Gardenia Garden

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Daniel Konishi conducted an unannounced Required-1 year visit. LPA were met by Leonisa Agnasin, Caregiver and LPA explained the p Marebeth Mallare, Administrator and Leonardo Mallare, Caregiver and explained the purpose of the visit. The facility cares for residents age range 60 and over and licensed for (5) non ambulatory, (1) bedridden resident (shall be in bedroom #3), and approved for (6) hospice residents only. There are currently (3) residents on hospice. LPA utilized the Compliance and Regulatory Enforcement (CARE) tools for the visit today and observed the following: Infection Control: Infection control practices and Personal Protective Equipment (PPEs) were observed. Staff are trained on the emergency infection control plan and following hand hygiene techniques. Emergency and disaster plan was completed and up to date. Operational Requirements: The Infection Control Plan has been reviewed and updated. A Hospice Waiver for six (6) is approved. Valid liability insurance policy is in place. The facility does not handle cash resources for the residents. Latest fire/earthquake drill was conducted on 02/05/2026. Physical Plant/Environment Safety: The facility is a single-story home located in a residential community. The home consists of living room, dining area, kitchen, four (4) resident bedrooms, one of the bedrooms has a fireplace that is adequately screened, four (4) bathrooms, back yard with swimming pool that is fenced and inaccessible to residents, and laundry area in the attached garage. The interior and exterior physical plant was inspected. Resident bedrooms were toured. Each bedroom has a smoke detector, bed, linen, dresser, light, and sufficient closet space. Hallway closet had extra linens and towels. Bathrooms have the required grabs bars and non-skid materials. The laundry room is clean and has cleaning supplies inaccessible to residents. Hot water temperature were measured between 109.5 degrees F to 110.8 degrees F which are within the required 105 - 120 degrees F. Physical Plant/Environment Safety [Cont.]: Carbon Monoxide detectors were tested and operable. All the appliances are clean and are working properly. The common areas such as activity room and dining room are clean and have the required furniture. The backyard has a shaded area and sitting area. Exit doors have auditory devices that were operating at the time of the visit. There are cameras in the front door, backyard, living room, dining area and kitchen. Exit doors are free of any obstruction. Cleaning supplies and toxic substances are inaccessible to residents. Sharps are locked, secure, and inaccessible to residents. The facility has (3) fully charged fire extinguishers, last serviced on 01/15/2025. Staffing: A total of three (3) caregivers including the Administrator provide care and supervision to the residents. Staff employed are over the age of 18 and have criminal background clearance, fingerprint cleared, have the required training and are associated to the facility. Personnel Records-Training: LPA reviewed three (3) staff files which include Personnel Record, Criminal Background Clearance, First Aid/CPR, Health Screening, TB Clearance, Employee Rights, and Staff Training. LPA reviewed that the Administrator did not provide a current Administrator Certificate in file and LPA checked pending Administrator Certificate Renewal Status CDSS (California Department of Social Services) website which did not show the Administrator’s name on the list. LPA reviewed Staff #1 (S1’s) file did not have a Valid First Aid Training. Resident Rights-Information: Resident personal rights are posted. Visiting policy is posted at a location that is visible and accessible to residents and families. LPA observed that the RCFE (Residential Care for the Elderly) “Let Us No” Complaint (PUB 475) Poster was not posted at the facility. Planned Activities: Information regarding Dementia is part of training for direct care staff and is included in the Plan of Operation. The facility has an activity calendar, activity supplies, and provides sufficient space to accommodate both indoor and outdoor activities. Food Service: The kitchen was inspected and has sufficient supply of 2 (two) day perishable & 7 (seven) day non-perishable food. Kitchen, food preparation area, and storage areas were observed to be clean and sanitary. The food is properly stored in the refrigerator (clean and well maintained). Pesticides and cleaning supplies are kept away from the food preparation areas. Plates, cups and utensils are kept cleaned and stored