Groveview Board and Care

Type of visit: POC

Licensing Program Analyst (LPA) Liliana Silveira conducted an unannounced visit to the facility to conduct a Plan of Correction (POC). LPA was welcomed by, identified herself to, and discussed the purpose of the visit with Sherell. on December 11, 2025 a citation was issued for the following: 87303(a) Maintenance and Operation: the facility shall be clean, safe, sanitary and in good repair at all times. The Licensee provided proof that they contracted professional fumigation services. LPA conducted a walk through and observed that the facility was clean. There were no health & safety concerns observed. This POC was cleared during today's visit. No new deficiencies were identified or cited during today's visit. An exit interview was conducted with Sherell, to whom a copy of this report and the Licensee/Appeal Rights (LIC9058 03/22) were provided during the visit.the state’s words, verbatim · CDSS document, Dec 11, 2025

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Liliana Silveira conducted an unannounced Required Annual Inspection. LPA identified herself and was granted entry into the facility by Caregiver Sherell Kremer, to whom she disclosed the purpose of the visit. Administrators Teresita "Tessie" and Benjamin Pedroso arrived a short time later but left early due to scheduled appointments. The inspection was completed with Sherell. According to the facility’s license, the facility is licensed for six (6) elderly residents, all of whom may be non-ambulatory. The facility has a hospice waiver for one. The facility does not feature a secured perimeter or delayed egress doors. LPA, accompanied by Sherell, toured the interior and exterior of the facility. The facility was clean, sanitary, and in good repair. Resident rooms had ample space and required furnishings. Pathways were free of obstruction and slip hazards. Doors, windows, and screens were present and sinks and toilets were in working order. Hygiene supplies and Personal Protective Equipment were present. The facility had sufficient space and equipment to facilitate visitation, meetings, and client activities. Hot water temperature in the three bathroom sinks accessible to residents were in compliance. No pools or bodies of water were observed on the premises. Per Licensee Tessie Pedroso, no firearms or ammunition are kept at the facility. Smoke alarms, carbon monoxide detectors, emergency lighting, and facility telephone were all working. Fire extinguisher was serviced within the last 12 months. First aid kit was complete and readily accessible. There were no sharp objects, fireplaces, or open-faced heaters accessible to clients. (CONTINUED ON NEXT PAGE, LIC 809C) (CONTINUED FROM FIRST PAGE, LIC 809) Toxic chemicals were stored in locked areas. Medications were checked and stored in a locked area. LPA interviewed staff and clients. LPA also reviewed staff and client records/files. The files that were reviewed by LPA contained required documents. Confidential records were stored in locked areas. Required licensing postings were observed in visible areas of the facility. No deficiencies were cited during today's visit. An exit interview was conducted with Sherell, to whom a copy of this report and the Licensee/Appeal Rights (LIC9058 03/22) were provided at the end of the visit. Signature on this report confirms receipt of these documents. NOTE: LPA left the facility for a lunch break and returned to complete the inspection.the state’s words, verbatim · CDSS document, Dec 11, 2025

Allegation investigated: Licensee does not ensure facility is free of pests.

Licensing Program Analyst (LPA) Liliana Silveira conducted an unannounced visit to conduct a complaint investigation visit and to deliver findings. LPA Silveira introduced themselves, disclosed the purpose of the visit and was granted entry into the facility by caregiver Sherell Kremer. Licensee Teresita Pedrozo arrived a short time after. The Department’s investigation consisted of observations and interviews. On November 10, 2025, it was alleged that The Licensee did not ensure the facility is free of pests. A Department health and safety tour conducted on November 18, 2025 revealed that the facility was clean, including communal areas, bathrooms and resident bedrooms. During the inspection, no cockroaches were observed in those areas of the facility, but were observed in the kitchen, on the countertop next to the refrigerator. (CONTINUED ON NEXT PAGE, LIC 9099C) Substantiated (CONTINUED FROM PAGE 1, LIC 9099) A Department interview with an Outside Source (OS) revealed that a visit to the facility was conducted the week of November 9 to 15, 2025 and the OS also observed cockroaches in the same location- on the kitchen countertop next to the stove. Interviews with (3) residents revealed that residents have not witnessed cockroaches in any communal areas, bedrooms or bathrooms, but have observed them in the kitchen. An interview with Care Staff #1 (CS1) revealed that the problem started about a month ago in a small section of the kitchen near the stove, and CS1 placed traps behind the refrigerator and stove. An interview with Resident #1 (R1) corroborated that R1 witnessed traps in the kitchen. Staff also placed traps on the counters near the kitchen appliances. Interviews with CS1, the Licensee and R1 revealed that the facility was fumigated approximately one year ago and all residents had to relocate. Based on the evidence obtained from observations and interviews, the complaint allegation is substantiated. A substantiated finding means the allegation is valid because the preponderance of the evidence standard has been met. A deficiency is cited per Title 22 California Code of Regulation. LPA Silveira conducted an exit interview with Sherell, to whom a copy of this report, the LIC 9099-D, and the Licensee/Appeal Rights (LIC 9058 03/22) were provided. Signature below confirms receipt of the reports.the state’s words, verbatim · CDSS document, Nov 18, 2025 · control 08-AS-20251110131049

From the deficiency page — Deficiency type: Type B · Section cited: CCR 87303(a) · Plan of correction due date: Dec 18, 2025

87303(a)The facility shall be clean, safe, sanitary and in good repair at all times. Maintenance shall include provision of maintenance services and procedures for the safety and well-being of residents, employees and visitors as evidenced by: Based on observations and interviews, the Licensee did not provide a clean or sanitary environment due to evidence of pests in the kitchen. This poses a potential health risk to 5 of 5 clients in care.the state’s words, verbatim · CDSS document, Nov 18, 2025

Plan of correction: Licensee conducted a deep cleaning, removed hot appliances and has placed traps/chemicals in area where pests are concentrated. Licensee will communicate with CCLD regarding progress-they are currently searching for professional pest control if needed. Due date is 12/18/25.

