A Peaceful Place on Rice Ranch Rd

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Type of visit: Required - 1 Year

At 10:00am on 09/11/2025 Licensing Program Analyst (LPA) Jeffries arrived unannounced to the facility to conduct the annual inspection. LPA met with care giver Diane Sanchez announced who he is and the reason for the visit. LPA contacted Administrator on cell and administrator arrived to the facility during the inspection. Care Giver and LPA conducted a physical tour of the facility. This facility is a 4 bedroom, 3 bathroom, living room, dining room, kitchen, medication room and den. There is a fenced back yard with table, chairs and umbrella for resident activities and visiting. LPA noted that there was a local power outage during this annual inspection and staff were able to navigate the emergency disaster plan, turn on and utilize the facility generator to preserve integrity of cold storage medication. Medication refrigerator has a pad lock and all other medication is stored in the facility medication room adjacent to the dining room. LPA noted that smoke detectors and carbon monoxide detectors were tested and functioning during inspection. LPA noted that there are at least three days of perishable foods and seven days of nonperishable foods on hand for six residents and staff. LPA noted that the water temperature was tested throughout the facility within regulation range, and LPA reminded care givers to test water temperature later in the day due to the power outage during the annual inspection. LPA noted that the facility has a complete first aide kit on hand. LPA observed fire extinguisher primed and in the green. LPA noted that all passage ways, door ways and exits were free and clear. LPA conducted cursory reviews of staff files, training, resident files, emergency disaster plan, infection control plan, and facility Plan of Operation. There were no violations or citations as a result of the facility annual physical tour. Administrator and LPA conducted a full reviewed of the annual care tools modules with no violations or citations. At this time there are no violations or citations as a result the facility annual inspection. Exit interview, report read, and report provided.the state’s words, verbatim · CDSS document, Sep 11, 2025

Allegation investigated: Staff does not ensure expired medications are properly discarded. Staff does not ensure medication are properly labeled. Staff does not ensure medication records are properly maintained. Staff does not ensure food containers are properly labeled. Staff does not ensure expired food is properly removed from the facility. Staff does not ensure resident health care needs are being met. Licensee allows unqualified staff to dispense medications.

