Al Hayba Home

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Paola Guerrero made an unannounced visit to the facility. The purpose of the visit was to conduct a required comprehensive annual inspection LPA met with Facility Caregiver Ashlee Gonzalez and was granted entry to the facility. At the time of the visit there was one (1) staff present, and four (4) residents present. The facility is a four (4) bedroom, three (3), bathroom home, with a kitchen/dining area, living room, and attached garage. The facility is a Residential Care Facility for Elderly (RCFE) designated home. Licensed capacity is (6) current census (4). LPA was accompanied by Facility Caregiver Ashlee Gonzalez 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, nightstands, storage space, and sufficient lighting; bathrooms were clean, and appliances were operating appropriately. LPA observed sufficient furniture and lighting throughout the facility. LPA measured and observed the water temperatures in the bathrooms to be at 110 degrees F 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 residents in care. There was a designated storage space for resident/staff files. Medications are kept inside medication cabinet inaccessible to residents. LPA conducted a walk through of the outside perimeter of the home and observed damaged wood boards that were sticking out throughout the home. LPA will be issuing a deficiency. Food Service: Non-perishable and perishable food supply is sufficient for number of residents in care. 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. All staff members working in the facility have criminal record clearance through the department. Record Review: LPA reviewed four (4) resident files for admission agreements, updated physician reports, and needs and services plans. LPA also reviewed two (2) staff file for First Aid/CPR certification, criminal record clearance, training's, and health screenings. Based on the observations made during today’s visit, LPA will be issuing one deficiency. Based on Title 22 Regulations Maintenance and Operation 87303(a), from division 6, chapter, article 6, is, cited on the attached LIC 9099 D. An exit interview was conducted where this report, appeal rights, and LIC9099-D was discussed, and a copy of the report was provided to Facility Caregiver Ashlee Gonzalez at the conclusion of the visit.the state’s words, verbatim · CDSS document, May 14, 2026

Allegation investigated: Staff does not ensure facility has adequate food supply. Staff does not ensure facility provides quality food. Staff are not practicing safe food practices.

Licensing Program Analyst (LPA) Paola Guerrero conducted an unannounced visit to deliver findings on the allegations listed above. LPA met with Facility House Manager Ashlee Gonzalez and explained the purpose of the visit. The investigation consisted of interviews and observations. First allegation: Staff does not ensure facility has adequate food supply. Regarding the allegation LPA conducted an inspection of facilities food supply during the inspection LPA observed enough food supply inside refrigerator and freezer to meet the needs of three residents. During the inspection LPA observed food to be fresh, safe, and shelf stable. During the inspection LPA observed facility to have a deep freezer LPA observed a good amount of food supply being stored. LPA conducted interviews with Resident #1 and R#2, regarding the allegation stated above and both residents stated that facility feeds them well and have no concerns regarding food. Resident #1 and Resident #2 informed LPA that facility feeds them three times a day (breakfast, lunch, and dinner), and in between snacks. LPA conducted an interview with Staff #1 LPA went over the allegation with S#1 and Staff #1 informed LPA that the facility Unsubstantiated currently grocery shops once a month for three residents and will go up to twice a month when facility is at capacity. In addition, Staff #1 informed LPA that facility will do small restock when needed. Second allegation: Staff does not ensure facility provides quality food. Regarding the allegation LPA conducted an inspection of facilities food quality during the inspection LPA observed facility to have an adequate amount of quality food to meet the needs of three residents in care. In addition, LPA observed that a food menu for the week was posted. LPA conducted an interview with R#1 and R#2, LPA went over the allegation with both residents and R#1 and R#2 informed LPA that they are not on food restrictions or special food diets, and they like to choose or have options on what they like to eat at the facility. In addition, R#1 and R#2 informed LPA that they like the quality of food that is served and have no concerns regarding the food quality at the facility. LPA conducted an interview with S#1 regarding the allegation stated above S#1 informed LPA that a menu is posted for the week and other options are also made available to residents. Third allegation: Staff are not practicing safe food practices. Regarding the allegation stated above LPA conducted an inspection along with a walkthrough concerning the allegation stated above during the inspection LPA observed that facilities refrigerator and freezer is following the temperatures of 45 F (7.2 C) and 0 F (-17.7 C) based on Tile22 regulation. During the inspection LPA did not observe frozen food or Tilapia packages to be left out in the kitchen or out in the patio. LPA conducted interviews with R#1 and R#2 regarding the allegation stated above both residents informed LPA that they have no concerns regarding the food. R#1 and R#2 informed LPA that they have no concerns on how the food is prepared and that they have not gotten sick from the food. Based on corroborating evidence obtained during the course of the investigation, LPA has determined that the above allegations are Unsubstantiated. Unsubstantiated: meaning that although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur. An exit interview was conducted where this report (LIC 9099) was discussed, and a copy was provided to Facility House Manager Ashlee Gonzalez at the end of the visit.the state’s words, verbatim · CDSS document, Sep 16, 2025 · control 56-AS-20250914121955

