Avatar Retirement Home

Type of visit: Required - 1 Year

n 8/27/2026, Licensing Program Analyst (LPA) Mia Lankford arrived unannounced to conduct an annual inspection. Upon arrival LPA was greeted by facility staff and granted entry. LPA began inspection with introduction and visit purpose. Upon arrival LPA learned that ten (10) clients live at this facility. There was three (3) staff members present. The Administrator, Guadalupe Licea was advised of the annual and came to conduct and completed the facility tour. Client Records/Incident Reports/Clients Rights Information: LPA reviewed client records. Seven (7) records were reviewed. LPA reviewed for identification and emergency information, admission agreement, medical assessment, and TB test results, needs and service plans, placement, functional assessment, centrally stored medication/destruction records, safeguard for personal property/valuables, and personal rights notification. Personnel Records/Training/ Staffing/ Administration: LPA reviewed employee records. Two (2) records were reviewed. LPA reviewed employee records for first aid certification, criminal record clearance or an exemption, health screening and TB test results, employee rights, training verification, and current administrative organization. Guadalupe Licea Administrator’s certificate expiration date was 3/15/2028. Food Service: Food prep areas are clean and organized. Food supply meets the requirement of one (1) week supply of nonperishable and two (2) day supply of perishables. Emergency food and water supply is present. There is a location for sharps in the kitchen. Physical Plant and Safety of Environment/Operational Requirements: LPA toured the facility inside and outside. LPA observed the facility to be clean and in good repair. The facility is maintained at 75 degrees for the client’s comfort. Lighting is sufficient for safety. Water temperature measured 108.0 degrees F. Cont... Cont.. Laundry is done in the laundry room. There is a locked location for storing laundry soap, cleaning supplies and chemicals in the closet in the garage. All outdoor and indoor passageways are free of obstruction. Emergency lighting is available. There is a telephone working at this location. LPA dialed the facility’s landline number, which rang and was operable. The LIC 610, emergency disaster plan is maintained. There are no firearms at this facility. There is one (1) secured fireplace at this facility. There is not a pool at the facility. There are two (2) secured gates that have a self-latching lock on the northwest and northeast sides of the house. LPA observed emergency supplies and two (2) first aid kits. The last emergency fire drill was conducted on 05/19/2026. Infection Control: The LPA observed the hand washing stations in the facility restrooms and kitchen had hand hygiene supplies and hand washing signs. LPA observed PPE equipment and cleaning supplies to do regular cleaning of the facility. LPA reviewed the facility's infection control plan which met department requirements. LPA reviewed staff records and found that all staff had infection control training. Medications/Health Related Services/Incidental Medical Services: The medications are centrally stored. There is a locked cabinet allocated for medication storage. Centrally stored medication and destruction logs are maintained separately. LPA reviewed medication logs and observed that they were dispensed accurately. LPA made observation throughout the inspection process to assess if the facility remains in conformity with the State Fire Marshall regulations. LPA observed twelve dual (12) smoke detectors and carbon monoxide detectors throughout the facility. There were two (2) fire extinguishers on site, date charged was 4/3/2026. An exit interview was conducted, this LIC 809 was reviewed with, and a copy of this report was provided to Administrator, Guadalupe Liceathe state’s words, verbatim · CDSS document, Aug 27, 2026

Allegation investigated: Facility failed to keep resident adequately hydrated

LPA Javier Prieto and LPA Eldin Serrano arrived at the facility to delivery findings to the listed allegations. LPA met with house manager Angel Sanchez and explained the nature of the visit. The investigation, conducted by Department staff consisted of interviews with relevant parties, and file reviews revealed that the administrator called 911 due to Resident 1 (R1) having a fast heart rate. R1 was admitted to the hospital on 2/4/2020, and discharged back to the facility on 2/6/2020, on hospice. Hospital documents indicates that R1 was dehydrated. Based on the LPAs interviews, and review of documents the preponderance of evidence standard has been met, therefore the above allegation is found to be SUBSTANTIATED. An exit interview was conducted where this report, LIC 9099D, and appeal rights were discussed with and provided to the house manager. Substantiatedthe state’s words, verbatim · CDSS document, Aug 28, 2024 · control 18-AS-20200207105543

