Waterview Residence

Type of visit: Case Management - Annual Continuation

On May 07, 2026, at 1:15 PM, Licensing Program Analyst (LPA) Avelina Martinez made an unannounced visit to this facility to conduct an annual required inspection. LPA Martinez met with Kevin Valino and Aly Ramirez and explained the purpose of today's visit. LPA Martinez conducted a continuation annual inspection to review Medication Administration Records (MAR) for three residents. Resident 1 (R1) Centrally Stored Medication and destruction record was not complete. Resident 3 (R3) Centrally Stored Medication and destruction record had three entries for Famotidine Tab 20 mg with the same RX number, and the three entries had different start dates, expiration dates, and filled dates. R3's had two medication bottles for Venlafaxine ER 1500MG Capsules. One bottle start date was February 23, 2026, with a quantity of 90 pills, and as of May 07, 2026, there are 47 pills left in bottle. The second bottle start date is April 30, 2026 with a quantity of 15 pills, and as of May 07, 2026, there are 14 pills left in the bottle. Based on this annual inspection, the facility was cited incidental 87465 (a)(4) Incidental Medical and Dental Care and 87465 (a)(6) Incidental Medical and Dental Care. An exit interview was conducted, and a copy of this 809 report, 809 D Page, and Appeals rights were provided to the facility.the state’s words, verbatim · CDSS document, May 7, 2026

Type of visit: Required - 1 Year

On April 21, 2026 at 9:30 AM, Licensing Program Analyst (LPA) Avelina Martinez made an unannounced visit to this facility to conduct an annual required inspection. LPA Martinez met with Kevin Valino and Aeleah Vizcarra and explained the purpose of today's visit. LPA Martinez inspected the physical plant including but not limited to the kitchen, dining room, resident bedrooms; resident bathrooms, laundry room, activity room, and outside courtyards of the facility to ensure compliance with Title 22 regulations. Administrator holds current certificate and expires on 11/24/2027. During today's inspection LPA Martinez learned that the facility did not have a current administrator certificate posted in the facility. Facility staff will post the updated administrator certificate. The facility is licensed for six non-ambulatory clients, which one can be bedridden (bedroom 1). There are currently five residents who reside at this facility. The facility has an approved hospice waiver for three. The LPA Martinez toured the facility with the Kevin Hans Valino on April 21, 2026. Facility staff 2 (S2) was not able to provide copies of the following documents natural disaster and infection control plan. The facility did not have a fire drill log, and two fire extinguishers did not have service tags. The fire extinguishers also did not have a purchase receipt. In addition, during the facility inspection, LPA Martinez observed that cleaning supplies were made accessible to residents in care. LPA Martinez also observed a mop bucket filled with water in the bathroom walk in shower. Continued... LPA Martinez also observed that the following food items did not have expiration dates and not sealed properly: strawberries with frost bite, salad dressing bottle, and marinated chicken in a food container. LPA Martinez reviewed three resident files, and all three files were missing reappraisals. LPA Martinez reviewed three staff files. Staff 2 (S2) did not have the following documents: a current first aid certificate and LIC 503 health screening. Staff files did not included 2026 staff training documentation. The facility did not have incident reporting binder. LPA Martinez will return at a late date to complete a medication inspection. An immediate civil penalty of $500.00 is hereby assessed on April 21, 2026, for 87203 Fire Safety violation. Based on today's inspection, an informal conference will be scheduled, and LPA Martinez will advise the Licensee of informal conference date and time. As a result of this annual inspection visit, deficiencies were cited, per California Code of Regulations, Title 22 and Health and Safety Code and can be found on the 809-D pages. An exit interview conducted, and a copy of the 809 report, 809D-Page, LIC421M, and appeals right were given to the facility at the end of this visit.the state’s words, verbatim · CDSS document, Apr 21, 2026

Type of visit: Required - 1 Year

On 2/7/25 at 1:20pm Licensing Program Analysts (LPAs) Kevin Gould and Cynthia Tamayo arrived at Waterview Residence RCFE for the purpose of conducting a required 1 year annual inspection. LPA met with Licensee, Aeleah McDonald and together conducted a tour of the home. LPAs and Licensee evaluated the physical plant to ensure the health and safety of the residents in care. Areas inspected are including but not limited to the kitchen, resident bedrooms; resident bathrooms, living and dining room and outdoor areas. LPAs observed the facility to be free of odor, clean and in good repair. LPAs observed that all rooms are equipped with the required furniture and sufficient lighting throughout the facility. LPAs observed sufficient seven day non-perishable and two day perishable food supplies. Fire extinguishers and smoke detectors are current and in compliance with fire safety. LPAs notes the facility had the required carbon monoxide detectors. First aid kit was checked and is complete. LPAs observed centrally stored medications secure from residents. LPAs conducted file for three residents and three staff members. LPAs observed resident file are in need of organization and observed two of the three resident files reviewed no personal rights forms were observed or singed by resident or authorized representatives. Additionally, LPAs requested three employee files to review and were unable to review because the files are being stored at another facility. LPAs were unable to verify staff records or training. LPA's were able to review one staff file who did not have a completed health screening form or verified TB test. LPAs observed staff member (S2) did have a criminal record clearance but was not associated to the facility prior to today's inspection. Report Continued on LIC 9099-C LPA Requested the following documents for facility file: LIC 308 Designation of Facility Responsibility, LIC 500 personnel report, LIC 9020 client roster and current administrator certificate. Per California Code of Regulations, Title 22 the following deficiencies are cited during today's inspection. An exit interview was conducted, and a copy of this report and appeal rights were left at the facility.the state’s words, verbatim · CDSS document, Feb 7, 2025

Type of visit: Prelicensing

On 4/19/24 at Licensing Program Analyst (LPA) Kevin Gould arrived at for the purpose of conducting a pre-licensing inspection. LPA met with Licensee Rhaymond Vizcarra and together conducted a tour of the home. LPA and licensee evaluated the physical plant to ensure the health and safety of future residents in care. Areas inspected are including but not limited to the kitchen, resident bedrooms; resident bathrooms, living and dining room and outdoor areas. LPA observed the facility to be free of odor, clean and in good repair. LPA observed that all rooms are equipped with the required furniture and sufficient lighting throughout the facility. LPA measured the water temperature, temperature measured at 120 degrees F which meets the 105-120 degree Fahrenheit regulation. LPA observed sufficient seven day non-perishable food supplies. Fire extinguishers and smoke detectors are current and in compliance with fire safety. LPA notes the facility had the required carbon monoxide detectors. First aid kit was checked and is complete. LPA observed centrally stored medications secure from residents. LPA and Licensee conducted component 3 orientation. LPA covered orientation for RCFE regulations, reporting requirements, common issues of facility operation. Licensee has met all requirements to be licensed. LPA will contact CAB with notification on completed pre-licensing and component III orientation.the state’s words, verbatim · CDSS document, Apr 19, 2024