Summit View Home Care

Type of visit: Case Management - Incident

Licensing Program Analyst (LPA) Cynthia Chan conducted a case management visit due to an incident that occurred at the facility. LPA arrived unannounced and met with Staff Theresa Kuwashima. The administrator, Silvia Castro, arrived shortly thereafter. The purpose of the visit was explained. On 9/17/26, the licensee called and submitted a special incident report regarding an alleged abuse of Staff #1 (S1). The incident stated that two (2) residents were arguing about a calendar because one of the residents did not want to return it. This prompted S1 to intervene, which S1 was talking to the resident calmly. After taking the calendar away, S1 forcibly placed it on the side table while striking Resident #1 on the left hand. During the visit today, LPA interviewed (2) Staff, (2) Residents, and a witness. Staff interviewed have never seen S1 act aggressively towards the residents. One of the residents stated that S1 got hold of the calendar book and slammed it on the R1’s hand. However, a witness observed S1 taking the calendar book and struck it across R1’s face. Per staff, there were no marks or bruises found on R1. Staff #1 (S1) is no longer working at the facility and was not interviewed. Based on the information gathered, there is sufficient evidence to show that S1 took an item and hit the resident. The preponderance of evidence standard has been met, therefore, the above allegation is found to be SUBSTANTIATED. California Code of Regulations, (Title 22, Division 6 and Chapter 8), are being cited on the attached LIC 9099D. An exit interview was conducted. The Plan of Correction was reviewed and developed with the administrator. A copy of this report and appeal rights were provided.the state’s words, verbatim · CDSS document, Sep 29, 2026

From the deficiency page — Deficiency type: Type A · Section cited: CCR 87468.1(a)(3) · Plan of correction due date: Sep 30, 2026

87468.1 Personal Rights of Residents in All Facilities (a) Residents in all residential care facilities for the elderly shall have all of the following personal rights: (3) To be free from punishment, humiliation, intimidation, abuse, or other actions... This requirement is not met as evidenced by: Based on interviews, S1 used an item to hit R1 which poses an immediate health, safety, and personal rights risk to residents in care.the state’s words, verbatim · CDSS document, Sep 29, 2026

Plan of correction: Licensee shall conduct an in-service training with all staff regarding personal rights. The log is due by 9/30/26.

Type of visit: Required - 1 Year

On 2/24/2026 at 10:20 a.m., Licensing Program Analyst(s) (LPA) Jewel Baptiste conducted an unannounced annual visit at Summit View Home Care, using the CARE tool. LPA Baptiste met with DSP Theresa Kuwashima and explained the reason for the visit. Administrator Silvia Castro arrived at 10:40 a.m. and further assisted with the visit. The facility is licensed to serve age range 60 and over. Fire clearance was approved for 6 non-ambulatory, of which 1 may be bedridden, residents. The facility is a single-story home, located in a residential area. It consists of a 4-resident bedroom (2 shared) 1 staff bedroom, 1 resident bathroom, 1 staff bathroom, 1 dining room, 1 living room with non-working fireplace, administrator office area, 1 utility closet, 1 laundry closet, kitchen, a garage, a front yard and backyard. LPA Baptiste conducted a tour of the facility with Administrator Castro and observed the following: Facility is clean and in good repair indoors and outdoors. Kitchen is clean, sharps were locked and inaccessible to residents. Fire extinguisher observed in kitchen and observed charged and updated. The fire extinguisher in hallway is missing its tag. The cleaning supplies were locked in the utility closet. Sufficient food supplies were observed, at least 2 days of perishables and 7 days of non-perishables. (4) Resident's bedrooms were observed with sufficient lighting, furniture, and bedding supplies. (1) staff bedroom and bathroom observed inaccessible to residents. (1) Resident’s bathrooms were observed in working conditions with grab bars, and skid mats. The water temperature was tested at 115.3, which is within the required 105-120 degrees F. The dining room and living room were observed with sufficient sitting area. Smoke/Carbon monoxide detectors were tested and in working condition. The garage contained storage supplies, PPE’s, water, toiletries and extra food. Backyard and front yard were observed with covered sitting area. (CONTINUED LIC 809C) The facility does not have any large body of water. Last emergency drill was conducted on 2/09/26. LPA Baptiste reviewed medication and files for 6 residents. Each resident file reviewed has all the required documentation. Staff files were reviewed for (3) staff and they have all the required documentation. An administrator certificate was reviewed for Silvia Castro exp:10/14/26. Per California Code of Regulations, Title 22, and California Health and Safety Code, there were no deficiencies observed during the visit. Exit interview was held and a copy of the report was provided to the Administrator.the state’s words, verbatim · CDSS document, Feb 24, 2026

Type of visit: Case Management - Annual Continuation

Licensing Program Analyst (LPA) Cynthia Chan conducted a follow up visit to continue the annual inspection. LPA met with Administrator, Silvia Castro. The initial visit was on 1/31/25. During the visit today, LPA inspected the rest of the domains of the CARE tools. Staffing: Per the administrator, there is sufficient staffing at the facility and backup staff if needed. Staff employed have fingerprint clearance and associated to the facility. Personnel Records-Training: LPA reviewed 3 staff files and all documents are in file. Staff have current CPR/first aid training and sufficient on-going training that meets the annual requirement. Resident Records-Incident Reports: LPA reviewed 6 resident files and the following documents are found - admission agreements, Identification & Emergency Information, Physician's Report, Consent forms, Resident rights, Safeguards for Property/Valuables form. Resident Rights-Information: The Complaint poster, Local Ombudsman, and Residents personal rights are posted. Planned Activities: Facility has sufficient space to accommodate indoor and outdoor activities. There are sufficient supplies and equipment to meet resident's physical/mental capability. Staff encourage residents to participate in activities. Incidental Medical & Dental: The medications are centrally stored and locked in the cabinet. All 6 resident medications were reviewed and marked in the Medication Administration Record (MAR) log when given. Resident with Special Needs: There are currently no residents with any prohibited or restricted health conditions or using oxygen. No deficiencies are issued today. An exit interview was held and a copy of this report was given to the administrator.the state’s words, verbatim · CDSS document, Feb 6, 2025

