Perpetual Help Home Care

Allegation investigated: Staff failed to meet resident's hygiene needs. Facility pool is unclean. Staff are not meeting resident's medical needs.

On April 2, 2026, the California Department of Social Services/Community Care Licensing (CDSS/CCL) Licensing Program Analyst (LPA) Antonine Richard conducted an unannounced follow-up complaint visit. The LPA met with the Administrator (A1), Helen Ramirez, and (A2) Jose Ricardo Ramirez, and explained that the purpose of the visit was to investigate the allegations mentioned above. The investigation consisted of collecting records and observing the facility. The Department obtained various documents, including the Personnel Report LIC 500 (dated 01/17/26), the Resident Roster (dated 01/30/26), service records for VA Home Health Aid dated 2026, Identification and Emergency Information LIC 601, Face Sheet & Emergency Info, Service Plan, Resident Appraisal LIC 603A, Medical Assessment for Residential Care Facilities for the Elderly LIC 602A, and other relevant records related to this complaint. On 10/19/2023, the department interviewed Advance Medical Support (AMS) and residents (R1). On 04/02/2026, the department interviewed the Administrator A1, and A2, one staff (S1), and five residents (R2-R6) and facility's scheduled appointments. Unsubstantiated Allegation #1: Staff failed to meet the resident’s hygiene needs. The complaint alleged that the facility failed to ensure that the resident's (R1) personal care hygiene needs were met. The residents are decent but unclean. On 04/02/2026, between 8:30 am and 10:15 am, the department interviewed the Administrator (A1), who denied the allegation. A1 stated that three residents (R2, R4, and R6) need help showering, and the Veteran Administration Home Health Aide (AVHHA) comes to the facility to assist them three times a week. However, R3 and R5 are independent and can shower themselves. The staff helps all residents with daily hygiene. The department also interviewed another Administrator (A2), who denied the allegation and stated that staff assist residents who need help, even if they do not ask. Since residents cannot be forced if they refuse, staff continue to let them know they are available to help. One staff member (S1) was also interviewed; S1 denied the allegation and stated that staff help all residents with hygiene unless they refuse. During the visit on October 19, 2023, the department interviewed residents (R1), who denied the allegation and stated that R1 showers whenever R1 wants. On April 2, 2026, the department also interviewed five residents (R2-R6), all of whom denied that staff assisted them with hygiene needs. They also stated they have the right to refuse any help if they wish. On the same day, the department reviewed the facility records for the (AVHHA) schedule, which showed that (AVHHA) visits the facility three times a week. The department then toured the facility and found a storage area full of hygiene products, as well as a bathroom stocked with hygiene products for residents to use. Although the allegation may have happened or is valid, there is not a preponderance to prove the alleged violation (s) did or did not occur, therefore the allegation is Unsubstantiated. Allegation #2: The facility pool is unclean. The complaint claimed that the backyard swimming pool had green, moldy water and was uncovered. On April 2, 2026, between 8:30 am and 10:15 am, the department interviewed the Administrator (A1), who denied the allegation and said that the facility is no longer using the pool. The department toured the facility inside and outside; it observed a lock on the backyard where the pool is located and noted that the pool was empty and clean. The department interviewed the Administrator (A2), who stated that the facility is in the process of covering the pool because they do not plan to use it. The department also spoke with five residents (R2-R6), who said they do not go outside to the pool because it has no water, and the gate is closed. Although the allegation may have happened or is valid, there is not a preponderance to prove the alleged violation (s) did or did not occur, therefore the allegation is Unsubstantiated. Allegation #3: Staff is not meeting the resident’s medical needs. The complaint alleged that the facility failed to follow up on medical appointments. The department interviewed the Administrator (A1), who denied the allegation and stated that the social worker schedules the doctor appointments and that the staff takes residents to those appointments. We have a doctor scheduled to see each resident. Sometimes, we receive instructions from the doctor regarding follow-up visits. The department also interviewed the Administrator (A2), who denied the allegation and stated that both A1 and A2 take residents to their appointments. The department interviewed five residents (R2-R6), all of whom said that staff usually take them to their doctor appointments or social worker visits. R3 mentioned they are leaving now for a doctor's appointment. During the visit on October 19, 2023, residents (R1) denied the allegation, stating that they attend all of their doctor appointments. Additionally, during that visit, the department interviewed Advanced Medical Support (AMS) about resident (R1), who confirmed that R1 did not miss any scheduled appointments and noted that one appointment was rescheduled for the same day with a virtual appointment instead of an in-person visit. On April 2, 2026, the department reviewed the facility’s scheduled doctor appointments for all residents, including the dates they attended and their upcoming appointment dates. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation (s) did or did not occur; therefore, the allegation is unsubstantiated. No deficiencies were cited. An exit interview was conducted, and a copy of the report was provided to Administrator Helen Ramirez.the state’s words, verbatim · CDSS document, Apr 2, 2026 · control 18-AS-20231016124246