At 8:00am on 04/03/2025, Licensing Program Analyst (LAP) Jeffries arrived to the facility unannounced to conduct the initial investigation visit to the allegations to this complaint. LPA met with Staff Diane Sanchez (S1), and Staff Luz Diaz-Valencia (S2). Both staff and LPA called Administrator on the phone and left a message to contact or come to the facility. Administrator, Rosa Castro arrived to the facility at 9:00am. LPA conducted a physical tour of the facility focusing on the kitchen and medication room. LPA took photographs of food, and noted the food to be of good quality and at least 2 days of perishable foods and at least 7 days of non perishable foods. LPA conducted interviews of staff and residents. LPA conducted a sample medication audit, requested and reviewed documentation. LPA issued final findings to all allegations to this complaint. As to the allegations of, “Staff does not ensure expired medications are properly discarded.” and “Staff does not ensure medications are properly labeled.” It was alleged that, in March of 2025, “old medications in the medication cabinet that were all expired and some bottles that had no labels on them.” CONTINUED on LIC 9099-C Unsubstantiated It was discovered through observations, that on 04/03/2025 Administrator and LPA conducted a medication audit and reviewed medications of R1 and R2. LPA noted that medications for R1 were stored in both bottle and bubble pack storage from the pharmacy. R1’s bottled storage was prescribed before his admission to the facility and was still current by the Physicians prescription requirements. The remainder of R1’s medications were stored in bubble pack form from the pharmacy. R2’s medications were stored in bubble pack form from the pharmacy. No irregularities were noted during the medication audit. No expired medication was present, and no medication labels were altered. On 04/03/2025, LPA Jeffries noted that 5 empty bubble packs were set aside as the medication had been administered as prescribed as medication cycle for those bubble packs had been exhausted on this day (04/03/2025) and were placed aside to be discarded. At this time there is not enough evidence to support the allegations of, “Staff does not ensure expired medications are properly discarded.” and “Staff does not ensure medications are properly labeled.” And is unsubstantiated at this time. As to the allegation of, “Staff does not ensure that medication records are properly maintained.” It was alleged that in March of 2025, that, “residents’ medications not being logged on the MAR sheet each day.” It was discovered through interviews and documentation review that on 04/03/2025, LPA Jeffries conducted an interview with Administrator who stated that medication training and shadow training indicates that staff dispensing medications to sign the Medication Administration Record (MAR) immediately after dispensing medication to Residents. On 04/03/2025, LPA Jeffries noted in the medication records audit that there were no abnormalities or missed medication logs observed. LPA Jeffries noted that MAR and Centrally Stored Medication Records (CSMR) are also free of error and free of discrepancies. At this time there is not enough evidence to support the allegation of, “Staff does not ensure that medication records are properly maintained.” and is unsubstantiated at this time. As to the allegation of, “Staff does not ensure food containers are properly labeled.” and “Staff does not ensure expired food is properly removed from the facility.” It was alleged that, “old food containers without dated labels on them in the fridge.” It was discovered through observation and interviews that on 04/03/2025 LPA Jeffries conducted observational investigation as to the content of all food stored and prepared at this facility and found no improperly stored food, no food with degradation of quality, no expired foods, or stored food at a damaging temperature. On 04/03/2025, LPA conducted interviews of S1 and S2 both indicated that the food served at the facility is always of high quality and if they need to they can discard spoiled, or damaged food as needed. CONTINUED on LIC9099-C On 04/03/2025, LPA Jeffries conducted interview with Residents 1-4.(R1, R2, R3, and R4) All residents had no complaints of the quality of food and have never been served spoiled or damaged foods. At this time there is not enough evidence to support the allegations of “Staff does not ensure food containers are properly labeled.” and “Staff does not ensure expired food is properly removed from the facility.” and is unsubstantiated at this time. As to the allegation of, “Staff does not ensure resident health care needs are being met.” It was alleged that in March of 2025, “one of the residents has shingles” and the licensee failed to get the resident proper treatment for health condition. It was discovered through interviews and documentation that on 04/03/2024, R2 has visited their primary care physician on 02/27/2025. 03/04/2025 and 03/27/2025 to specifically address the condition alleged in this allegation. On 04/03/2025, LPA Jeffries conducted an interview with Administrator who stated that R1 has visited their physician three times for assessment and treatment to the condition listed in this complaint allegation. On 04/03/2025 LPA reviewed R1’s full file documentation on medical documentation verifying that R1 has been seen by a medical professional on 02/27/2025. 03/04/2025 and 03/27/2025 and has had their health care needs being met. On 04/03/2025, LPA Jeffries conducted and interview with R2, who stated they feel safe in this facility, and they (facility) have helped with all needs medical and other. At this time there in not enough evidence to support the allegation of. “Staff does not ensure resident health care needs are being met.” And is unsubstantial at this time. As to the allegation of, “Licensee allows unqualified staff to dispense medications.” It was alleged that in March of 2025 that. “Care staff are not trained on dispensing medications to residents.” It was discovered through documentation and interviews that on 04/03/2025, LPA Jeffries conducted interviews with S1 and S2 who both stated that they have had several hours of medication administration training and shadowing. An interview on 04/03/2025 LPA conducted an interview with Administrator who stated that all staff get medication administration training but has S1 and S2 are the main medication technicians for dispensing medication at this facility. On 04/03/2025 LPA reviewed and collected documentation indicating that S1 and S2 have had required medication administration training to assist residents with daily medications. At this time there is not enough evidence to support the allegation of, “Licensee allows unqualified staff to dispense medications”. And is unsubstantiated at this time. Exit interview, report read, and report providedthe state’s words, verbatim · CDSS document, Apr 3, 2025 · control 29-AS-20250401115533