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Cynthia Chan conducted the unannounced annual inspection. LPA met with Staff, Theresa Kuwashima. Administrator, Silvia Castro, arrived shortly after to assist with the visit. The facility is licensed for 6 non-ambulatory residents, ages 60 and over, of which 1 may be bedridden. There is a hospice waiver approved for 3 residents. LPA utilized the Compliance and Regulatory Enforcement (CARE) tool to inspect the facility. Infection Control: The facility staff are continuing to follow their infection control and performing proper hand hygiene to assist residents. Staff are cleaning and disinfecting daily. The Administrator reviews the Infection Control plan annually and provides the training to staff. Operational Requirements: The facility has a dementia care plan to accept or retain residents with dementia. There are currently 5 non-ambulatory and 1 ambulatory residents residing at the facility. There are no residents with a prohibited or restricted health condition. The facility has the sufficient liability insurance to cover injury to residents and guests. Physical Plant & Environment Safety: The one-story home consists of 4 resident bedrooms, 1 communal bathroom, 1 staff room with private bathroom, living room, kitchen, dining area, laundry area, and attached garage. The smoke detectors are hard-wired and 1 carbon monoxide detector in the hallway by the front door. The fireplace is adequately screened. There are no pools or bodies of water on the premises and no items obstructing the walkway. Cleaning supplies are locked in the closet and inaccessible to residents. Knives and sharps are locked. Food Service: Sufficient food supplies of perishable and non-perishable are observed. Extra foods are stored in the garage refrigerator. Disaster Preparedness: The facility has an Emergency Disaster Plan posted with contact numbers and at least 2 relocation sites. Disaster drills are conducted quarterly with staff and residents. LPA will return another day to inspect the remainder of the domains. No deficiencies were issued today. An exit interview was held and a copy of this report was given to the administrator.the state’s words, verbatim · CDSS document, Jan 31, 2025

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Cynthia Chan conducted the annual inspection on 2/1/24. LPA arrived unannounced and met with Staff, Theresa Kuwashima. The purpose of the visit was explained. Administrator, Silvia Castro, arrived shortly after to assist with the visit. The facility is licensed for 6 non-ambulatory residents, ages 60 and over, of which 1 may be bedridden. There is a hospice waiver approved for 3 residents. LPA utilized the Compliance and Regulatory Enforcement (CARE) tool to inspect the facility and the following were observed: Infection Control: The facility staff are performing hand hygiene and wearing gloves when necessary to assist residents. Staff are cleaning and disinfecting daily and following the infection control plan. Administrator provides annual training on infection control. Operational Requirements: The facility has a dementia care plan to accept or retain residents with dementia. There are currently 5 non-ambulatory and 1 ambulatory resident residing at the facility. The facility maintains sufficient liability insurance to cover injury to residents and guests. Physical Plant & Environment Safety: The facility is a one-story house that consists of 4 resident bedrooms, 1 communal bathroom, 1 staff room with private bathroom, living room, kitchen, dining area, laundry area, and attached garage. Cleaning supplies are locked in the closet and inaccessible to residents. The facility has smoke detectors in each room and 1 carbon monoxide detector in the hallway by the front door. The fireplace is adequately screened. There are no pools or bodies of water on the premises and no items obstructing the walkway. Staffing: There is sufficient staffing at the facility. Staff employed have fingerprint clearance and associated to the facility. Personnel Records-Training: Staff files are maintained at the facility. LPA reviewed 3 staff files. They have current CPR/first aid training and sufficient on-going training that meets the annual requirement. Staff #2 did not have the TB test result nor chest x-ray on file. Resident Records-Incident Reports: Resident files are maintained at the facility and have the following documents in their files - Admission Agreements, Identification & Emergency Information, Physician's Report, Consent forms, Resident rights, Safeguards for Property/Valuables form. Resident Rights-Information: The Complaint poster, Local Ombudsman, and Residents personal rights are posted. Planned Activities: Facility has sufficient space to accommodate indoor and outdoor activities. There are sufficient supplies and equipment to meet resident's physical/mental capability. Staff encourage residents to participate in activities. Food Service: There are sufficient food supplies of 2-day perishable and a week of non-perishable items. The kitchen is clean and free of rodents or insects. Incidental Medical & Dental: The medications are centrally stored and in their original bubble packs. The facility uses the Medication Administration Record (MAR) log to document medications given. LPA reviewed all 6 residents' medications and they are being administered as prescribed by the physician. Disaster Preparedness: The facility has an Emergency Disaster Plan posted with contact numbers and at least 2 relocation sites. They conduct different types of disaster drills and are documented with the date, time, and participants. Residents with Special Health Needs: The facility accepts and retains residents with dementia and/or hospice. The staff receive the appropriate number of hours annually to care for residents with dementia. LPA interviewed 2 Staff and a resident during the visit. A deficiency is issued on the LIC809D. An exit interview was held. A copy of this report and appeal rights were given to the administrator.the state’s words, verbatim · CDSS document, Feb 1, 2024