Eagel Time Care Facility

Type of visit: Required - 1 Year

Licensing Program Analysts (LPAs) Yolanda Delgado and Toni Nwala arrived unannounced to conduct an annual inspection. Upon arrival LPA's was greeted by facility staff and granted entry by Juan Cornell. LPA's began inspection with introduction, visit purpose and provided Juan with LPA's identification and business card. Resident record review began- Four (4) records were reviewed. LPA reviewed for admission agreement, medical assessment and TB test results, consent forms, identification and emergency information, appraisal, needs and service plans, centrally stored medication/destruction records, safeguard for personal property/valuables, and personal rights notification. This facility is meeting documentation requirements. Physical Plant and Safety of Environment/Operational Requirements- LPA toured the facility inside and outside. The home is maintained at a comfortable temperature for the clients. Lighting is sufficient for safety and comfort. Water temperature measured 105.0 degrees F. Laundry facilities and a locked cabinet is present for storing laundry soap and other chemicals in the home. All indoor passageways are free of obstruction, outdoor passage way is not free from obstruction. A locked area is provided for medications and sharp objects. LPA verified there is a telephone working at this location. Food Service- Food supply meets the requirement of one week supply of nonperishable and 2 day supply of perishables food on hand. A sample menu is provided, foods are dated to assure safety. Food prep areas are clean and organized. (Continued on next page) (Continued from Page 1) LPA began review of employee records- Three (3) records were reviewed. LPA reviewed employee record for first aid certification, fingerprint clearance, personnel/job application, health screening-1 missing and TB test results-1 missing, criminal record statement, employee rights, training verification. CPR and requirements have been met. The facility employs enough staff to maintain cleanliness and meet the needs of the clients in care. Administrator certification has been renewed as of 12/5/2025; expires 12/13/2027; Certificate is pending to be received. LPA made observation throughout the inspection process to assess if the facility remains in conformity with the State Fire Marshall regulations. The facility has not exceeded its capacity limitation and the structure remains unchanged according to the approved floor plan. Smoke detectors and carbon monoxide detectors were tested and found to be operational. Fire extinguishers was last serviced 6/11/2025. The facility is conducting emergency disaster drills. The last disaster drill was conducted on 12/21/2025. Based on the information received during this visit today, there are 1 deficiency and a technical advisory is being cited per Title 22, Division 6 of The California Code of Regulations. This report, LIC809-D, Appeal Rights was reviewed with and copies provided to the facility representative at the time of the exit interview.the state’s words, verbatim · CDSS document, Jan 26, 2026

Type of visit: Case Management - Other

Licensing Program Analyst (LPA) Yolanda Delgado conducted a case management visit to clear deficiencies that were issued on 1/27/2025. There were no issues or concerns observed during the visit. There are five (5) clients that live at the facility with one (1) is at program currently. There are sufficient staff on duty. Deficiencies were cleared and copy was provided. A copy of this report was reviewed with the Administrator and a copy was provided at the time of the exit interview.the state’s words, verbatim · CDSS document, Jan 29, 2025

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Yolanda Delgado arrived unannounced to conduct an annual inspection. Upon arrival LPA was greeted by facility staff and granted entry. LPA began inspection with introduction, visit purpose and provided the facility caregiver with LPA identification and business card. Resident record review began- Five (5) records were reviewed. LPA reviewed for admission agreement, medical assessment-1 missing and TB test results-1 missing, consent forms, identification and emergency information, appraisal-5 missing, needs and service plans, centrally stored medication/destruction records-not being updated, safeguard for personal property/valuables, and personal rights notification. This facility is meeting is not meeting documentation requirements. Physical Plant and Safety of Environment/Operational Requirements- LPA toured the facility inside and outside. The home is maintained at a comfortable temperature for the clients. Lighting is sufficient for safety and comfort. Water temperature measured 111.0 degrees F. Laundry facilities and a locked cabinet is present for storing laundry soap and other chemicals in the home. All indoor passageways are free of obstruction, outdoor passage way is not free from obstruction. A locked area is provided for medications and sharp objects. LPA verified there is a telephone working at this location. Food Service- Food supply meets the requirement of one week supply of nonperishable and 2 day supply of perishables food on hand. A sample menu is provided, foods are dated to assure safety. Food prep areas are clean and organized. Stove interior needs cleaning LPA began review of employee records- Three (3) records were reviewed. LPA reviewed employee record for first aid certification, fingerprint clearance, personnel/job application, health screening-1 missing and TB test results-1 missing, criminal record statement, employee rights, training verification-not available to be reviewed, and current administrator certification. CPR and requirements have been met. The facility employs enough staff to maintain cleanliness and meet the needs of the clients in care. Administrator certification is present and current. (Continued on next page) (Continued from Page 1) CPR and requirements have not been met. The facility employs enough staff to maintain cleanliness and meet the needs of the clients in care. Administrator certification is present and current. LPA made observation throughout the inspection process to assess if the facility remains in conformity with the State Fire Marshall regulations. The facility has not exceeded its capacity limitation and the structure remains unchanged according to the approved floor plan. Smoke detectors and carbon monoxide detectors were tested and found to be operational. Fire extinguishers was last serviced 6/1/2022. The facility is conducting emergency disaster drills. The last disaster drill was conducted on 11/17/2024. LPA allocated time to prepare this report for delivery. Based on the information received during this visit today, there are 12 deficiencies is being cited per Title 22, Division 6 of The California Code of Regulations. This report, LIC809-D, Appeal Rights, LIC 421IM for Civil penalties for $500 will be issued was reviewed with and copies provided to the facility representative at the time of the exit interview. LPA has requested updates to the following documents to be submitted to the CCLD by 01/31/2025: LIC 500the state’s words, verbatim · CDSS document, Jan 27, 2025

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Janira Arreola conducted a required annual visit. LPA was greeted and was granted entry and met with Licensee, Juan Cornell, who was informed of the purpose of the visit. At time of visit there were (3) clients and (2) staff present. The facility is a one story home with (4) bedrooms and (3) bathrooms with attached garage. The facility does not have a pool or fire arms. The facility is a residential care facility for the elderly serving elderly ages 60 and above. LPA observed the following: Infection Control: LPA observed hand hygiene supplies, PPE equipment and cleaning supplies to do regular cleaning of the facility. The facility has a infection control plan on file. Physical Plant: Physical plant, floors, windows, and doors were observed to be clean and fixtures and furniture were present and in good repair. The facility's outdoor area was observed to be free of hazards. Laundry equipment was observed to be in good working condition. The carbon monoxide detector was tested and operational during the visit. Hot water temperature was within the required range. All client medication was locked in a first aid box in kitchen. Food Service: 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 food items. Record Review and Resident/Staff Files: LPA reviewed staff files and training along with CPR/First Aid. Client files were reviewed and possessed all required paperwork, except for (1) client file which did not have a care plan. Technical note was documented and staff to document one and keep on file.. Disaster preparedness: LPA reviewed the facility's emergency and disaster plan. LPA reviewed documentation showing last fire drill conducted on August of 2023. Deficency was cited for staff to conduct a drill by the end of the month and send documentation to LPA. An exit interview was conducted where a copy of this report, appeal rights and deficiency pages were reviewed and provided to Licensee, Juan Cornell.the state’s words, verbatim · CDSS document, Jan 24, 2024

The state marks this report as 4 pages; the online copy we transcribed has 3. You can request the full file from the county licensing office.