Butterfly Gardens II

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Janet Ngallo conducted an unannounced Required Annual Inspection. The facility file was reviewed prior to the visit. LPA was welcomed by, identified herself to, and discussed the purpose of the visit with Caregiver Joselle Rivera. Administrator Leo Espinoza later joined the visit. The facility's license shows a maximum capacity of six (6). All may be non-ambulatory of which one (1) may be bedridden. The facility also has a hospice waiver for three (3). During today’s inspection there were six (6) residents in care. LPA toured the interior and exterior of the facility, and inspected each room. The facility was clean, sanitary, and in good repair. Pathways were free of obstruction and slip hazards. Client 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, meetings, and client activities. Hot water at taps used by residents were all compliant. 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 toxic chemicals/poisons accessible to clients. Medications were labeled, as required, and stored in locked areas. One fully gated pool exists on the premises. Per Caregiver Joselle, no firearms or ammunition are kept at the facility. Carbon monoxide detectors, emergency lighting, and facility telephone were all working. Fire extinguisher(s) were present. First aid kit(s) were complete and readily accessible. Required licensing postings were observed in visible areas of the facility. (Cont. on LIC 809-C) (Cont. from LIC 809) LPA reviewed multiple staff and client records/files. The files which LPA reviewed contained the required documents. Files were stored in a locked area. No deficiencies were cited during today's visit. An exit interview was conducted with Administrator Leo Espinoza 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, May 13, 2026

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Arian Golbakhsh conducted an unannounced, required Annual Inspection. The facility file and personnel report was reviewed prior to the visit. LPA was welcomed by, identified themselves to, and discussed the purpose of the visit to Caregiver Viviana Silva. Administrator Leo Espinosa arrived later in the visit. The facility's license shows a maximum capacity of six (6). All may be non-ambulatory of which one (1) may be bedridden. The facility also has a hospice waiver for three (3). During today’s inspection there were six (6) residents in care. LPA and Caregiver Galila toured the interior and exterior of the facility and inspected each room. The facility was clean, sanitary, and in good repair. Pathways were free of obstruction and slip hazards. Client bedrooms contained the required furnishings. Doors, windows, screens, toilets, and showers were in working order. Hot water temperature at taps accessible to clients were all compliant: Bathroom sink in shared client bathroom was 118F. 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. The facility contained at least two (2) days of perishable food, and at least seven (7) days non-perishable food, all safely stored. Cooking, dining equipment, and utensils were present. Knives were locked and inaccessible to residents. [Continued on LIC 809-C] [Continued from LIC 809] No toxic chemicals or poisons were accessible to clients. Medications were labeled, as required, and stored in locked areas. No pools or bodies of water exist on the premises. Per Caregiver Galila, no firearms or ammunition are kept at the facility. Carbon monoxide detectors, emergency lighting, and facility telephone were all in working order. Fire extinguishers were serviced within the last 12 months. First aid kit was complete and readily accessible. Required licensing postings were observed in visible areas of the facility. LPA interviewed one (1) staff and zero (0) clients, and interviews did not reveal any licensing or regulatory concerns. LPA reviewed facility records. The files reviewed by LPA contained required documents. Confidential records were stored in locked areas. No deficiencies were cited during the inspection. An exit interview was conducted with Administrator Espinosa to whom a copy of this report was provided. Their signature below confirms receipt of this document.the state’s words, verbatim · CDSS document, May 1, 2025

Allegation investigated: Facility did not have a staff alert feature at the door

Licensing Program Analyst (LPA), Sabel Martinez, conducted an unannounced complaint investigation visit to deliver findings. The LPA introduced himself and disclosed the purpose of the visit to Caregiver Joselle Rivera. It was alleged the facility did not have a staff alert feature at the door. On 08/26/2024, it was reported to the Department the facility did not have an auditory alert feature at the entrance door. During multiple visits to the facility, the LPA observed the facility had an auditory alert feature at the entrance door, and the device was emanating sound when the door was opened. The LPA also observed several exit doors and sliding windows used to exit the facility had auditory devices, but these devices were not operating properly. Some of these devices did not produce an auditory sound when engaged or were turned off due to the devices not operating properly. Review of physician’s reports for residents at the facility confirmed they were all diagnosed with dementia and could be confused. Substantiated Based on observations and review of records, the facility did not have auditory devices, or alert features to monitor exit doors. This deficiency was cited in accordance with California Code of Regulations, Title 22, and listed on the LIC 9099D. A plan of correction was jointly formulated with Caregiver Joselle Rivera. An exit interview was conducted with Rivera, to whom a copy of this report, LIC 9099D, and Licensee/Appeals Rights (LIC 9058), were provided. The agency was not able to provide information of who had signed the subsequent visit forms. The LPA reviewed records for this agency obtained at the facility, and there was no clear indication that R1 had signed any legal documents from that agency. It was alleged the facility did not have a perimeter fence. On 08/26/2024, it was reported to the Department the facility did not have a perimeter fence. An observation by the LPA confirmed the facility did have a perimeter fence securing the facility's patio area. Although this fence did not extend to the front of the facility, the facility did have an auditory signal/ alert device at the main entrance door. Additionally, the facility did not have an approved locked perimeter fire clearance. Based on the evidence obtained, the allegations were unsubstantiated. An exit interview was conducted with Caregiver Rivera, to whom a copy of this report, and Licensee/Appeals Rights (LIC 9058), were provided.the state’s words, verbatim · CDSS document, Oct 30, 2024 · control 08-AS-20240826180224

From the deficiency page — Deficiency type: Type B · Section cited: CCR 87705(j) · Plan of correction due date: Oct 30, 2024

87705 Care of Persons with Dementia (j) The licensee shall have an auditory device or other staff alert feature to monitor exits, if exiting presents a hazard to any resident. This requirement was not met as evidenced by: Based on observations and review of records, the Licensee did not ensure exit doors had auditory, or alert features to monitor exit doors of residents with dementia, which posed a potential health, safety and personal rights risk to five of five residents in care.the state’s words, verbatim · CDSS document, Oct 30, 2024

Plan of correction: Staff agreed to replace all auditory/ alert features monitoring exit doors that are not working properly, and notify the LPA by 11/04/2024.

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Sabel Martinez conducted an unannounced Required Annual Inspection. The LPA introduced himself and disclosed the purpose of the visit to Administrator Leo Espinosa. The facility was approved for a capacity of six (6) non-ambulatory residents, of which one (1) could be bedridden. The facility also had a hospice waiver for three (3) residents. The LPA, accompanied by staff, toured the interior and exterior of the facility, and inspected each room. The facility was clean, sanitary, and in good repair. Pathways were free of obstruction and slip hazards. Resident bedrooms contained the required furnishings. Doors, windows, screens, 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, meetings, and client activities. 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 toxic chemicals/poisons accessible to clients. Medications were labeled, and stored in a locked area. A pool was observed to be secured and inaccessible to residents in care. Per staff, no firearms, nor ammunition were kept at the facility. A Carbon monoxide detector was tested and operational. A fire extinguisher, first aid kit and a working telephone were present. Due to time constraints, a return visit on a subsequent day is needed to complete the annual inspection. An exit interview was conducted with Administrator Leo Espinosa, to whom a copy of this report, and Licensee/Applicant Rights (LIC 9058), were provided.the state’s words, verbatim · CDSS document, May 30, 2024