day non-perishables. Several fire extinguishers were observed throughout the facility. They had current inspections and were fully charged, lasted tested 09/20/2023. The first aid kit was inspected and had the required items, as well as a current first aid manual. All sharps were observed to be locked and inaccessible in a drawer in a file cabinet near the kitchen. Other cleaning supplies were locked and inaccessible, in hallway closet. All equipment was operational and in good repair. A hallway closet had additional towels and linens for clients. The smoke/carbon monoxide detectors were tested, were interconnected and operational at the time of the visit. Continued on 809C..... Medications are centrally stored in a file cabinet near the kitchen along with resident and staff files. There is a fish pond in the backyard that has a fence around the entire perimeter, LPA observed the pond to be drained and has no water. The facility has cameras in the common areas. According to staff, the cameras are do not record, they are only used for surveillance. LPA observed a 30-day supplies of Personal Protective Equipment (PPE) stored in a closet inside bathroom# 1. Additional PPE was observed at the entrance of the facility- the central entry point for screening clients, staff, and visitors. PPE signage was observed throughout the facility to promote hand washing, cough/sneeze etiquette, and social distancing, as required by infection control practices. All hand washing stations were noted to have paper towels. All resident files were reviewed and had updated emergency contact information and health screenings. (3) staff files were reviewed and had Criminal Background Clearances and health screenings. Certification for the staff were observed and are in compliance. All resident medications were reviewed. Four (4) residents’ medications were reviewed, LPA observed the MARs was being used to document administration of the medication. LPA observed all residents to have full bed railings on their beds, all four residents have physician orders for full railing. No deficiencies were observed on today’s visit. An exit interview was conducted with Administrator Estanislao and a copy of this report and were provided.the state’s words, verbatim · CDSS document, Sep 10, 2024

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) V. Maldonado made an unannounced visit at the facility for the purpose of conducting the required annual inspection, using the Compliance and Regulatory Enforcement (CARE) Tool, to evaluate the facility. LPA Maldonado met with Caregiver, Angela Gavilanes, and explained the purpose for the visit. Administrator, Ralph Estanislao, arrived shortly after and assisted with the visit. During today's visit, LPA Maldonado conducted a tour of the physical plant with Ralph, observed the facility food supplies, reviewed (6) resident medications, (6) resident files, (3) staff files, and conducted interviews with (3) staff and attempted interviews with (6) residents. The facility is a two-story home, operating as a Residential Care Facility for the Elderly. It is licensed to serve (6) older adults, ages 60 and over. It has an approved dementia care plan. There is a fire clearance approved for (6) non-ambulatory residents, of which (1) may be bedridden, and has a hospice waiver approved for (4). There is currently (1) resident receiving hospice services. An approved mitigation plan is in place and Infection Control plan has been submitted to the department for review. The facility has an active and current liability insurance policy on file. The home consists of a living room, kitchen, dining room, (6) resident bedrooms, (1) staff room located upstairs, (2) bathrooms, (1) staff/visitor bathroom, a shaded patio in the backyard with seating, and a detached garage. Upon arrival to the facility, LPA was unable to enter the property and observed the front gate locked. LPA Maldonado had to ring the doorbell and a caregiver had to open the gate by key to allow LPA entry. LPA asked Ralph the reason for the locked gate. He stated it was due to safety precautions as there are transients near the home. The facility does not have a fire clearance approved for locked perimeters. LPA observed all resident bedrooms to have the required furniture, sufficient lighting, and storage space. (5) of (6) residents' beds were observed to have bed rails. However, Resident# 4 (R4) did not have a written physician's order indicating the need for them, in their file. All other residents had proper written physician's orders for the bed rails in their files. The facility is required to have auditory devices. LPA Maldonado observed the auditory device in room# 3 to be inoperable. Cameras were observed operating in common areas of the home. No cameras were observed in private areas/resident rooms. (Report continued on LIC809-C...) Resident bathrooms were observed to have a shower, toilet, and wash basin. The showers accommodate non-ambulatory residents and have the required grab-bars and non-skid mats. The hot water was tested and measured at 126*F, which is not in compliance. The food supplies was observed and had the required 2-day perishables and 7-day non-perishables. Emergency food and water was also available. Fire extinguishers were observed throughout the facility, with current inspections and were fully charged. The first aid kit was observed to be complete and a current first aid manual was available. All sharps, cleaning supplies and toxins were observed locked and inaccessible to residents in care. A fire place was observed in the living room, covered by a screen and inaccessible. The smoke/carbon monoxide detectors were tested, were interconnected and operational at the time of the visit. A fish pond was observed in the back yard. It had water, but it is completely fenced off, inaccessible to residents in care. The last fire drill was conducted on 5/21/23, which is not in compliance. During the file review, it was discovered that Staff# 3's (S3) file was missing proof of the required annual training, and CPR/First Aid certification expired on 05/2020. The file for Staff# 2 (S2) was also missing a health screening. LPA also discovered that the Administrator did not have a complete file at the facility available to review/audit. After review of resident files, it was discovered that Residents# 1, 4 and 5 (R1, R4, and R5) do not have an updated medical assessment as they are required to, due to cognitive impairment. It was also discovered that (5) of (6) residents do not have an Appraisal/Needs and Services Plan on file. After review of resident medications, it was discovered that R2, R5, and R6 were missing medications that have not yet been refilled. It was also discovered that R2 and R4 had medications and vitamins that are being administered to them without physician's orders on file. Per California Code of Regulations, Title 22, Division 6, Chapter 8, deficiencies were observed during today's visit and will be cited on the LIC809-D. Additionally, immediate civil penalties were assessed in the amount of $500, due to a Fire Clearance Violation. An exit interview was conducted with Administrator, Ralph Estanislao, and a copy of the report and appeal rights were provided and discussed.the state’s words, verbatim · CDSS document, Nov 27, 2023