House at Vinewood

Type of visit: Required - 1 Year

On this day, Licensing Program Analyst (LPA) Andrea Mendivil made an unannounced visit to conduct a required annual visit. LPA was greeted and granted entry by staff and explained the reason for the visit. The facility is a four bedroom single story building with an approved fire clearance of six non-ambulatory residents of which four may be on hospice. The facility currently has a census of five residents in care. During today’s visit, LPA toured the facility and inspected the physical plant, including but not limited to testing all smoke detectors and testing hot water temperature in two of two resident bathrooms. The hot water temperature measured 111.3 and 117.3 degrees Fahrenheit and all smoke detectors were operational. The swimming pool is fenced and locked and inaccessible to residents. The facility conducted an emergency drill on June 18, 2026. LPA inspected the facility food supply and observed the facility retained a minimum of two days perishable and seven days non-perishable food on hand. LPA observed medication storage and reviewed the centrally stored medications. LPA observed emergency food and water in the laundry room. LPA reviewed three staff training and fingerprint records and conducted a complete review of five out of five resident records. LPA confirmed that administrator has a current administrator certificate which expires on February 15, 2027. No deficiencies noted, an exit interview was conducted and a copy of this report was provided.the state’s words, verbatim · CDSS document, Jul 10, 2026

Allegation investigated: Staff did not administer medication to a resident in care. Staff are not following resident's dietary plan. Staff are not properly cleaning a resident in care.

On this day, Licensing Program Analyst (LPA) Andrea Mendivil made an unannouced visit to deliver complaint findings. LPA was greeted and granted entry into the facilty and explained the reason for the visit. The Department received a complaint on 08/26/2025 and the initial 10 day visit was conducted on 09/02/2025. During the initial visit LPA Mendivl obtained copies of pertinent documents such as physician's reports, medication administration records and hospital discharge paperwork for Resident 1 (R1) LPA Mendivil also interviewed staff and residents. Regarding the allegations Staff did not administer medication to a resident in care, Staff are not following resident's dietary plan and Staff are not properly cleaning a resident in care the investigation revealved the following: R1 was admitted to the facility on 07/21/2025 and based on physician's report dated 07/15/2025 R1 was diagnosed with major neurocognitive disorder and is listed to be able to communicate their own needs. Unsubstantiated It was alleged that staff did not administer medication as prescribed for R1 per review of Medication Administrator Record (MAR) for July and August 2025 the R1 was given medication as prescribed. Per interviews with 3 out of 3 staff they administer medications as prescribed. Interviews with 1 out of 4 residents stated they are getting their medications as prescribed, the 3 remaining residents were not oriented to place and time. It was alleged the facility is not following the resident's dietary plan. Per review of physician's report dated 07/15/2025 there was no mention of special diet for R1 and it was not until hospital discharge paperwork dated 08/22/2025 a modified diet was mentioned. The paperwork advised "no beef/pork, lactose intolerant and take lactaid before every meal." Per review of MAR starting on 08/22/2025 lactaid was provided at each meal. Based on interviews with Licensee Linda Bolivar, R1 did not eat lunch and therefore staff did not provide lactaid at lunch time. Per interview with Licensee Linda if someone has a modified diet they follow physician's orders. It was alleged the staff are not properly cleaning a resident in care, per interviews with 3 out of 3 staff stated that they assist residents as needed, including changing briefs or providing assistance in the bathroom. Interviews with staff stated they properly wipe residents. Per LPA Mendivil observations all residents are well groomed and dressed appropriately and the facility does not have any odors. Therefore based on the preponderance of evidence through records reviewed and interviews the allegations Staff did not administer medication to a resident in care, Staff are not following resident's dietary plan and Staff are not properly cleaning a resident in care are determined to be UNSUBSTANTIATED, meaning that although the allegations may have happened or are valid, there is not a preponderance of the evidence to prove that the alleged violations occurred. An exit interview was conducted and a copy of this report and LIC 811 provided to the facility.the state’s words, verbatim · CDSS document, Oct 14, 2025 · control 22-AS-20250826220701

Type of visit: Required - 1 Year

On this day, Licensing Program Analyst (LPA) Andrea Mendivil made an unannounced visit to conduct a required annual visit. LPA was greeted and granted entry by staff and explained the reason for the visit. Licensee Linda Bolivar arrived at 1:00PM The facility is a four bedroom single story building with an approved fire clearance of six non-ambulatory residents of which four may be on hospice. The facility currently has a census of four residents in care. During today’s visit, LPA toured the facility and inspected the physical plant, including but not limited to testing all smoke detectors and testing hot water temperature in two of two resident bathrooms. The hot water temperature measured 112 and 116.6 degrees Fahrenheit and all smoke detectors were operational. The swimming pool is fenced and locked and inaccessible to residents. The facility conducted an emergency drill on 04/24/2025. LPA inspected the facility food supply and observed the facility retained a minimum of two days perishable and seven days non-perishable food on hand. LPA observed medication storage and reviewed the centrally stored medications. Per review medications are being given as prescribed. LPA observed emergency food and water in the garage. LPA reviewed six of six staff training and fingerprint records and conducted a complete review of four out of four resident records. LPA confirmed that administrator has a current administrator certificate which expires on February 15, 2027. No deficiencies noted, an exit interview was conducted and a copy of this report was provided.the state’s words, verbatim · CDSS document, Jul 11, 2025

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Rose Ruppert made an unannounced visit to the facility today to conduct an Annual Required Evaluation. LPA was greeted and granted entry by Staff #1 (S1) at 12:45pm. During today’s visit, LPA met with Socorro Sabino, Administrative Designee. The facility is a four bedroom single story building with an approved fire clearance of six non-ambulatory residents of which four may be on hospice. The facility currently has a census of six residents in care. During today’s visit, LPA toured the facility and inspected the physical plant, including but not limited to testing all smoke detectors, testing hot water temperature in two of two resident bathrooms, and testing auditory devices on all exits. The hot water temperature measured 105.0 degrees Fahrenheit and all smoke detectors were operational. The swimming pool is fenced and locked and inaccessible to residents. The fire extinguishers are charged and were serviced on June 28, 2024. The facility has not conducted a fire drill. LPA inspected the facility food supply and observed the facility retained a minimum of two days perishable and seven days non-perishable food on hand. LPA observed medication storage and reviewed the centrally stored medications. Per review medications are being given as prescribed. A Technical Violation is being given regarding documentation of dispensed medications in the Medication Administration Record. LPA reviewed three of three staff training and fingerprint records and conducted a complete review of resident records. LPA interviewed alert residents regarding their quality of care and spoke to staff present regarding care provided. LPA confirmed that administrator has a current administrator certificate which expires on February 15, 2025. The following deficiency is being cited per Title 22 Division 6 of the California Code of Regulations. An exit interview was conducted with Socorro Sabino, Adminstrative Designee and a copy of this report was given to the facility along with a copy of the LIC 858, LIC 859; LIC 809-D and Appeal Rights.the state’s words, verbatim · CDSS document, Aug 20, 2024

The state marks this report as 3 pages; the online copy we transcribed has 2. You can request the full file from the county licensing office.