Allegation investigated: Staff does not ensure that resident is adequately fed Staff isolates resident to her bedroom Staff prohibits resident from accessing the common areas for personal use

Licensing Program Analyst (LPA) Raquel Hernandez conducted an unnannounced visit for the purpose to deliver findings on the allegations listed above. LPA met with House Manager Ashlee Gonzalez and explained the purpose of the visit. The investigation consisted of staff interviews, resident interviews and facility tour. For the allegation, Staff does not ensure that resident is adequately fed LPA Hernandez conducted (2) resident interviews. 2 out of the 2 residents stated staff ensure they are adequately fed. Resident #1 (R1) stated Staff #1 (S1) ensures they are fed three times a day and portions are adequate. LPA Hernandez conducted (2) staff interviews. 2 out of the 2 staff stated residents are adequately fed. Additionally, LPA observed non-perishable and perishable food supply sufficient for number of residents in care. Unsubstantiated For the allegation, Staff isolates resident to her bedroom LPA Hernandez conducted (2) resident interviews. 2 out of the 2 residents stated they are not isolated in their bedrooms and are able to go into the living room and outside whenever they may want. LPA Hernandez conducted (2) staff interviews. 2 out of the 2 staff stated residents are not isolated to their bedrooms and are able to come out of their rooms whenever they may like. For the allegation, Staff prohibits resident from accessing the common areas for personal use LPA Hernandez conducted (2) resident interviews. 2 out of the 2 residents stated they are able to access common areas for personal use. LPA Hernandez conducted (2) staff interviews. 2 out of the 2 staff stated residents are able to access common areas such as the living room and outside. Based on the evidence gathered during today’s investigation, the allegations listed above are deemed UNSUBSTANTIATED. A finding that the complaints are UNSUBSTANTIATED means although the allegation may have happened or is valid, there is not a preponderance of the evidence to prove that the alleged violation occurred. During today’s visit, no deficiencies were cited per Title 22, Division 6, of the California Code of Regulations. An exit interview was conducted, and this report (LIC9099) was discussed and provided to House Manager Ashlee Gonzalez.the state’s words, verbatim · CDSS document, Jun 25, 2025 · control 56-AS-20250619105858

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Paola Guerrero made an unannounced visit to the facility. The purpose of the visit was to conduct a required comprehensive annual inspection LPA met with Facility Caregiver Ashlee Gonzalez and was granted entry to the facility. At the time of the visit there was two (2) staff present, and five (5) residents present. The facility is a four (4) bedroom, three (3), bathroom home, with a kitchen/dining area, living room, and attached garage. The facility is a Residential Care Facility for Elderly (RCFE) designated home. Licensed capacity is (6) current census (5). LPA was accompanied by Facility Caregiver Ashlee Gonzalez 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, nightstands, storage space, and sufficient lighting; bathrooms were clean, and appliances were operating appropriately. LPA observed sufficient furniture and lighting throughout the facility. LPA measured and observed the water temperatures in the bathrooms to be at 115.4 degrees F 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 residents in care. There was a designated storage space for resident/staff files. Medications are kept inside medication cabinet inaccessible to residents. 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. 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. All staff members working in the facility have criminal record clearance through the department. Record Review: LPA reviewed five (5) resident files for admission agreements, updated physician reports, and needs and services plans. LPA also reviewed two (2) staff files for First Aid/CPR certification, criminal record clearance, trainings, and health screenings. Based on the observations made during today’s visit, no 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 Facility Caregiver Ashlee Gonzalez.the state’s words, verbatim · CDSS document, Jun 7, 2024