Paradise Home

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Ivashia Wright conducted an unannounced annual required visit. Upon entry, LPA was greeted by Milagros Jacob, caregiver, and informed them of the purpose of the visit. Administrator Agnes Martinez arrived shortly after. At the time of the visit, there were two (2) staff members and five (5) residents present. Facility Overview: The facility is a single story building with five (5) residents bedrooms, three and half (3.5) bathrooms, a dinning room, an office, a kitchen and a garage. There is no gated pool and there are no firearms on the premises. Infection Control: LPA observed that hygiene and cleaning supplies were available for regular facility maintenance. The facility’s infection control plan was reviewed and found to meet department requirements. Physical Plant: The physical plant, including floors, windows, and doors, was clean and well maintained. Fixtures and furniture were in good repair. The outdoor area was free of hazards. Laundry equipment was in good working condition. Sharp and dangerous objects were securely locked under kitchen cabinet and inaccessible to residents. Both the smoke detector and carbon monoxide detector were operational, and the hot water temperature was measured at 112.6 meeting the department requirements. LPA observed fire extinguishers to be in compliance with the department's requirements and with an expiration date of 3/8/2027. Food Service: The facility’s kitchen was clean and equipped to prepare food. The facility maintained the required two-day supply of perishable foods and a seven-day supply of non-perishable foods. Continued on LIC809-C.... Care & Supervision/Administration: Adequate staff were present to supervise clients during the visit. The administrator holds a current administrator’s certificate which expires 12/28/2027 and CPR certification which expires 8/8/2027. Record Review and Resident/Staff Files: LPA reviewed files for two (3) staff members, confirming criminal clearances, updated training, and CPR/First Aid certification. Three (3) resident files were reviewed and contained all required documentation. LPA observed first aid kit to be stored in a locked hallway closet inaccessible to residents. Health-Related Services/Incidental Medical Services: All resident medications were securely locked in the kitchen area. LPA reviewed medications for 3 (three) residents, confirming that all medications were listed on the Medication Administration Record (MAR) and accounted for. Disaster Preparedness: LPA reviewed the facility’s emergency and disaster plan, including documentation of the last fire/earthquake drill conducted on 4/5/2026, which met department requirements. All facility exits were clear of obstructions. No deficiencies were cited during the visit. An exit interview was conducted, during which this report was reviewed and provided to the Administrator Agnes Martinez.the state’s words, verbatim · CDSS document, May 6, 2026

Type of visit: Case Management - Other

Licensing Program Analyst (LPA) Abdoulaye Zerbo conducted an unannounced visit to the facility to issue an amended report to clarify the findings. LPA met with Caregiver Milagros Jacob, identified himself and discussed the purpose of the visit. A tour of the facility was facility. No immediate health and safety concerns were observed during the visit. During today’s visit, LPA obtained Caregiver Milagros Jacob 's signature on an amended version of a report originally delivered on 04-17-2025. An exit interview was conducted, and a copy of this report was provided to Caregiver Milagros Jacobthe state’s words, verbatim · CDSS document, Jun 26, 2025

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Abdoulaye Zerbo conducted an unannounced visit for a required annual inspection. The LPA was greeted by Licensee/Administrator Agnes Martinez, notified them of the purpose for the visit and was allowed to enter the facility to conduct the inspection. Facility Overview: The facility is a single story building with five(5) residents bedrooms, three and half (3.5) bathrooms, a dinning room, an office, a kitchen and a garage. There is no gated pool and there are no firearms on the premises. Infection Control: LPA observed that hygiene and cleaning supplies were available for regular facility maintenance. The facility’s infection control plan was reviewed and found to meet department's requirements. Physical Plant: The physical plant, including floors, windows, and doors, was clean and well maintained. Fixtures and furniture were in good repair. Laundry equipment was in good working condition. Sharp and dangerous objects were securely locked in the kitchen and inaccessible to residents. The smoke detector and carbon monoxide detector were in good working condition. LPA observed fire extinguishers to be in compliance with the department's requirements and with an expiration date of February 28, 2026. The water temperature was tested within regulations measuring at 113.3 F Continued 809-C...... Care & Supervision/Administration: Adequate staff were present to supervise residents during the visit. The administrator holds a current administrator’s certificate with expiration date of December 29, 2025 and a CPR certification with the expiration date of August 20th, 2025 Record Review and Resident/Staff Files: LPA reviewed files for two(2) staff members, confirming criminal clearance, updated training, and CPR/First Aid certification. Three (3) residents' files were reviewed and contained all required documentation. LPA observed first kit to be locked and inaccessible to the residents in care. The residents and staff files were kept locked and inaccessible to unauthorized individuals Health-Related Services/Incidental Medical Services: All residents' medications were securely locked in a cabinet and located in the kitchen area. LPA reviewed medications for three(3) residents, confirming that all medications were listed and accounted for. Disaster Preparedness: LPA reviewed the facility’s emergency and disaster plan, including documentation of the last emergency drill conducted on February-06-2025, which met the department's requirements. All facility exits were clear of obstructions. No deficiencies were cited during the visit. An exit interview was conducted, during which this report was reviewed, and a copy was provided to Licensee/Administrator Agnes Martinez.the state’s words, verbatim · CDSS document, May 13, 2025