properly. Incident Medical and Dental: All residents have Restricted Health Care Plan and Needs and Services Plan on file. Home Health personnel services the residents in the facility. Hospice and Home Health Nurses conduct visits on a regular basis. LPA reviewed five (5) residents' medications. Based on record review, LPA observed Resident #1 (R1’s) Medication Administration Record (MAR) for the month of February 2026 was not up to date as initials for three (3) medications were missing initials and was last initialed on 02/02/2026. LPA also observed for Resident #2 (R2’s) MAR for the month of February 2026 was not up to date and not accurate since one medication was initialed from 02/01/2026 to 02/31/2026. LPA observed that Resident #3 (R3) did not have a current MAR in file. Resident Records-Incident Reports: LPA reviewed five (5) resident files which included face sheet, admission agreements, Physician's Report, Ambulatory Status, TB Clearance, Medical/Functional assessments, Needs and Services Plans, and Personal rights. Based on record review, Resident #6 (R6’s) file did not have documentation of determination for ambulatory status. Disaster Preparedness: The facility has a complete Emergency Disaster Plan in place and at least two (2) relocation sites. Last Fire and Earthquake Drill was conducted on 02/05/2026. Residents with Special Health Needs: Three (3) Residents are hospice and palliative care. Based on record review, LPA observed that Resident #1 (R1), Resident #2 (R2), and Resident#4 (R4) to Resident #6 (R6) had half bed rails and R1, R2, and R4 to R6’s file did not have physician's order for bed rails. Based on observation and record review, LPA observed that Resident #3 (R3) had full bed rails and R3’s file did not have a hospice care plan specifying a need for a full bed rail. Per California Code of Regulations, Title 22, and California Health and Safety Code, the deficiencies observed during the visit are documented on the LIC809-D. Exit interview, appeals rights and a copy of this report were provided to the Administrator, Marebeth Mallare.the state’s words, verbatim · CDSS document, Feb 19, 2026

Type of visit: Required - 1 Year

Licensing Program Analysts (LPAs) Bennette Pena and Gabriela Castro conducted an unannounced Required-1 year visit. LPAs were met by Marebeth Mallare, Administrator and Leonardo Mallare, Caregiver and explained the purpose of the visit. The facility cares for residents age range 60 and over and licensed for (5) non ambulatory, (1) bedridden resident (shall be in bedroom #3), and approved for (6) hospice residents only. There are currently (3) residents on hospice. LPAs utilized the Compliance and Regulatory Enforcement (CARE) tools for the visit today and observed the following: Infection Control: Infection control practices and Personal Protective Equipment (PPEs) were observed. Staff are trained on the emergency infection control plan and following hand hygiene techniques. Emergency and disaster plan was completed and up to date. Operational Requirements: The Infection Control Plan has been reviewed and updated. A Hospice Waiver for (6) is approved. Liability insurance policy is in place and expiring on 06/19/2025. The facility does not handle cash resources for the residents. Latest fire drill was conducted on 03/01/2025. Physical Plant/Environment Safety: The facility is a single story home located in a residential community. The home consists of living room, dining area, kitchen, (4) resident bedrooms, one of the bedrooms has a fireplace that is adequately screened, (4) bathrooms, back yard with swimming pool that is fenced and inaccessible to residents, and laundry area in the attached garage. The interior and exterior physical plant was inspected. Resident bedrooms were toured. Each bedroom has a smoke detector, bed, linen, dresser, light, and sufficient closet space. Bathrooms have the required grabs bars and non-skid materials. The laundry room is clean and has cleaning supplies inaccessible to residents. The kitchen was inspected. There is sufficient perishable and non-perishable food. All the appliances are cleaning and are working properly. The common areas such as activity room and dining room are clean and have the required furniture. The backyard has a shaded area and sitting area. There is also a swimming pool in the backyard Exit doors have auditory devices that were operating at the time of the visit. There are cameras in the front door, backyard, living room, dining area and kitchen. There were no cameras seen in private areas. Exit doors are free of any obstruction. Cleaning supplies and toxic substances are inaccessible to residents. The facility has (3) fully charged fire extinguishers, last serviced on 01/15/2025.