JC Home for Seniors - Thor

Type of visit: Required - 1 Year

Licensing Program Analysts (LPAs) Nancy Guillen and Kevin Saborit-Guasch made an unannounced visit for the purpose of conducting a required annual inspection. LPAs were greeted and granted entry by care provider Noel Mallari after explaining the purpose of the visit. Administrator (AD) Maria Emeterio was notified via telephone and later arrived to assist with the inspection. LPAs observed the Administrator certificate was current and expires August 15, 2026. This is a Residential Care Facility for the Elderly (RCFE) licensed to six non-ambulatory residents, of which one may be bedridden, with a hospice waiver for six. The facility is a one-story home with four resident bedrooms, one staff bedroom, two bathrooms, and an attached garage. During the inspection, LPAs and AD conducted a tour of the inside and outside of the facility, common areas, resident rooms, kitchen, garage and observed the following: LPAs observed a residents watching television in the living room and resting in their respective bedrooms. LPAs observed six residents in care and four staff present. LPAs observed the See Something Say Something Poster (PUB 475) mounted on the wall in the dining room. All resident bedrooms had the required furnishings. LPAs observed all resident beds had linens and blankets with additional linens stored in the hallway storage closet. LPAs observed bathrooms were clean and equipped with grab bars and non skid floor mats. LPAs observed all windows were appropriately screened. Bathrooms were observed to be free of debris and mildew, faucets and toilets were operational. Water temperature tested between 116.6 and 117.1 degrees Fahrenheit. LPAs toured the outside of the facility and observed outdoor passageways were free of obstruction. LPAs observed the backyard had a shaded sitting area with furniture for resident use. LPAs observed fireplace in dining area had appropriate screening. Continued on LIC 809C LPAs observed the facility had a 2-day supply of perishables and a 7-day supply of non-perishable food as required by regulations. Smoke detectors and carbon monoxide detectors tested operational. Fire extinguisher was observed to be fully charged with a purchase date of November 25, 2025 and located in the living room. Gas stove, and dish washer were all inspected and observed to be operable. The garage is used for storage. Toxic chemicals, cleaning solutions, and disinfectants were observed to be locked and inaccessible to residents in the garage, however LPAs observed Clorox wipes in resident bathroom and Polyethylene Glycol in kitchen pantry accessible to residents in care. A deficiency was cited on today's date. Medication cabinet was observed to be locked and centrally stored in a hallway storage. LPAs observed the First Aid Kit had all the required components. LPAs observed the facility conducted their last emergency disaster drill on April 22, 2026 and is conducted every 3 months. While waiting for the AD, LPAs began review of the records. LPA Guillen reviewed six resident records. All the required documentation were present and current in the residents files reviewed, however Resident #5 was missing TB test on file; a deficiency was cited on today's date. LPAs reviewed three employee records. All employee’s present have a criminal record clearance and were associated to the facility. LPAs observed records reviewed have a current First Aid certificate. LPAs informed Licensee of pending annual fees and PIN number was provided. Before concluding visit Licensee paid for pending fees. Based on the observations made during today’s inspection, deficiencies and technical violations/advisories are being cited per Title 22 Division 6 of the California Code of Regulations. An exit interview was conducted, and a copy of this report, appeal rights and Legionnaire’s Disease fact sheet was left at the facility.the state’s words, verbatim · CDSS document, May 19, 2026

The state marks this report as 7 pages; the online copy we transcribed has 4. You can request the full file from the county licensing office.

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Samer Haddadin conducted an unannounced annual inspection visit at the facility. Upon arrival, LPA Haddadin was greeted by Administrator (AD) Jay Parungao, who granted access to the premises. LPA Haddadin explained the purpose of the visit. LPA Haddadin, accompanied by AD Parungao, toured the interior and exterior portions of the facility. The following observations were made: The facility is a single-story residence featuring four (4) resident bedrooms, two (2) bathrooms, a staff room, a kitchen, a dining room, a living room, and an attached garage. At the time of the visit, three (3) residents were present and were observed relaxing in their respective rooms. Resident bedrooms were furnished with beds, chairs, clean linens, and adequate storage space. All rooms were free of tripping hazards. Manual smoke detectors, carbon monoxide detectors, and exit alarms were tested and confirmed to be operational. The bathrooms were observed to be in good repair and equipped with grab bars. The hot water temperature was measured at 115.3∘F. The facility met the minimum food stock requirements, maintaining a two-day supply of perishable items and a seven-day supply of non-perishable items. A fire extinguisher was observed with a stated purchase date of August 29, 2024. The exterior portion of the facility included outdoor furniture in good condition. The grounds were free of tripping hazards and provided ample space for activities. The kitchen was found to be in good repair. Cleaning supplies and sharp items were stored in a manner that made them inaccessible to residents in care. Medications were stored securely in a locked location in the hallway. LPA Haddadin reviewed the files and medications for two (2) clients; no discrepancies were noted. A review of two (2) staff files also revealed no discrepancies. All staff and client files contained all required documentation. Upon review of facility records, it was noted that documentation for the required quarterly fire drill was not on file. No other deficiencies were noted during today's inspection visit. An exit interview was conducted with AD Parungao, and a copy of this report was providedthe state’s words, verbatim · CDSS document, May 12, 2025

Type of visit: Required - 1 Year

On 8/29/2024, Licensing Program Analyst (LPA) Janette Romero conducted an unannounced visit to the facility for a required annual inspection. LPA was greeted and granted entry by Caregiver, Noel Mallari and who was informed of the purpose of the visit. Administrator, Maria Emeterio-Parungao arrived during the visit and was also informed of the purpose of LPA's visit. The facility has a fire clearance for six (6) non-ambulatory elderly residents, of which one (1) may be bedridden. LPA toured the facility with Caregiver Mallari and observed the facility is made up of a one-story home with four (4) resident bedrooms, two (2) bathrooms, a staff room, kitchen, dining room, living room and attached garage. During the tour, Caregiver Mallari tested one (1) of the smoke alarms/carbon monoxide detectors and LPA observed it to be operational. Indoor and outdoor passageways were free of obstruction. The facility has outdoor shaded seating for the residents in care. There were no bodies of water observed on the premises. Medications are secured in a locked hallway closet. Resident bedrooms had the required furniture and lighting. Bathrooms had grab bars near the toilets and in the showers. The facility had a 2-day supply of perishable foods and 7-day supply of non-perishable food items. Resident files reviewed had signed admission agreements and physician's reports. Staff present have a criminal record clearance and valid first aid/CPR certification. During the tour, LPA observed the facility had one (1) fire extinguisher mounted near the kitchen that was labeled with a green tag noting it was last serviced on 7/13/2020. LPA observed the fire extinguisher's pressure gauge needle to the left of the green zone and in the red zone, meaning the extinguisher is undercharged, warrants a recharge, and may not have enough pressure to work properly. Administrator Emeterio-Parungao reported the facility did not have another extinguisher available at that moment. LPA issued a deficiency. An exit interview was conducted where this report was reviewed and provided to Administrator Emeterio-Parungao along with an LIC809-D and appeal rights.the state’s words, verbatim · CDSS document, Aug 29, 2024