Sierra Vista

Type of visit: Required - 1 Year

On 9/14/2026 at 9:10 AM, Licensing Program Analyst (LPA) Eldin Serrano made an unannounced visit to the facility. The purpose of the visit was to conduct a required comprehensive annual inspection. LPA met with Executive Director (ED) Kimberly Mejia and was granted entry to the facility. The facility has (50) resident's bedrooms, (44) bathrooms. There is a kitchen, a lobby area, a dining area, a living room, a laundry room, and a courtyard. The facility is Residential Care Facility for the Elderly (RCFE). The facility is licensed for a capacity of ninety-nine (99) residents of which fifteen(15) ambulatory, eighty four (84) non-ambulatory of which twenty (20) maybe bedridden, hospice waiver granted for twenty (20) and the current census is forty seven (47) residents. LPA was accompanied by a ED 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 Division (CCLD). There are no obstructions to indoor and outdoor passageways. The facility is maintained at a comfortable temperature of 73 degrees Fahrenheit. LPA inspected resident bedrooms; they are equipped with the 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 bathroom to be at 111.7 degrees Fahrenheit. The facility is equipped with operating smoke detectors and carbon monoxide alarms on every bedrooom. Fire extinguisher was also observed at the facility. Posters such as personal rights, the CCLD complaint poster, and the disaster plan were posted in a common area. ***Continuation in LIC809C *** 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. There is a Medicine cabinet with the resident’s medications locked. LPA observed first aid kit and first aid book at the facility. Food Service: Seven (7) days’ supply of Non-perishable foods and two (2) days’ supply of perishable food supply were observed and sufficient for the number of residents in care. Care & Supervision: The facility has an Administrator present in the facility with enough hours to appropriately manage the facility. The facility has sufficient number of staff to provide care and supervision to the residents in care. Also, LPA observed that the facility has dementia residents. Record Review: LPA reviewed four (4) resident files for admission agreements, updated physician reports, pre-placement appraisals and needs and services plans. LPA audited residents medication and observed that the start date were not written to determine the accuracy of medication administration. Deficiency issued. LPA reviewed four (4) staff files and the administrator file for First Aid/CPR certification, criminal record clearance, trainings, and health screenings. No issues observed. Based on the observations made during today’s visit, One (1) deficiency was cited per Title 22, Division 6, of the California Code of Regulations. An exit interview was conducted, and this report LIC809, LIC809C, LIC809D and Appeal Rights were discussed and provided to Executive Director Kimberly Mejia.the state’s words, verbatim · CDSS document, Sep 14, 2026

From the deficiency page — Deficiency type: Type B · Section cited: CCR 87465(d)(3) · Plan of correction due date: Sep 21, 2026

Title 22, Division 6 Chapter 8 Incidental Medical and Dental Care (d)If theresident is unable to determine his/her own need for a prescription or nonprescription PRN medication, and is unable tocommunicate his/her symptoms clearly, facility staff designated by the licensee, shall be permitted to assist the resident with self-administration provided all of thefollowing requirements are met:(3) The date and time the PRN medication was taken, the dosage taken, and the resident's response shall be documented and maintained in the resident's facility record. This requirement is not met as evidence by: Based on interviews and record reviews, the licensee did not comply with the section cited above by not ensuring that the medication's start date are recorded for medication administration's accuracy which poses a potential health, safety or personal rights risk to persons in care.the state’s words, verbatim · CDSS document, Sep 14, 2026

Plan of correction: Licensee will submit the training conducted signed by all the medtechs to accurately document the start date of the medication administered by the plan of correction (POC) due date.

Type of visit: Case Management - Other

Licensing Program Analysts (LPAs) Mary Rico and Hannah Rodgers made an unannounced collateral visit to the facility. The purpose of the visit was to conduct an interview with resident (R1) in regards to a complaint that is not related/associated with this facility. Complaint Control Number 56-AS-20260205134817 LPA was greeted and granted , where LPA explained the purpose of her visit Administrator Kimberly Mejia. An exit interview was conducted, and a copy of this report was reviewed and provided to Administrator Kimberly Mejia.the state’s words, verbatim · CDSS document, Feb 11, 2026