*****CONTINUED ON LIC809-C***** Staffing: A total of three (3) caregivers including the Administrator provide care and supervision to the residents. Staff employed are over the age of 18 and have criminal background clearance, fingerprint cleared, have the required training and associated to the facility. Personnel Records-Training: Three (3) staff files were reviewed for criminal background clearance and training. Personnel records have health/TB screenings. Administrator has completed the required Administrator courses but has not submitted the certification renewal. Resident Rights-Information: Resident personal rights are posted. Visiting policy is posted at a location that is visible and accessible to residents and families. Physician orders for use of full/half bed rails were reviewed in residents files. LPAs conducted (3) resident interviews. Planned Activities: Information regarding Dementia is part of training for direct care staff and is included in the Plan of Operation. The facility provides sufficient space to accommodate both indoor and outdoor activities. Food Service: The kitchen was inspected and has sufficient supply of 2 day perishable & 7 day non-perishable food. Kitchen, food preparation area, and storage areas were observed to be clean and sanitary. The food is properly stored in the refrigerator (clean and well maintained). Pesticides and cleaning supplies are kept away from the food preparation areas. Plates, cups and utensils are kept cleaned and stored properly. Incident Medical and Dental: All residents have Restricted Health Care Plan and Needs and Services Plan on file. Home Health personnel services the residents in the facility. Hospice and Home Health Nurses conduct visits on a regular basis. (5) residents' medications were reviewed with no issues observed. Resident Records-Incident Reports: Five (5) resident files were reviewed containing admission agreements, Physician's Report, Medical/Functional assessments, Needs and Services Plans, TB clearance, Personal rights, Medical Consent, Medication Records, Disaster Preparedness: The facility has a complete Emergency Disaster and Mass Casualty Plan containing emergency evacuation, storage and preservation of medications, operation of manual assist devices. The facility conducts emergency drill on a quarterly basis for all staff and residents. Residents with SHN: (3) Residents are on hospice and palliative care. Per California Code of Regulations, Title 22, deficiencies were cited. An exit interview was conducted and a copy of the report and appeal rights were provided to the Administrator, Marebeth Mallare.the state’s words, verbatim · CDSS document, May 15, 2025

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Bennette Pena conducted an unannounced required-1 year visit. LPA met with Marebeth Mallare, Administrator and explained the reason for the visit. The facility cares for residents age range 60 and over. The facility is licensed for (5) non ambulatory, (1) bedridden resident (shall be in bedroom #3), and approved for (6) hospice residents only. There are currently (3) residents on hospice. LPA utilized the Compliance and Regulatory Enforcement (CARE) tools for the visit today and observed the following: Infection Control: Infection control practices and Personal Protective Equipment (PPEs) were observed. The facility has submitted a COVID-19 Mitigation Plan and Infection Control Plan. Staff are trained on the emergency infection control plan and following hand hygiene techniques. Emergency and disaster plan was completed and up to date. Operational Requirements: A current Plan of Operation was reviewed. The Infection Control Plan has been added to the Plan. A Hospice Waiver for (6) is approved. Liability insurance policy expired on 03/01/2024 and the Administrator has not renewed the policy.The facility does not handle cash resources for the residents. Latest fire drill was conducted on 03/12/2024. Physical Plant/Environment Safety: The facility is a single story home located in a residential community. The home consists of living room, dining area, kitchen, (4) resident bedrooms, one of the bedrooms has a fireplace that is adequately screened, (4) bathrooms, back yard with swimming pool that is fenced and inaccessible to residents, and laundry area in the attached garage. The interior and exterior physical plant was inspected. Resident bedrooms were toured. Each bedroom has a smoke detector, bed, linen, dresser, light, and sufficient closet