Type of visit: Required - 1 Year

On 02/13/2026, Licensing Program Analysts (LPAs) Aziz Faizi and Abdoulaye Zerbo made an unannounced visit to the facility to conduct a required annual inspection. LPAs were greeted and granted entry by caregiver Elvira Neronamangabat who was informed of the purpose of the visit. The administrators joined the visit at a later time. The facility is a one-story home with six (6) bedrooms and three (3) bathrooms, including an empty pool. The pool gates were locked and the fence meets the height requirements. LPAs toured the facility's exterior and observed outdoor pathways were free of obstructions. Outdoor shaded seating area is available for the clients in care. The physical plant, including floors, windows, and doors, was clean and well maintained. Fixtures and furniture were in good repair. LPAs toured the kitchen and observed the facility has a two-day supply of perishable foods and seven-day supply of non-perishable foods, which are stored in a safe and healthy manner. LPAs observed the laundry equipment to be in good working condition. Sharp and dangerous objects were securely locked and inaccessible to residents. Restrooms were clean and had toilet paper, paper towels, and soap readily available for resident. Chemicals, cleaning solutions and disinfectants were securely locked and inaccessible to residents. Both the smoke detector and carbon monoxide detector were operational, and the hot water temperature was 120.0°F. LPAs observed fire extinguishers to be in compliance with the department's requirements with the expiration date of 12-31-27. Continued on LIC809-C.... Adequate staff were present to supervise clients during the visit. The administrator holds a current administrator’s certificate with the expiration date of 2/19/2027 and a CPR certification with the expiration date of 01-28-28. LPAs reviewed files for three (3) staff members, confirming criminal clearances, updated training, and CPR/First Aid certification. Three (3) residents files were reviewed and some documents were missing. Administrator agreed to send all required documentation by 2/27/2026.. All client medications were securely locked. LPAs reviewed medications for three clients, confirming that all medications were listed on the Medication Administration Record (MAR) and accounted for. LPAs reviewed the facility’s infection control plan, the emergency and disaster plan, including documentation of the last emergency drill conducted on 12/09/2025, which met department requirements. All facility exits were clear of obstructions. No deficiencies were cited per title 22. An exit interview was conducted, during which this report was reviewed and a copy was provided.the state’s words, verbatim · CDSS document, Feb 13, 2026

Type of visit: Case Management - Deficiencies

Licensing Program Analyst (LPA) Javina George made an unannounced case management deficiencies visit. LPA requested the file for Resident #1 (R1) and was informed that there was no file at the facility due to R1 being discharged. LPA was unable to review the file requested. Deficiency cited. Based on today's visit a citation will be issued in accordance with the California Code of Regulations (Title 22, Division 6, Chapter 8) on the attached 809D. An exit interview was conducted and a copy of this report, appeal rights, LIC9098-Proof of Corrections form and LIC811-Confidential names list was reviewed and provided to Elvira Mangabat, Caregiver.the state’s words, verbatim · CDSS document, Mar 17, 2025

From the deficiency page — Deficiency type: Type B · Section cited: CCR 87506(e) · Plan of correction due date: Mar 31, 2025

87506 Resident Records (e) Original records or photographic reproductions shall be retained for a minimum of three (3) years following termination of service to the resident. This requirement is not met as evidenced by: R1s resident file was not at the facility, or brought to the facility for LPA to review during today's visit, which poses a potential health, safety and personal rights risk to persons in care.the state’s words, verbatim · CDSS document, Mar 17, 2025

Plan of correction: The licensee agrees to provide the full file, including MARs for C1 for LPA to review. The file can be emailed and scanned, or copies dropped at the regional office. Proof of POC is to be submitted to the department by 5pm on the due date indicated.

Type of visit: Required - 1 Year

On 02/19/25 Licensing Program Analyst (LPA) Javina George made an unannounced visit to the facility to conduct a 1 year required visit. LPA was greeted and granted entry by Caregiver Elvira Mangabat, the Administrator's Jose and Helen Ramirez arrived shortly after. The facility has an approved hospice waiver for (1) with (0) residents currently receiving hospice services. At the time of the visit there was (3) staff and (6) residents present. LPA verified the contact information for the facility that is on file with the department. LPA conducted a tour of the interior and exterior and upon exiting the car there was an odor of sewage outside per Administrator there is a clog with the line, and someone is due to come out and service it tomorrow 2/20/25. The administrator agreed to show proof of service to the department no later than 5pm on Friday 02/21/25. The facility was observed to have running water, and the smoke and carbon monoxide detectors were observed to be operable. The facility was observed to have several cob webs throughout the facility in the window sills, in the hallway hanging from fixtures. The medications were observed to be locked inside a closet inside the hallway by the kitchen. LPA observed for there to be (3) bottles of liquid medication and (1) vile of liquid medication, that was siting in a small box on table inside the hallway. The medication was moved and locked in the closet during the visit. Emergency disaster drills are being conducted on a quarterly basis, the last drill was conducted on 01/29/25. The facility has pool that is drained, there is a fully charged fire extinguisher. There are no known guns or ammunition on the premises. File review: The administrator's Jose and Helen did not have their files available to review at the time of the inspection. In addition there was no staff present with valid CPR certification, deficiencies cited. Resident files had the appropriate assessments and appraisals as well as admissions agreements. All staff present had criminal record clearance and were observed to be associated to the facility. The facility had a sufficient food supply 2 days of perishables and 7 days of non perishable food items. Based on today's inspection a citation will be issued on the attached 809D, in accordance with the California Code of Regulations (Title 22, Division 6, Chapter 8). An exit interview was conducted and a copy of this report, appeal rights, LIC9098-Proof of Corrections form and LIC 811- Confidential names list was provided to Helen Ramirez.the state’s words, verbatim · CDSS document, Feb 19, 2025