Type of visit: Prelicensing

On 10/09/2024, Licensing Program Analyst (LPA) Brian Phillips arrived at the facility above to conduct a scheduled, required Pre-Licensing inspection visit and Comp III for new License of a Residential Care Facility for the Elderly (RCFE). When the LPA arrived, they were greeted by Licensee/Director Rosa Castro and informed them of the reason for the visit. On 05/09/2024, applicant/Licensee participated in COMP II. The facility has an approved capacity for Six (6) residents an age range of 60 and over. The facility is cleared for Six (6) Non-Ambulatory residents, of which one (1) may be bedridden with a Hospice Waiver for Two (2) residents. The LPA toured the physical plant areas inside and outside to ensure there are no health and safety hazards and facility is in compliance with Title 22 Regulations. The LPA inspected the food service area and observed that knives/sharp instruments will be stored in locked drawers inaccessible to clients. All appliances were in operable condition and looked clean/in good repair. Appliances such as microwaves, refrigerators, stoves, etc. are clean and operating properly. Food utensils, dishes, glasses, etc. are clean and in good repair with no cracks or chips. Furniture is room/resident appropriate, clean and in good repair. All rooms are appropriately furnished for their intended use such as bedrooms, dining rooms, kitchens, living rooms, etc. Hot water temperature is maintained between 105-120 degrees Fahrenheit. Outdoor activity spaces have shaded areas and furnished for outdoor use. Each resident has an adult bed with a mattress, pad, bedsprings, and pillow, which are clean and in good repair. Each bed is fitted with sheets, pillowcase, blankets, and bedspread that are clean and in good repair. Each resident has adequate dresser and closet space for clothing and other belongings that includes at least two drawers or adequate dresser space. The facility has a sufficient supply of linens to permit weekly changing or more often to always insure clean linens for residents. Equipment and supplies for resident personal hygiene is available and on site. Activity supplies are available for residents. As the facility has an approved fire clearance for a maximum of six (6) residents, there is no signal system required or observed by LPA. Continued on 809-C Refrigerator and freezer are maintained at an appropriate temperature Fahrenheit. Food storage and preparation areas, including pantries, cupboards, counters, etc., are clean and appropriate for food preparation. The food service area was clean and sanitary, with covered trashcans and operating ventilation systems. No toxic substances are stored in any food preparation or storage area, and all cleaning supplies for the kitchen are kept in a separate area than the food supplies. There is enough tableware and utensils for all clients living in the facility, and enough equipment for the storage, preparation, and service of food. A locked storage area for central storage of medications is available. Cleaning supplies will be kept in areas separate from where food supplies are stored. Walls, ceilings, floors, carpeting, window screens, and areas around the facility are clean, painted and/or in good repair. There are locked storage area(s) for poisons, toxic, cleaning solutions, disinfectants, etc. Fire extinguishers and smoke detectors operate properly. Doors, stairways, and passageways are unobstructed. There are no pools/bodies of water on the physical plant of the facility as observed by LPA. During the inspection, LPA did not observe any firearms that would require trigger locks, locked and inaccessible, or firing pins removed. At the time of the visit, all common areas/interior rooms of the facility were observed to be appropriately furnished, with all furniture in good condition. There are activity materials in the common areas of the facility in good repair and operating condition. The facility maintained a comfortable temperature in all areas inspected. Smoke detectors and carbon monoxide detectors were tested and operational at the time of the visit. The fire extinguishers in all buildings inspected were fully charged and recently purchased in 2024. The LPA observed required postings throughout all common spaces. All window screens were in good repair in all the areas comprising the facility. There is appropriate lighting in all the common areas of the facility. All passageways through the common areas of the facility were free of obstruction, with changes in incline having ramps and/or sturdy hand railings/stair chair accessibility devices. This facility is one (1) story throughout and therefore there are no stairways for clients to utilize. The facility is completely enclosed with a main entrance door and an emergency exit at the rear of the facility. There is a main entrance into the facility