Dela Paz Care Home

Type of visit: Case Management - Incident

Licensing Program Analyst (LPA) Sabrina Calzada arrived unannounced to conduct a case management inspection and met with DSP staff, Jocelyn Lemence and Maria Rosario Parochilin. LPA spoke to Administrator Designee, Lourdes de la Paz, by phone, and stated the reason for today's inspection. The Administrator Designee confirmed there are (4) clients residing at the care home, (1) was currently attending day program, and the Administrator was unable to attend today's inspection due to not feeling well. LPA and the Administrator discussed the recent incident with client (C1), as follows: The Administrator reiterated the information emailed to LPA on 7/31/2026 (5:36 am), regarding client (C1) going to the Emergency Room last night (10:00 pm) after having an unwitnessed fall. The Administrator stated (2) staff were present when they heard a loud thud coming from (C1's) room, immediately responded and observed (C1) to be on the floor, bleeding from the top of their head. Staff immediately applied pressure to stop the bleeding, while not moving (C1) from their position, and called 9-1-1. (C1) was not able to describe to staff how they fell before going to the ER, but stated to LPA today that they were sitting on the side of their bed, facing towards the window, and then fell on the floor, hitting their head. LPA observed (C1) to be sitting upright in their bed with a bandage/s on their head. (C1) stated they are feeling good and has had no change in appetite. LPA observed (C1) to be eating lunch later during the inspection. The Administrator explained how (C1) uses a half side bed rail and sometimes reaches for items on the side table, next to their bed, "will always utilize their call button", but did not this time. (C1) was cleared for any fractures or internal bleeding, was given a prescription to apply ointment twice daily, and will follow up with their primary care physician on 8/3/2026. The facility will submit an incident report within (7) days to the Department. (C1) has not fallen before while living at the care home, and there have been no recent medication changes. It appears the facility took appropriate and timely action in seeking medical attention for (C1). There are no deficiencies issued in this report. Exit interview. Copy of report provided.the state’s words, verbatim · CDSS document, Jul 31, 2026

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Sabrina Calzada arrived unannounced to conduct an annual inspection. LPA met with staff, Evie Sloan, and Jocelyn Lemence, and explained purpose of inspection. Administrator, Lourdes dela Paz, and facility manager, Dennis Abadilla, arrived at 10:30 am. The facility is a level 7, vendorized by Alta California Regional Center, and is licensed for (4) non-ambulatory clients. LPA observed (2) clients in the home during the inspection and was advised (1) client was attending day program, and (1) client remains hospitalized temporarily. There are no clients currently under hospice care. LPA and Administrators toured the interior/exterior of the facility including the common areas, (4) private resident bedrooms, staff room, (2) resident bathrooms, kitchen, office, laundry area and garage. LPA observed the facility to be clean, in good repair and odor-free. Bathrooms have the necessary grab bars, non-skid flooring or shower chair, paper towels, trash can with lids and 20-second hand-washing poster. There is sufficient 2+day perishable, including fresh produce, and 7+day non-perishable supply of food. Sharps and toxins are locked in the kitchen, and medications are secured in the office. The inside temperature measured 69*F and hot water measured 116*F in the kitchen. The fire extinguisher was last serviced on 8/4/25. Smoke/monoxide alarms are in working order. Resident rooms are very organized and decorated according to personal preference. All required postings and an emergency clipboard are posted in the common area. There are (2) unlocked exit gates on the outside patio and covered patio seating. LPA reviewed (2) client files. Files contain current documentation. P&I funds and medications were reviewed for (1) client. No discrepancies noted. (2) staff files reviewed- current training documentation on file. RCFE Administrator Cert #7035764740 (exp 7/12/26). LPA requested current copy of liability insurance, LIC308 and LIC500. There were no deficiencies observed. Exit interview. Copy of report provided.the state’s words, verbatim · CDSS document, Mar 11, 2026

