Sungarden Villa III

Type of visit: Case Management - Incident

Licensing Program Analyst (LPA) Sabrina Calzada arrived unannounced to conduct a case management inspection following receipt of an incident report. LPA met with Nonadel Soriano, caregiver and Aizza Gonzales, Assistant Administrator/caregiver. Russelle Robinson, Administrator Designee, arrived very shortly. LPA observed (1) resident in the common area and (5) residents resting in their rooms. LPA and Administrator Designee discussed an incident report submitted on May 22, 2026 for resident (R1) who was sent to the Emergency Room after contacting the palliative nurse. (R1) was admitted to the hospital on May 21, 2026, due to swelling and rashes. The Administrator Designee indicated (R1) had new swelling on their left arm,after (3) days of extra diuretics that were increased on May 18, 2026. (R1) normally has swelling on their legs. (R1) was admitted to the hospital for Cellulitis, received IV antibiotics, and was discharged with oral antibiotics on May 25, 2026, which they continue to take. The care staff noted that the swelling on (R1's) arms has decreased from prior to hospitalization. (R1) moved in in February 2026 and presented with a generalized rash, throughout the body. LPA observed multiple prescriptions from a dermatologist, February 2026 through May 2026, for topical ointment and oral steroids, but there was no improvement. (R1) was most recently prescribed a new ointment to try during the palliative care visit on May 18, 2026. Staff will continue to monitor and follow up with the palliative health care provider. It appears the facility took appropriate steps in contacting the palliative care and then sending (R1) to the emergency room. There are no deficiencies issued in this report. Exit interview. Copy of report provided.the state’s words, verbatim · CDSS document, May 26, 2026

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Sabrina Calzada arrived unannounced to conduct an annual inspection LPA met with Diwata Vallejo, and Aizza Gonzales, Assistant Administrator/caregiver. Administrator Designee, Russelle Robinson, who is also a certified Administrator was present. The facility is licensed for (6) non-ambulatory residents, (1) of whom may bedridden, and has a hospice waiver for (4). Currently, no residents are under hospice care. LPA observed (1) resident in the common area and (4) residents in their rooms. LPA and the Administrator Designee toured the interior/exterior of the facility including the common areas, (6) resident bedrooms with half bath, (2) full bathrooms, kitchen, staff room and locked laundry area. LPA observed the facility to be clean, in good repair and odor-free, and the bathrooms have the necessary grab bars, slip-resistant flooring, paper towels and hand-washing posters. LPA observed 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 nearby. The inside temperature to be 75*F. Fire extinguisher was last serviced 6/3/25, and the facility conducts quarterly fire drills- will vary the type of drill and time of day. LPA observed (2) unlocked gates from the inside back patio. There is not a pool or fountain. Administrator certificate #7022575740- (exp 6/14/26). Administrator Designee's certificate is current. All postings posted. LPA reviewed (2) resident files and (4) staff files- Files were organized and contained current paperwork. LPA reviewed ordered medications for (1) resident- no discrepancies found. All staff is cleared and associated and has current First Aid/CPR, and has completed the required training in last 12 months, through an approved on-line provider. Dementia care paperwork is current. Obtained current liability insurance. All contact information is current. There are no deficiencies issued. Exit interview with Administrator. Copy of report provided.the state’s words, verbatim · CDSS document, Oct 16, 2025

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Sabrina Calzada arrived unannounced to conduct an annual inspection LPA met with Diwata Vallejo, caregiver. Administrator Designee, Russelle Robinson, who is also a certified Administrator, arrived shortly. LPA explained purpose of inspection. The facility is licensed for (6) non-ambulatory residents, (1) of whom may bedridden, and has a hospice waiver for (4). There are currently (5) residents and (2) residents are under hospice care. LPA observed (2) residents in the common area and (3) in their rooms at the start of the inspection. LPA and the Administrator Designee toured the interior and exterior of the facility including the common areas, (6) resident bedrooms with half bath, (2) full bathrooms, kitchen, staff room and locked laundry area. LPA observed the facility to be clean, in good repair and odor-free, and the bathrooms have the necessary grab bars, non-skid flooring, paper towels and hand-washing posters. LPA observed sufficient 2+day perishable and 7+day non-perishable supply of food, and locked sharps and toxins in the kitchen and medications to be secured nearby. There are sufficient linens/towels/blankets/PPE, and the inside temperature measured 73*F. .Fire extinguisher was last serviced 6/19/24, and the facility conducts quarterly fire drills- last drill conducted 8/15/24. LPA observed (2) unlocked gates from the inside back patio. There is sufficient outdoor space with seating and shade, and there are not any pools/ponds. LPA reviewed (2) resident files and found them to be organized, complete and current. LPA reviewed ordered medications for (1) residents to those being administered and found no discrepancies. (2) staff files were reviewed- staff is fingerprint cleared, associated and has current First Aid/CPR, and has completed the required training in last 12 months, through an approved on-line provider. Administrator certificate #605337740- exp 6/14/24- pending renewal. RCFE Adm Designee certificate # 6056696740-exp 12/10/2024. An updated copy of current liability insurance was obtained. LPA obtained an updated LIC500 and requested a LIC308 by 11/13/24. There are no deficiencies issued. Exit interview with Administrator. Copy of report provided.the state’s words, verbatim · CDSS document, Nov 6, 2024

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Sabrina Calzada arrived unannounced to conduct a required annual. LPA met with Russelle Robinson, Administrator Designee. Also present were staff, Aizza Gonzales and Nonadel Soriana. LPA observed (2) residents to be resting in recliner chairs in the common area and (4) residents to be resting or watching television in their resident rooms. The facility is licensed for (6) non-ambulatory residents and has a hospice waiver for (2). Currently there is (1) resident on hospice. LPA and the Administrator Designee toured the interior and exterior of the facility including the common areas, (6) resident bedrooms/private half bathrooms, (2) separate full bathrooms, kitchen, staff room, locked medication room, locked laundry and additional storage area. The upstairs area is not used by residents and is gated off. LPA observed the facility to be clean, in good repair and odor-free. LPA observed the bathrooms to have the necessary grab bars, non-skid flooring, paper towels and hand-washing posters. LPA observed sufficient 2+day perishable/7+day non-perishable supply of food, locked sharps and toxins in the kitchen and medications to be secured nearby. Hot water temperature measured 110*F in the kitchen. There is a separate kitchen sink that dispenses hot water of 125+*- LPA observed the required signage posted. LPA observed sufficient linens/blankets/incontinent supplies, PPE, and a complete First Aid kit. The inside temperature was 76*F. Fire extinguisher last serviced 6/5/2023. Quarterly fire drills are conducted -last drill Nov 2023. There are cameras in the common area with a sign posted as well as other required postings. There is a covered patio with seating and (1+) unlocked gates on the patio. There is signage posted near the Emergency Gas Shut off. All exit doors have alarms. Residents participate in outings. LPA reviewed (3) resident files and found them to be complete and contain current paperwork. Medications were reviewed for (2) residents and no discrepancies were noted. Medication documentation is current and accurate. (2) staff files were reviewed. LPA observed complete paperwork and staff to have recently completed training hours in excess of what is required annually and have current First Aid/CPR. Infection Control Plan was approved. There are no deficiencies issued during today's inspection. Exit interview with Administrator. Copy of report provided.the state’s words, verbatim · CDSS document, Nov 14, 2023