Allegation investigated: Staff interacted inappropriately with a resident

Licensing Program Analyst (LPA) Abdoulaye Zerbo conducted an unannounced visit to the facility to deliver findings on the complaint investigation. LPA Abdoulaye was greeted and granted entrance by Licensee Agnes Martinez. LPA Abdoulaye Zerbo identified himself and discussed the purpose of the visit. LPA conducted a health and safety check by conducting tour of the facility. No immediate health and safety concerns were observed during the visit. It was alleged that a staff member interacted inappropriately with a resident. However, interviews with staff revealed that the allegation had been investigated and determined to be false. The Administrator explained R1 is on hospice care and frequently complains about pain. Information obtained revealed R1’s medications were adjusted per physician’s order. Additionally, staff highlighted R1’s inconsistent behavior, such as making calls and hanging up, yelling, or sending incoherent text messages. Unsubstantiated LPA interviewed S1, who denied all allegations of inappropriate behavior. S1 explained R1 repeatedly removes their oxygen tubing and requests assistance to put it back on, which S1 would accommodate R1 by adjusting the oxygen mask per R1’s request. Interviews with other residents revealed the incident stemmed from R1’s attempts to obtain a controlled substance outside of their prescribed schedule. Additional information obtained from residents’ interview also revealed the allegation never took place and R1 struggles with addiction to controlled substances and frequently requests additional medications outside of their scheduled medication time. Based on the evidence, the allegation mentioned above is UNSUBSTANTIATED. A finding that the complaint is UNSUBSTANTIATED means although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur, therefore the allegation is unsubstantiated at this time. An exit interview was conducted where this report, LIC9099 was discussed and provided to Licensee Agnes Martinez. This is an amended version of the original report created on 04-17-25. The findings were clarified and a new 9099 now supersedes it.the state’s words, verbatim · CDSS document, Apr 17, 2025 · control 18-AS-20241120160638

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Janira Arreola conducted an unannounced to the facility in order to conduct the required annual. LPA met with Administrator, Agnes Martinez who was informed of the purpose of the visit. There were (5) residents and (3) staff present during the time of the visit. The facility is a one story home with (5) resident rooms and (3) bathrooms. There is an attached garage and outdoor space. No pools or firearms are beingkept at the facility. The facility is a residential care facility for the elderly. The following was observed: The LPA observed PPE equipment and cleaning supplies to do regular cleaning of the facility. Physical plant, floors, windows, and doors were observed to be clean. Fixtures and furniture were in good repair were present. The outdoor area was observed to be free of hazards. Laundry equipment was observed to be in good condition. Hot water temperature was recorded at 115F. LPA observed facility kitchen had the ability to prepare food in clean environment and possessed equipment in good working condition. LPA observed the facility met the required 2-day supply of perishable and 7-day supply of non-perishable foods. Adequate staff are present for the supervision of residents during the visit. LPA reviewed (5) staff files and training as well as (5) client files. LPA issued technical note with (1) staff that had CPR certification expired within a few days. The licensee agreed to have staff recertify 5/16/2024 and send LPA proof of this. All client medication was locked in kitchen pantry. LPA reviewed MARS and bubble packs for clients and found medication was accounted for. LPA reviewed documentation showing the facility's last fire drill 1/15/2024, the facility is late (1) month in conducting their fire drill. Technical note was issued and licensee agreed to conduct fire drill by the end of the month and send proof to LPA. LPA observed all facility exits were clear from obstructions. The carbon monoxide detectors were tested during the time of the visit and were operational. LPA observed emergency supplies and first aid kit. No deficiencies were cited at the time of the visit. An exit interview was conducted with Agnes Martinez where this report was reviewed and provided to them.the state’s words, verbatim · CDSS document, May 15, 2024

The state marks this report as 4 pages; the online copy we transcribed has 2. You can request the full file from the county licensing office.