Type of visit: Case Management - Incident

Licensing Program Analyst (LPA) Sabrina Calzada arrived unannounced to conduct a case management inspection and met with DSP staff, Eduardo Chico and Olive Jackson. Dennis Abadilla, Administrator Designee, arrived shortly and LPA stated the reason for the inspection. LPA observed (2) clients resting in the front common area, a third client resting in their room. A fourth client was attending day program. LPA and Administrator Designee discussed (2) recent incident reports submitted to the Department for client (C1) who was hospitalized on both occasions. (C1) has a renal mass on both kidneys. Client (C1) was hospitalized on November 12, 2025 after receiving results from blood work done two days prior and admitted for testing and fluid hydration. (C1) was discharged on November 16, 2025, and the facility was given instructions to continue to monitor for signs/symptoms related to the renal mass. Discussions of surgery and options most viable to (C1) are ongoing. On November 25, 2025, (C1) was taken to a follow up appointment with urology following hospitalization and for foley management. Due to having a low blood pressure reading, the Urologist recommended (C1) be evaluated further in the Emergency Room. The incident report states that upon arrival to the ER, Diagnostic procedures including an x-ray, urinalysis and blood draw were completed. Medication to increase blood pressure was administered via IV and (C1) was admitted to the Intensive Care Unit (ICU) for (4) days. It was determined (C1) had sepsis due to a possible infection related to the catheter. Medications were changed, including a Beta Blocker, Propranolol, which was paused at the last hospital stay. The facility will continue to monitor blood pressure 2x/day and communicate with the primary care physician (PCP). LPA reviewed blood pressure logs which document blood pressure has increased. (C1) will continue to be seen weekly by both a home health nurse and a facility nurse. The facility is awaiting a call from the PCP to schedule a follow up. There are no deficiencies issued in this report. Exit interview. Copy of report providedthe state’s words, verbatim · CDSS document, Dec 9, 2025

Type of visit: Case Management - Incident

Licensing Program Analyst (LPA) Sabrina Calzada arrived unannounced to conduct a case management inspection and met with DSP staff, Junald Nate and Olive Jackson. Dennis Abadilla, Administrator Designee, arrived shortly and LPA stated the reason for the inspection. LPA and the Administrator discussed an incident when (C1) was in the bathroom on November 1, 2025 (7:30 pm) and fell to the floor, face down. (S1) went to get another staff to assist when she observed blood on the right eye socket area and called another staff to assist. (C1) got up on their own and staff observed a cut on the right and left orbital. The administrators were contacted and requested staff take (C1) to to the hospital for further medical evaluation. The CT Scan showed no fractures on the head or spine; however, there was a fracture on the maxillary bone. (C1) received sutures, antibiotics and returned the same day. A follow up appointment is scheduled on November 10, 2025 to have the sutures removed and determine if a referral to the oral surgeon is needed. The administrator stated (C1) returned to day program on Monday, November 3, and has been attending all week. LPA observed (C1) return from the day program at the start of the inspection and to be ambulating fine. LPA observed the bruising on (C1's) right eye area and the administrator stated (C1) seems to be back to baseline- their appetite is okay. The administrator stated (C1) will often pretend to be fainting to get attention from staff and has also done this while being transported to day program. (C1) is now required to be in a wheelchair during transport. LPA reviewed (C1's) Individual Health Care/Nursing Plans which note "caregivers should be aware that (C1) may have sudden movements and pseudo seizures behaviors and to ensure safety from injury during these events". The administrators will review the Nursing Care Plan with all staff to reinforce what steps can be taken to minimize any injuries. The facility took immediate action in getting (C1) medically evaluated. (C1) was last injured in December 2024. There are no deficiencies issued. Exit interview. Copy of report provided.the state’s words, verbatim · CDSS document, Nov 5, 2025

