Royal Palms Guest Home

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Raquel Hernandez made an unannounced visit to the facility. The purpose of the visit was to conduct a required comprehensive annual inspection. LPA met with House Manager Marco Pascaran and was granted entry to the facility. Licensed capacity is (6) current census (2). LPA was accompanied by House Manager Marco Pascaran to conduct a general overall inspection, which included, but was not limited to, the following: Physical Plant: The facility is operating in the capacity approved by Community Care Licensing (CCL). There are no obstructions to indoor and outdoor passageways. The facility is maintained at a comfortable temperature. LPA inspected resident bedrooms; they are equipped with required furniture such as: mattresses, night stands, storage space, and sufficient lighting; bathrooms were clean, and appliances were operating appropriately. Hot water temperature tested within regulation. LPA observed sufficient furniture and lighting throughout the facility. The facility is equipped with operating smoke detectors and carbon monoxide alarms. Posters such as personal rights, the CCL complaint poster, and the disaster plan were posted in a common area. Cleaning supplies, toxins, sharps, and other dangerous items were kept inaccessible to clients in care. There was a designated space for resident/staff files. Overall, the facility is clean, in good repair, and operating in safe conditions for residents in care. Food Service: Non-perishable and perishable food supply is sufficient for number of residents in care. Facility has a variety of food available for residents. Dishes, cups, and utensils were also stored properly. Care & Supervision: Facility has sufficient care staff for coverage 24 hours a day, 7 days a week. Record Review: LPA reviewed (2) resident files for admission agreements, updated physician reports, pre-placement appraisals and needs and services plans. No issues observed. LPA reviewed (2) resident medications. No issues were observed. Additionally, LPA also reviewed (2) staff files for First Aid/CPR certification, criminal record clearance, training's, and health screenings. LPA observed facility staff did not have updated annual training. Deficiency will be issued. Based on the observations made during today’s visit, (1) deficiency was cited/issued per Title 22, Division 6, of the California Code of Regulations. An exit interview was conducted, and this report (LIC809) (LIC809C) were discussed and provided to House Manager Marco Pascaran along with copy of appeal rights.the state’s words, verbatim · CDSS document, Sep 9, 2026

From the deficiency page — Deficiency type: Type B · Section cited: CCR 87411(c) · Plan of correction due date: Sep 23, 2026

87411 Personnel Requirements – General (c) All RCFE staff who assist residents with personal activities of daily living shall receive initial and annual training as specified in Health and Safety Code sections 1569.625 and 1569.69 Based on observation and record review, the licensee did not comply with section cited above by not ensuring facility staff were trained annually, which poses a potential health, safety, and personal rights risk to persons in care.the state’s words, verbatim · CDSS document, Sep 9, 2026

Plan of correction: Licensee stated to submit to LPA annual training for facility staff by Plan of Correction (POC) due date.

Allegation investigated: Staff did not follow reporting requirements

On 08/12/2026 Licensing Program Analyst (LPA) Raquel Hernandez conducted an unannounced visit to deliver findings for above allegations. LPA met with House Manager Marco Pascaran and explained the purpose of today's visit. On 06/26/2026, the licensing department received a complaint with five (5) allegations. One allegation is indicating staff did not follow reporting requirements. LPA discovered facility's air conditioner stopped working on 06/16/2026 approximately. LPA observed facility did not report this to licensing department. Based on the evidence gathered during today’s investigation, the one (1) allegation listed above are deemed SUBSTANTIATED. A finding that the complaints are SUBSTANTIATED means that the allegation are valid because the preponderance of evidence the standard has been met. During today’s visit, a deficiency was cited per Title 22, Division 6, of the California Code of Regulations. An exit interview was conducted, and this report (LIC9099) and (LIC9099D) was discussed and provided to House Manager Marco Pascaran along with a copy of the appeal rights. Substantiatedthe state’s words, verbatim · CDSS document, Aug 12, 2026 · control 56-AS-20260624141657

From the deficiency page — Deficiency type: Type B · Section cited: CCR 87211(a)(1)(D) · Plan of correction due date: Aug 19, 2026

(a) Each licensee shall furnish to the licensing agency... (1) A written report shall be submitted to the licensing agency and to the person responsible for the resident within seven days...(D) Any incident which threatens the welfare, safety or health of any resident... Based on observation and interviews, the licensee did not comply with section cited above by not ensuring facility reported air conditioner breaking to licensing department within seven days of occurence, which poses a potential health, safety, and or personal rights risk to persons in care.the state’s words, verbatim · CDSS document, Aug 12, 2026

Plan of correction: Licensee stated moving forward to submit all special incident reports (SIR) that regard residents personal, health, and or safety risks to licensing department within seven days of occurence.