on a public street. The facility has walls surrounding the interior of the facility. There are no bodies of water on the facility premises. There is an outdoor activity space for clients equipped with furniture for resident use and shade. The outdoor activity space is completely enclosed by fencing and latching gates. The designated laundry area is located in the interior of the facility with the storage of cleaning products locked and inaccessible to clients, away from food products. There was emergency food and water in the garage area which was observed to be in good condition. Cleaning supplies, disinfectants, and other items that could pose a danger to clients are kept in areas inaccessible to clients. Continued on 809-C The facility restrooms were sanitized and in operating condition while the LPA toured the facility. Restrooms in the facility that included soap, paper towels, required postings, and clean trashcans with closed lids. All restrooms were sufficiently stocked with soap, paper towels, and additional supplies; towels and washcloths are not shared. The hot water temperature was measured in the restrooms at the appropriate degrees Fahrenheit as per the regulations between 105-120 degrees Fahrenheit. There are an adequate number of toilets per resident in the facility. Nightlights are installed as observed by LPA. All toilets and hand washing areas are maintained in safe and sanitary operating condition. Additional equipment, aids, and/or conveniences are available accommodate any physically handicapped residents who need such items. The LPA observed the resident bedrooms, which were furnished appropriately with clean linens, appropriate furnishings, and sufficient lighting. Designated resident rooms in the facility have bed/beds, nightstands, and lights and nightstand lamps to provide sufficient lighting. Each closet in all the resident rooms has extra pillows, clean/fresh linens, and appropriate incontinence materials if applicable for any resident. The resident bedrooms are big enough for all beds, furniture, and any resident assisting device a resident might need such as a wheelchair or a walker. Each room has sufficient lighting for each resident. The facility has provisioned to each resident of furniture, equipment and supplies necessary for personal care and maintenance of personal hygiene. An emergency exiting plan and emergency phone numbers posted in an appropriate place. A current disaster and mass casualty plan maintained at the facility. First-aid supplies, which include sterile first-aid dressings, bandages, adhesive tapes, scissors, tweezers, thermometer, antiseptic solution, and a current first-aid manual, are maintained. Administrator’s records, employees and resident records will be maintained at the facility and available for review by the LPA as employees are hired and residents accepted into the facility. The facility will comply with the organization’s standards for health screening, TB clearance, staff training, criminal background clearance and transfer requests. Admission agreements and needs and services (ANS) plan will be maintained for each resident and/or their authorized representative. A Component III Orientation was completed by LPA during this Pre-Licensing Inspection visit to the facility above on 10/09/2024. This report will be sent to the Centralized Application Bureau (CAB). You will be notified by the CAB Analyst when License has been approved. You are not allowed to begin operating until you have been notified that your license has been approved by the CAB Analyst. Failure to comply could affect approval of your license. Exit interview conducted. Copy of this report provided.the state’s words, verbatim · CDSS document, Oct 9, 2024

Type of visit: Office

Facility Type: RCFE Application Type: Initial Capacity: 6 Census (if any clients in care): 0 COMP II Participants: Rosa Castro - Applicant/Administrator Interview Method: Telephone interview On 05/09/2024, applicant/administrator participated in COMP II. Identification of the applicant and administrator was verified through interview questions based on photo ID and other identifying personal information. During COMP II, applicant and administrator confirmed that they have read and understand community care facility licensing laws included in the Health and Safety Codes and the California Code of Regulations Title 22. Signed LIC 809 with copy of photo ID have been obtained. During COMP II, CAB analyst confirmed Applicant/Administrator’s understanding of following areas: 1. Facility operation: License type, client/resident populations, and program 2. Admission Policies 3. Staffing requirements & Training 4. Restrictive/Prohibited Health Conditions 5. General provisions 6. Emergency Preparedness 7. Complaints & Reporting 8. Pre-licensing readinessthe state’s words, verbatim · CDSS document, May 9, 2024