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Liliana Silveira conducted an unannounced visit to conduct a Required Annual Inspection. The facility file was reviewed prior to the visit. LPA identified themselves to, and discussed the purpose of the visit with Licensee Teresita Pedroso. According to the facility’s license, the facility has a maximum capacity of 6 non-ambulatory residents age 60 and over. Facility was approved for a hospice waiver for one. During today’s inspection, four (4) residents were at the facility, of which 1 (one) was non-ambulatory. LPA, accompanied by licensee, toured the interior and exterior of the facility and inspected common areas and a sampling of resident bedrooms. LPA also interviewed staff and residents and reviewed staff and resident files. The facility was clean, sanitary, and in good repair. Pathways were free of obstruction and slip hazards. Client bedrooms contained required furniture. Doors, windows and screens, toilets, and showers were clean and in working order. Extra linens and hygiene supplies were present, as well as Personal Protective Equipment. The facility had sufficient space and equipment to facilitate dining, laundry, visitation, meetings, and client activities. Confidential records and centrally stored medications were kept in locked areas. The facility had at least two days of perishable food and seven days of non-perishable food present. The facility had cooking and dining utensils to facilitate resident meal service. The facility’s ambient internal temperature was compliant at 70 F. Where tested, hot water temperature at taps (which were used by residents for personal care) were compliant: Bathroom #1 sink was 116.1 F, Bathroom #2, was 110.3 F and Bathroom #3 was 111.1 F. (continued on LIC 809-C, next page) There were no sharp objects, toxic chemicals/poisons, fireplaces, or open-faced heaters accessible to residents diagnosed with Dementia. No pools or bodies of water were observed on the premises. Per the licensee Teresita Pedroso, no firearms or ammunition are kept at the facility. Smoke and fire alarms, carbon monoxide detectors, emergency lighting, and facility telephone were all working. A complete first aid kit was present and readily accessible. Licensee's staff also presented proof of current/active business liability insurance. Required licensing postings were observed in visible areas of the facility. No citation were issued during today's visit. An exit interview was conducted with Teresita, to whom a copy of this report and Licensee/Appeal Rights (LIC9058 03/22) were provided.the state’s words, verbatim · CDSS document, Dec 31, 2024

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Dawn Segura conducted an unannounced required annual inspection. LPA identified herself, was granted entry into the facility, and met with Teresita Pedroso, licensee, to whom she disclosed the purpose of the visit. According to the facility’s license, the facility has a maximum capacity of six (6) residents, all of whom may be non-ambulatory. During today’s inspection, there were a total of six (6) residents residing in the home. This facility does not feature a secured perimeter or delayed egress doors. LPA, accompanied by licensee, toured the interior and exterior of the facility, and inspected the rooms. The facility was clean and in good repair. Pathways were free of obstruction and slip hazards. Resident bedrooms contained the required furnishings. Doors, windows, toilets, and showers were in working order. Extra linens and hygiene supplies were present. The facility had sufficient space and equipment to facilitate dining, laundry, visitation, and meetings. The facility’s internal temperature was within regulatory range. Refrigerators and freezers were operational and food was appropriately stored. Hot water temperature in bathroom used by residents measured at 113.3 degrees F. There was at least 2 days of perishable food, and at least 7 days non-perishable food present, all safely stored. Cooking/dining equipment and utensils were present. There were no sharp objects, toxic chemicals/poisons, fireplaces, or open-faced heaters accessible to residents. Medications were labeled, as required, and stored in a locked cabinet. Confidential records were stored in locked areas. No pools or bodies of water were observed on the premises. Per the licensee, no firearms or ammunition are kept at the facility. Smoke alarms, carbon monoxide detectors, emergency lighting, and facility telephone were all working. Fire extinguisher was present and had been serviced within the past 12 months. First aid kit was complete and readily accessible. Required licensing postings were observed in visible areas of the facility. LPA reviewed staff and resident records/files. A review of resident records reflected that resident appraisals had not been updated within the past 12 months. LPA also interviewed staff and residents; interviews did not raise any licensing concerns. Licensee also had proof of current/active business liability insurance. Administrator’s certification was recently renewed. A deficiency was cited per California Code of Regulations, Title 22 (refer to the attached LIC 809-D), and a Plan of Correction was jointly developed with the licensee. Licensee was also issued a technical advisory and technical violations. An exit interview was conducted with Teresita Pedroso, to whom a copy of this report, the LIC 809-D, LIC 9102TVs, LIC 9102TA, and the Licensee/Appeal Rights (LIC9058 03/22) were provided at the end of the visit. Licensee’s signature on this report acknowledges receipt of copies of the reports and rights.the state’s words, verbatim · CDSS document, Dec 8, 2023

The state marks this report as 6 pages; the online copy we transcribed has 3. You can request the full file from the county licensing office.