Type of visit: Required - 1 Year

On 9/22/2025 at 11:00 AM, Licensing Program Analyst (LPA) Eldin Serrano made an unannounced visit to the facility. The purpose of the visit was to conduct a required comprehensive annual inspection LPA met with Administrator Kimberly Mejia and was granted entry to the facility. The facility has (50) resident's bedrooms, (44) bathrooms. There is a kitchen, a lobby area, a dining area, a living room, a laundry room, and a courtyard. The facility is Residential Care Facility for the Elderly (RCFE). The facility is licensed for a capacity of ninety-nine (99) residents of which fifteen(15) ambulatory, eighty four (84) non-ambulatory of which twenty (20) maybe bedridden, hospice waiver granted for twenty (20) and the current census is forty six (46) residents. LPA was accompanied by a staff 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 Division (CCLD). There are no obstructions to indoor and outdoor passageways. The facility is maintained at a comfortable temperature of 77 degrees Fahrenheit. LPA inspected resident bedrooms; they are equipped with the 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 bathroom to be at 110 degrees Fahrenheit. The facility is equipped with operating smoke detectors and carbon monoxide alarms on every bedrooom. LPA observed that the facility did not have an updated earthquake drill. Technical violation issued. Fire extinguisher was also observed at the facility. Posters such as personal rights, the CCLD complaint poster, and the disaster plan were posted in a common area. ***Continuation in LIC809C *** 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. There is a Medicine cabinet with the resident’s medications locked. LPA observed first aid kit and first aid book at the facility. Food Service: Seven (7) days’ supply of Non-perishable foods and two (2) days’ supply of perishable food supply were observed and sufficient for the number of residents in care. LPA observed that the facility does not have the 72 hour emergency food and water. Citation issued. Care & Supervision: The facility has an Administrator present in the facility with enough hours to appropriately manage the facility. The facility has sufficient number of staff to provide care and supervision to the residents in care. Also, LPA observed that the facility has dementia residents. Record Review: LPA reviewed four (4) resident files for admission agreements, updated physician reports, pre-placement appraisals and needs and services plans. LPA observed resident files reviewed were complete. LPA reviewed six (6) staff files for First Aid/CPR certification, criminal record clearance, trainings, and health screenings.LPA observed that staff #6 (S6) does not have an updated food handler training certificate. Citation issued. LPA observed that staff #6 (S6) does not have the health screening on file with tuberculosis (TB) test result. Citation issued. Based on the observations made during today’s visit, Three (3) deficiencies were cited per Title 22, Division 6, of the California Code of Regulations. An exit interview was conducted, and this report LIC809, LIC809C, LIC809D and Appeal Rights were discussed and provided to Administrator Kimberly Mejia.the state’s words, verbatim · CDSS document, Sep 22, 2025

The state marks this report as 6 pages; the online copy we transcribed has 5. You can request the full file from the county licensing office.

Type of visit: Prelicensing

Licensing Program Analysts (LPAs) Mary Rico and Eldin Serrano conducted an announced visit to complete a pre-licensing inspection and component III. LPA met with Administrator Kimberly Mejia. The pending application is for a change of ownership for a Residential Care Facility for the Elderly (RCFE). The approved fire clearance granted for (15) ambulatory, (64) non-ambulatory and (20) bedridden residents on 7/17/2024. The facility has (50) resident's bedrooms, (44) bathrooms. There is a kitchen, a lobby area, a dining area, a living room, a laundry room, and a courtyard. The following were inspected: The interior and exterior were toured of the pending facility. Overall, the pending facility is clean and in good condition. LPAs observed all bedrooms to be appropriately furnished with adequate lighting. Bathroom toilets, showers have grab bars and non-skid mats. The hot water temperature in the kitchen was measured at 109 degrees Fahrenheit. LPAs observed food storage and preparation areas to be clean and sanitary. Refrigerator and freezer temperatures are maintained at appropriate temperatures. All appliances are clean and operating properly. There is a sufficient supply of linens, towels, and personal hygiene items. The first aid kit was reviewed; all items are present including a First Aid Manual. LPAs observed an adequate supply of recreation and leisure items and activities. The courtyard space is suitable for resident use that includes a covered patio with a table and chairs. LPAs observed the fire extinguishers to be recently serviced and completely charged. Smoke alarms and carbon monoxide detectors are present and functional. Medications will be centrally stored and secured in a locked cabinet. All hazardous materials such as, cleaning, and disinfecting supplies, knives and other sharps are locked and inaccessible to residents. All required forms are posted in a common area. Pre-Licensing Inspection is complete and has no deficiencies. No corrections need to be made. An exit interview was conducted where this report was discussed and provided to Administrator Kimberley Mejia.the state’s words, verbatim · CDSS document, Sep 30, 2024