The Vineyard Residential

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Magda Malcore made an unannounced visit to the facility to conduct a required comprehensive annual inspection. LPA met with Staff, Janette Mabutas, and discussed the purpose for the visit. The facility is a Residential Care Facility for Elderly (RCFE) with a license capacity of (6), and a current census of (4). LPA conducted a general inspection of facility, which included, but was not limited to, the following: Operation/Physical Plant: Indoor and outdoor passageways were kept free of obstruction. The facility has no swimming pools or similar bodies of water. The facility has sufficient indoor and outdoor space for resident activities. Outdoor activity space is enclosed with a latching gate. The facility is maintained at a temperature of 72 degrees Fahrenheit. Resident bedrooms were furnished with beds, night stands, chairs, bed linen and lighting. Resident bathrooms were maintained clean and fixtures were operating properly. The hot water temperatures in the bathrooms measured at 114 degrees Fahrenheit. The facility is equipped with operating smoke/carbon monoxide alarms, fully charged fire extinguisher, laundry equipment, door signal, emergency supplies/water and telephone service. The facility has posted in a common area Community Care Licensing complaint poster, Ombudsman poster, Resident Personal Rights, facility license, facility sketch, food menu, "oxygen in use" signs, emergency plan and telephone numbers. The facility has a designated area for resident and staff files. In a non-private bathroom located near resident room #2, LPA observed cleaning supplies stored in unlocked and left unattended. Food Service: Kitchen and dining areas were maintained cleaned. Non-perishable and perishable food supply was sufficient for number of residents in care. Cups, plates, and utensils were sufficient for residents in care. **continued on LIC809-C** Health Related Services: The facility maintains a first aid kit with manual and medications were centrally stored in a locked area. LPA audited medications for three (3) residents. LPA observed hand written, altered prescription labels on two (2) prescribed medications for resident #1 (R1). Staff stated the there was a recent order change to the medication dosage and they altered the label to reflect the new dosage. LPA observed a medication supplement for R1 not stored in it's original container. Staff stated that resident's spouse had brought the medication to them in gum container. LPA observed the supplement was listed under medications in R1's Hospice Plan of Care. Record Review: Three (3) resident files were reviewed for admissions agreements, physician’s reports, appraisals, needs and services plans. LPA observed Resident #2 (R2) who was admitted to the facility in October 2025, did not have a hospice care plan maintained at the facility for review. Three (3) staff files were reviewed for First Aid/CPR certifications, criminal record clearances, training, and health screenings. Files were complete. The facility has available an infection control plan, emergency/disaster plan, client registry, and liability insurance for review. During today's visit, deficiencies were cited per Title 22, Division 6, of the California Code of Regulations. An exit interview was conducted where this report was discussed and a copy provided with appeal rights to Staff Mabutas.the state’s words, verbatim · CDSS document, Mar 6, 2026

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Magda Malcore conducted an unannounced visit to this facility for a required annual inspection. LPA met with Administrator Mayleen Saludez and was informed of the purpose of today's visit. The facility is approved for a capacity of six (6) non-ambulatory residents with a current census of one (1) resident in care. LPA conducted a tour of the interior and exterior of the facility. Physical Plant: All indoor and outdoor passageways are kept free of obstruction. There are no pools or other bodies of water located on the premises. The facility's outdoor activity space is enclosed with a self-latching gate. The facility is being maintained at a comfortable temperature for resident. Resident bedroom equipment are in operating condition and bathrooms are equipped with grab rails and slip mats. Hot water temperature in resident bathrooms measured between 105 degrees Fahrenheit. The facility is equipped with fire extinguishers, fire alarms, first aid kit, hallway night lights, bottled water and telephone service. The facility has posted in a common area: Community Care Licensing complaint poster, Ombudsman poster, facility license, evacuation sketch and emergency telephone numbers. Kitchen and Food Service: The facility is equipped with a two-day perishable and at least a 7-day non-perishable supply of food. All readily perishable food or beverages capable of micro-organism growth are being stored appropriately within regulatory temperatures. Sharps and cleaning agents are kept locked and secured. Medication and Supervision: The facility maintains sufficient staffing to provide services needed to meet residents' needs. Resident's medication is central stored and kept locked and secured. Record Review: Resident file had admissions agreement, physician's medical assessment, preadmission appraisals, reappraisal and/or needs and services plan. Staff files had criminal records clearances and/or exemptions, employment history, health screening, first Aid/CPR certifications and job related training. The facility has a client registry and disaster plan for review. The Administrator's certification and facility insurance are current. Overall the facility is in good repair. No deficiencies where cited during today's visit. An exit interview was conducted were this report was discussed and copy was provided to Administrator Saludez at the conclusion of the visit.the state’s words, verbatim · CDSS document, May 1, 2025

The state marks this report as 9 pages; the online copy we transcribed has 3. You can request the full file from the county licensing office.

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Anna Fannell conducted an unannounced visit to this facility for a required annual inspection. Entry into the facility is unobstructed and LPA met with care staff Janette Mabutas who was informed of the purpose of today's visit. Mabutas notified administrator Mayleen Saludez and Administrator arrived at the facility. The facility is approved for a Hospice Waiver for six (6) non-ambulatory residents, all of whom may be bedridden. Administrator left the facility before the conclusion of the visit. LPA and Staff toured the interior and exterior of the facility. Physical Plant: There are no pools or other bodies of water located on the premises. The facility is being maintained at a comfortable temperature for residents. All passageways are kept free of obstruction. Hot water temperature was measured in all bathrooms and measured between 105 and 110 degrees Fahrenheit. Grab bars, textured/tiled shower floors, and shower aid equipment are utilized by residents. Fire safety installations such as extinguishers, sprinklers, and alarms are present. Fire extinguisher is kept in the laundry area and was observed to be charged and last inspected on 06/28/2023. Carbon monoxide detector and bedroom and hallway smoke detectors were tested by Staff and units were observed working. Overall the facility is in good condition, is clean and sanitary, and is not malodorous. Kitchen and Food Service: LPA was present during lunch service. LPA observed food provisions and found a two-day perishable and at least a 7-day non-perishable supply. All readily perishable food or beverages capable of micro-organism growth are being stored appropriately within regulatory temperatures. Sharps and cleaning agents are kept locked and secured. Medication, Care, and Supervision: The facility maintains sufficient staffing to provide services needed to meet residents' needs. Chemicals and cleaning agents are stored inaccessible to residents. LPA inspected medications and found them in original containers and appear to be dispensed according to doctors' orders. Resident and Staff Files: LPA reviewed all staff and resident files. Resident files had the required documents including admission's agreement, consent forms, and appraisal and/or needs and services plan. Staff files had the required documentation and training including mandated reporting, health screening report, and CPR certification. Operations and Administration: Disaster Plan is present. Administrator is present in the facility a sufficient amount of hours and their administrator certification is up to date. The required ombudsman and licensing posters are posted in public view. Residents rights are posted and a copy is kept the resident's file. During today's visit, LPA Fannell issued technical advisories to remind staff of current regulations. An exit interview was conducted where this report in its entirety was discussed and provided to care staff Janette Mabutas.the state’s words, verbatim · CDSS document, Apr 9, 2024

The state marks this report as 5 pages; the online copy we transcribed has 2. You can request the full file from the county licensing office.