Type of visit: Case Management - Deficiencies

Licensing Program Analyst (LPA) Sabrina Calzada arrived unannounced to conduct a case management inspection and met with Evie Sloan, DSP and Dennis Abadilla, Administrator Designee. LPA stated the reason for the inspection. A case management inspection is being conducted today to follow up on (2) allegations made through a formal complaint on June 2, 2025, at a related facility. During the investigation, it was determined that the (2) staff/individuals referenced in the allegations did not work or were not present at the related facility, but at this facility. The (2) allegations and determinations are as follows: Uncleared adult(s) are present in the facility. The complaint alleged that staff (S1) was working at the facility without the required fingerprint clearances. Documentation was reviewed confirming that (S1) received a fingerprint clearance on May 1, 2024 and was associated to the facility on this same day. The allegation also stated individual (S2) who was not employed at the facility, stayed at the facility beginning in March 2025 and was not fingerprint cleared. The investigation revealed that (S2) entered the facility on/around March 10, 2025 and stayed there until as late as on/around May 18, 2025. The Administrator indicated that (S2) stayed at the facility for approximately two weeks. Staff (S3) stated (S2) was visiting the facility off and on starting on March 10, 2025. Review of department records showed that (S2) did not receive fingerprint clearance and was not associated to this facility, or any other licensed facility. Based on information obtained, this portion of the allegation is substantiated and a citation and penalties are being issued. *cont on 809C-1.. 809C-1.. Allegation: Residents were exposed to a staff member with Tuberculosis. The allegation states that individual (S2) was visiting and staying with staff (S3) and (S2) was recently discharged from the hospital for having a diagnosis of Tuberculosis (TB). The allegation states (S3) and the clients are/were possibly exposed to TB. During the investigation, LPA spoke with (2) public heath nurses in June 2025 regarding (S2) possibly being treated and hospitalized due to having TB. One nurse provided information on (S2's) TB status beginning on 5/20/25 and confirmed that (S2) was "approved to be discharged to a skilled nursing" on 5/29/25, after being hospitalized in San Diego County starting on 5/20/25. This nurse confirmed there was "no active TB" upon discharge but "(S2) has a history of TB from the Philippines" and (S2) completed all their treatments. A second public health nurse, in Sacramento County, confirmed that (S2) was in San Diego and Sacramento County was planning on seeing them again but (S2) was in the process of relocating to another area. The nurse stated that (S2) was not considered to have active TB; however, a "final determination is still needed" from her office, asserting (S2) "would not have had an active disease in March 2025" and the county was planning to see them. The nurse explained that (S2) could have had residual findings related to a positive test and "collective sputem on (S2)" which is not considered an active case. The Administrator stated (S2) is currently residing out of state and was recently hospitalized due to other medical conditions unrelated to TB. The Administrator stated that it's very common for individuals from (S2's) country of origin to test positive initially for TB after taking a Quantiferon TB test and then follow up with a chest X-ray which shows a negative result for TB. All staff and clients (4) at this facility had a TB test given from June 2025 through August 2025. All results provided showed a negative result, if not initially from the Quantiferon test, then from a follow up X-ray. (S3) was advised to have a follow up X-ray done on 6/16/25, and was not found to have active TB. Based on information obtained, this allegation is found to be UNSUBSTANTIATED- A finding that the complaint is Unsubstantiated means that although the allegation may have happened or is valid, there is not a preponderance of the evidence to prove that the alleged violation occurred. Exit interview. Copy of report provided.the state’s words, verbatim · CDSS document, Sep 10, 2025

From the deficiency page — Deficiency type: Type A · Section cited: CCR 87355(d)(3) · Plan of correction due date: Sep 11, 2025

87355 Criminal Record Clearance (d) All individuals subject to criminal record review shall be fingerprinted and sign a Criminal Record Statement (LIC 508 [Rev. 1/03]) under penalty of perjury. (3) The licensee shall submit these fingerprints to the California Department of Justice, along with a second set of fingerprints for the purpose of searching the records of the Federal Bureau of Investigation, or comply with Section 87355(c), prior to the individual's employment, residence, or initial presence in the facility. This requirement was not met as evidenced by: Based on record review and interviews conducted, the Licensee did not ensure that individual (S2) received a finger print clearance prior to residing at the facility, on/around March 10, 2025, which posed an immediate health and safety risk to residents in care.the state’s words, verbatim · CDSS document, Sep 10, 2025

Plan of correction: Licensee/Administrator agree to read Regulation 87355 and submit a statement of understanding. Also submit fingerprints for processing for (S2), if they plan to be present in the facility in the future. Request (S2) complete an LIC508 also prior to being present in the facility again.