space. Bathrooms have the required grabs bars and non-skid materials. At 9:55am, LPA tested hot water temperature which measured at 108.6 deg F in bathroom #1, 110.4 deg F in bathroom #2, 112.4 deg F in bathroom #3 and 105.4 deg F in bathroom #4 which is within the required 105-120 degrees. Resident #3 (R3) and Resident #4 (R4) are both on hospice and observed to have full-length bed rails. Resident #2 is also on hospice and observed to have half bed rail. The resident in room #1 has 3 small dogs that are free to roams around the house. One resident enjoyed talking to and holding the dog. The laundry room is clean and has cleaning supplies inaccessible to residents. The kitchen was inspected. There is sufficient perishable and non-perishable food. All the appliances are cleaning and are working properly. The common areas such as activity room and dining room are clean and have the required furniture. The backyard has a shaded area and sitting area. There is also a swimming pool in the backyard Exit doors have auditory devices that were operating at the time of the visit. There are cameras in the front door, backyard, living room, dining area and kitchen. There were no cameras seen in private areas. Exit doors are free of any obstruction. Cleaning supplies and toxic substances are inaccessible to residents. The facility has four (4) fully charged fire extinguishers, last serviced on 01/13/2024. *****CONTINUED ON LIC809-C***** Staffing: A total of three (3) caregivers including the Administrator provide care and supervision to the residents. Staff employed are over the age of 18 and have criminal background clearance, fingerprint cleared, have the required training and associated to the facility. Personnel Records-Training: Three (3) staff files were reviewed for criminal background clearance and training. Personnel records have health/TB screenings. Administrator has completed the required Administrator courses but has not submitted the certification renewal. Resident Rights-Information: Resident personal rights are posted. Visiting policy is not posted at a location that is visible and accessible to residents and families. Physician orders for use of full/half bed rails were reviewed in residents files. LPA conducted (2) resident interviews. Planned Activities: Information regarding Dementia is part of training for direct care staff and is included in the Plan of Operation. Food Service: The kitchen was inspected and has sufficient supply of 2 day perishable & 7 day non-perishable food. Kitchen, food preparation area, and storage areas were observed to be clean and sanitary. The food is properly stored in the refrigerator (clean and well maintained). Two (2) residents have a special soft diet residing at this facility. Pesticides and cleaning supplies are kept away from the food preparation areas. Plates, cups and utensils are kept cleaned and stored properly. Incident Medical and Dental: All residents have Restricted Health Care Plan and Needs and Services Plan on file. Home Health personnel services the residents in the facility. Hospice and Home Health Nurses administer oxygen to the residents. Resident Records-Incident Reports: Four (4) resident files were reviewed containing admission agreements, Physician's Report, Medical/Functional assessments, Needs and Services Plans, TB clearance, Personal rights, Medical Consent, Medication Records, Restricted Health Care Plans and Hospice Records. Administrator did not have a current and complete medication record for all the residents for the month of April 2024. Disaster Preparedness: The facility has a complete Emergency Disaster and Mass Casualty Plan containing emergency evacuation, storage and preservation of medications, operation of manual assist devices. The facility conducts emergency drill on a quarterly basis for all staff and residents. Residents with SHN: (3) Residents on hospice requiring oxygen on as need basis but the facility did not have "No smoking-oxygen in use" signs posted on their rooms. Administrator has not reported to the local fire department that oxygen is in use at the facility. Administrator cannot provide proof of staff training on knowledge and use of the oxygen equipment. Per California Code of Regulations, Title 22, deficiencies were cited and Technical Assistance were issued. Exit interview conducted with Administrator Marebeth Mallare. A copy of the report and appeal rights were issued.the state’s words, verbatim · CDSS document, Apr 9, 2024

The state marks this report as 8 pages; the online copy we transcribed has 6. You can request the full file from the county licensing office.