From the deficiency page — Deficiency type: Type A · Section cited: CCR 87705(c)(3)(A) · Plan of correction due date: Sep 3, 2024

CARE OF PERSONS WITH DEMENTIA Licensees who accept residents with dementia shall be responsible for ensuring:(3)on-the-job training to staff who provide direct care.(A) which should include, but not limited to, knowledge about hydration. This requirement was not met as evidenced by: Based on interviews and record review, the facility failed to ensure that Resident 1 (R1) remained hydrated. Hospital discharge documents dated 2/6/20 indicates R1 was dehydrated. This poses an immediate health and safety risk to residents in care.the state’s words, verbatim · CDSS document, Aug 28, 2024

Plan of correction: The facility will ensure that all residents are properly hydrated and assessed for signs of dehydration. A declaration will be sent to LPA by the POC date,

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Kathleen Banrasavong arrived unannounced to conduct an annual inspection. Upon arrival LPA was greeted by facility staff and granted entry. LPA began inspection with introduction and visit purpose. Upon arrival LPA learned that seven (7) clients live at this facility. There was two (2) staff members present. The Administrator, Yolanda Alkawass was advised of the annual and came to conduct and completed the facility tour. Client Records/Incident Reports/Clients Rights Information: LPA reviewed client records. Seven (7) records were reviewed. LPA reviewed for identification and emergency information, admission agreement, medical assessment, and TB test results, needs and service plans, placement, functional assessment, centrally stored medication/destruction records, safeguard for personal property/valuables, and personal rights notification. Personnel Records/Training/ Staffing/ Administration: LPA reviewed employee records. Two (2) records were reviewed. LPA reviewed employee records for first aid certification, criminal record clearance or an exemption, health screening and TB test results, employee rights, training verification, and current administrative organization. Yolanda Alkawass, Administrator’s certificate expiration date was 12/14/2023. The Administrator submitted her renewal on 12/04/2023 to the Department of Social Services. Food Service: Food prep areas are clean and organized. Food supply meets the requirement of one (1) week supply of nonperishable and two (2) day supply of perishables. Emergency food and water supply is present. There is a location for sharps in the kitchen. Physical Plant and Safety of Environment/Operational Requirements: LPA toured the facility inside and outside. LPA observed the facility to be clean and in good repair. The facility is maintained at 75 degrees for the client’s comfort. Lighting is sufficient for safety. Water temperature measured 108.0 degrees F. Laundry is done in the laundry room. There is a locked location for storing laundry soap, cleaning supplies and chemicals in the closet in the garage. All outdoor and indoor passageways are free of obstruction. Emergency lighting is available. There is a telephone working at this location. LPA dialed the facility’s landline number, which rang and was operable. The LIC 610, emergency disaster plan is maintained. There are no firearms at this facility. There is one (1) secured fireplace at this facility. There is not a pool at the facility. There are two (2) secured gates that have a self-latching lock on the northwest and northeast sides of the house. LPA observed emergency supplies and two (2) first aid kits. The last emergency fire drill was conducted on 05/01/2024. Infection Control: The LPA observed the hand washing stations in the facility restrooms and kitchen had hand hygiene supplies and hand washing signs. LPA observed PPE equipment and cleaning supplies to do regular cleaning of the facility. LPA reviewed the facility's infection control plan which met department requirements. LPA reviewed staff records and found that all staff had infection control training. Medications/Health Related Services/Incidental Medical Services: The medications are centrally stored. There is a locked cabinet allocated for medication storage. Centrally stored medication and destruction logs are maintained separately. LPA reviewed medication logs and observed that they were dispensed accurately. LPA made observation throughout the inspection process to assess if the facility remains in conformity with the State Fire Marshall regulations. LPA observed twelve dual (12) smoke detectors and carbon monoxide detectors throughout the facility. There were two (2) fire extinguishers on site, date charged was 06/03/2023. Pursuant to Title 22 of The California Code of Regulations Division 6, there are zero (0) deficiencies observed. An exit interview was conducted, this LIC 809 was reviewed with, and a copy of this report was provided to Administrator, Yolanda Alkawass.the state’s words, verbatim · CDSS document, Jun 26, 2024

The state marks this report as 6 pages; the online copy we transcribed has 3. You can request the full file from the county licensing office.