Allegation investigated: Staff did not have required training Staff did not treat residents with dignity

Licensing Program Analyst (LPA) Sabel Martinez conducted an unannounced follow-up investigation visit and delivered complaint findings. The LPA introduced himself and disclosed the purpose of the visit to Caregiver Elvira Mangabat. Administrator Raymond Ramirez arrived during the visit and assisted the LPA. Throughout the investigation, the Department secured pertinent records and conducted interviews with sources. It was alleged the staff did not have the required training. It was reported to the Department staff were assisting residents with medications. Interviews with multiple sources did not reveal concerns with lack of assistance from staff. Records obtained from the facility revealed care staff had received medication assistance training. (See LIC 9099C for continuation of report.) Unsubstantiated It was alleged staff did not treat residents with dignity. A source reported to the Department staff had treated a resident in a mean way. This source did not provide any specific action from staff, nor a timeframe. Interviews with several sources did not reveal any concerns with staff not treating residents with dignity, and revealed staff treated residents well. Sources also revealed residents may have raised their voices at staff and other residents. Based on the evidence gathered throughout the investigation, the allegations were unsubstantiated. An exit interview was conducted with Administrator Ramirez, to whom a copy of this report, and Licensee/Appeals Rights (LIC 9058), were provided via electronic mail. An electronic mail read receipt confirms the documents were received by Ramirez.the state’s words, verbatim · CDSS document, Feb 13, 2024 · control 08-AS-20201014134932

Type of visit: Case Management - Other

Licensing Program Analyst (LPA) Sabel Martinez conducted an unannounced case management visit. The LPA introduced himself and disclosed the purpose of the visit to Administrator Raymond Ramirez. During the visit, the LPA secured reports signatures and delivered an amended report. An exit interview was conducted with Administrator Ramirez, to whom a copy of this report, and Licensee/Appeals Rights (LIC 9058), were provided via electronic mail. An electronic mail read receipt confirms the documents were received by Ramirez.the state’s words, verbatim · CDSS document, Feb 13, 2024

Type of visit: Required - 1 Year

On February 08, 2024, Licensing Program Analyst (LPA), Venus Mixson arrived at the facility unannounced to conduct the required annual inspection and interviewed the Administrator, Jose Ramirez, via the telephone. The facility file review was conducted in the office and additional records were requested and reviewed on site. The facility is licensed for six elderly adults and is operating at full capacity. LPA met with the Lead Caregiver Elvira. LPA Mixson toured the facility along with Lead Caregiver, Elvira Mangabat and inspected the facility inside and outside. There were no obstructions to the indoor or outdoor passageways currently at the time of this visit. The facility is a single-story home, located at 29531 Mactan RD, Valley Center, CA 92082. Physical Plant: The facility phone number is (858) 610-4098 and is operable. The LPA observed the residents’ bedrooms, and they are equipped with required furniture as per Title 22. The LPA inspected facility bathrooms, and the hot water temperature tested within regulations. The bathrooms were clean, and appliances were operating appropriately currently at the time of this visit. The facility is equipped with operating smoke detectors, carbon monoxide alarms, and fire extinguishers. The LPA observed required postings such as "If you See Something, Say Something" the "Personal Rights" and the Ombudsman postings were posted in a common area. The cleaning supplies and sharp items were kept locked and inaccessible to the residents in care. There was a designated storage space for the resident and staff files, and it was locked. Medications: were reviewed, locked and inaccessible to residents, and there was a 30-day supply. The overall facility is clean, the furniture is in good condition. The facility heating system and other appliances were operable currently at the time of this visit. Food Service: Non-perishable and perishable food supply is sufficient per regulations, and there are a variety of food types available for residents. Dishes and utensils were in sufficient supply and stored properly. Care & Supervision Facility has sufficient staff, one staff at the time of this visit and the staff were engaging the residents with a meal and ADL's. Records Review: The LPA reviewed staff and resident files, conducted staff and resident interviews, and reviewed previous Community Care Licensing forms. There were no Title 22, Division 6 Regulation violations observed or cited during today’s visit. An exit interview was conducted, and a copy of this report was given to the Lead Caregiver, Elvira Manabat.the state’s words, verbatim · CDSS document, Feb 8, 2024