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Raquel Hernandez made an unannounced visit to the facility. The purpose of the visit was to conduct a required comprehensive annual inspection. LPA met with House Manager Marco Pascaran and was granted entry to the facility. Licensed capacity is (6) current census (2). LPA was accompanied by House Manager Marco Pascaran to conduct a general overall inspection, which included, but was not limited to, the following: Physical Plant: The facility is operating in the capacity approved by Community Care Licensing (CCL). There are no obstructions to indoor and outdoor passageways. The facility is maintained at a comfortable temperature. LPA inspected resident bedrooms; they are equipped with required furniture such as: mattresses, night stands, storage space, and sufficient lighting; bathrooms were clean, and appliances were operating appropriately. LPA tested water temperature to test at 106 degrees Fahrenheit. LPA observed sufficient furniture and lighting throughout the facility. The facility is equipped with operating smoke detectors and carbon monoxide alarms. Posters such as personal rights, the CCL complaint poster, and the disaster plan were posted in a common area. Cleaning supplies, toxins, sharps, and other dangerous items were kept inaccessible to clients in care. There was a designated office for resident/staff files. Overall, the facility is clean, in good repair, and operating in safe conditions for residents in care. Food Service: Non-perishable and perishable food supply is sufficient for number of residents in care. Facility has a variety of food available for residents. Dishes, cups, and utensils were also stored properly. Care & Supervision: Facility has sufficient care staff for coverage 24 hours a day, 7 days a week. Record Review: LPA reviewed (2) resident files for admission agreements, updated physician reports, pre-placement appraisals and needs and services plans. LPA observed no updated physician report for Resident #1 (R1). Technical Violation will be issued. LPA observed no reappraisal being conducted for (2) residents in care. Technical violation was issued. House Manager stated a reappraisal will be sent to LPA. LPA observed facility does not have a Plan of Operation in place. Deficiency will be issued. Additionally, LPA observed facility does not have a dementia care plan and has (1) resident diagnosed with dementia. Deficiency will be issued. LPA reviewed (1) resident medications. No issues were observed. Additionally, LPA also reviewed (3) staff files for First Aid/CPR certification, criminal record clearance, training's, and health screenings. No issues were observed. Based on the observations made during today’s visit, (2) deficiencies and (2) technical violation were cited/issued per Title 22, Division 6, of the California Code of Regulations. An exit interview was conducted, and this report (LIC809), (LIC809D), (LIC9102TV) and copy of appeal rights were discussed and provided to House Manager Marco Pascaran.the state’s words, verbatim · CDSS document, Sep 10, 2025

The state marks this report as 6 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) Mary Rico made an unannounced visit to the facility. The purpose of the visit was to conduct a required comprehensive annual inspection. LPA met with House Manager Marco Pascaran and was granted entry to the facility. Licensed capacity is (6) current census (4). LPA was accompanied by House Manager Marco Pascaran to conduct a general overall inspection, which included, but was not limited to, the following: Physical Plant: The facility is operating in the capacity approved by Community Care Licensing (CCL). There are no obstructions to indoor and outdoor passageways. The facility is maintained at a comfortable temperature. LPA inspected client bedrooms; they are equipped with required furniture such as: mattresses, nightstands, storage space, and sufficient lighting; bathrooms were clean, and appliances were operating appropriately. LPA observed sufficient furniture and lighting throughout the facility. Posters such as personal rights, the CCL complaint poster, and the disaster plan were posted in a common area. Cleaning supplies, toxins, sharps, and other dangerous items were kept inaccessible to clients in care. There was a designated space for client/staff files. Food Service: Non-perishable and perishable food supply is sufficient for number of clients in care. Facility has a variety of food available for clients. Dishes, cups, and utensils were also stored properly. Care & Supervision: Facility has sufficient care staff for coverage 24 hours a day, 7 days a week. Record Review: LPA reviewed (4) resident files for admission agreements, updated physician reports, and needs and services plans. LPA reviewed (4) client medications. During medication audit LPA observed 1 out of the 4 residents did not have their PRN medication documented with the time, date, dosage, and resident’s response. LPA also reviewed (3) staff files for criminal record clearance, trainings, and health screenings During staff record review, LPA observed the (3) present staff CPR certification expired in July 2024. In addition, the facility did not have an Infection Control Plan created and did not have documentation of their quarterly drills, Based on the observations made during today’s visit, (4) deficiencies were cited per Title 22, Division 6, of the California Code of Regulations. An exit interview was conducted, and this report (LIC809) was discussed and provided to House Manager Marco Pascaran. Along with the appeal rights.the state’s words, verbatim · CDSS document, Sep 10, 2024