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Sabrina Calzada arrived unannounced to conduct an annual inspection. LPA met with Evie Sloan, staff and Edgardo Chico, staff, and explained purpose of inspection. Administrator, Lourdes dela Paz, and facility manager, Dennis Abadilla, arrived around 10:30 am. The facility is a level 7, vendorized by Alta California Regional Center, and is licensed for (4) non-ambulatory clients. LPA observed (2) clients in the home during the inspection and was advised (2) clients were attending day program. There are no clients currently under hospice care. LPA and staff toured the interior/exterior of the facility including the common areas, (4) private resident bedrooms, staff room, (2) resident bathrooms, kitchen, office, laundry area and garage. LPA observed the facility to be clean, in good repair and odor-free. Bathrooms have the necessary grab bars, non-skid flooring or shower chair, paper towels, trash can with lids and 20-second hand-washing poster. There is sufficient 2+day perishable and 7+day non-perishable supply of food and sharps were locked in the kitchen. There are locked toxins in the laundry area and locked medications in the office. There are sufficient towels, linens/blankets/PPE/emergency supplies. The inside temperature measured 68*F and hot water measured 107*F in the kitchen. The fire extinguisher was last serviced on 8/16/24. Smoke/monoxide alarms are in working order. Resident rooms are very organized and decorated according to personal preference. There are (2) evacuation clipboards posted in the common areas that contain forms required for emergencies. There are (2) unlocked exit gates on the outside patio and covered patio seating. There is a very shallow pond that is fenced in the back yard. LPA reviewed (2) of (4) client files. Files contain current individual/nursing care plans, physician's reports and other documentation. P&I funds were reviewed for (1) client- funds match documentation maintained. Medications were checked for (1) client. Orders match medications and documentation on file. (4) staff files were reviewed. Staff are completing initial/ongoing required training, including First Aid/CPR. RCFE Administrator Cert #7035764740 (exp 7/12/26). Discussed PIN 24-09 and age exception currently needed. LPA to provide additional information by email. LPA obtained current copy of liability insurance, LIC308 and LIC500. There were no deficiencies observed. Exit interview. Copy of report provided.the state’s words, verbatim · CDSS document, Mar 19, 2025

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Sabrina Calzada and IB Investigator, Nathan Rodriguez, arrived unannounced to conduct an annual inspection. LPA met with Jennifer Newell and Luz Sunga, staff, and explained purpose of inspection. Administrator, Lourdes, arrived at approximately 1:00 pm. The facility is a level 4--I home, vendorized by Alta California Regional Center, and is licensed for (4) non-ambulatory clients. LPA observed (2) clients in the home at the start of the inspection and (2) clients return from day program with staff, Edgar. There are no clients currently under hospice care. LPA and Administrator toured the interior and exterior of the facility including the common areas, (4) private resident bedrooms, staff room, (2) resident bathrooms, kitchen, office, laundry area and garage. LPA observed the facility to be clean, in good repair and odor-free and each bathroom to have the necessary grab bars, non-skid flooring or shower chair, paper towels, trash can with lids and 20-second hand-washing poster. There is sufficient 2+day perishable and 7+day non-perishable supply of food and sharps were locked in the kitchen. There are locked toxins in the laundry area and locked medications in the office. There are sufficient towels/linens/blankets/PPE/emergency supplies. The inside temperature measured 70*F and hot water measured 108*F in the kitchen. The fire extinguisher was last serviced on 9/12/23 and the smoke/monoxide alarms are in working order. LPA observed locks on each client door, as required by Title 17, and there is a key for each client and a spare key for staff, if needed. There are (2) unlocked exit gates on the outside patio and covered patio seating. LPA reviewed (2) of (4) client files and found them to contain current individual/nursing care plans, physician's reports and other documentation. P&I funds were reviewed for (2) clients, found to be accurate with receipts/documentation maintained. Current copy of a surety bond was obtained. Medications orders were compared to medications being administered for (2) clients and no discrepancies were noted. (9) staff files were reviewed and found to contain current First Aid/CPR training and other required training. RCFE Administrator Cert #6041507740- exp 7/12/24.LPA observed required postings to be posted. LPA requested an updated copy of the LIC308, LIC500 be sent to CCLD by 3/22/24. Current insurance copy obtained. There are no deficiencies issued during today's inspection. Exit interview. Copy of report provided.the state’s words, verbatim · CDSS document, Mar 15, 2024