Rillera's Guest Home

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) David Marrufo conducted an unannounced Required - 1 Year visit and met with Clarence Rillera. During visit, LPA toured the facility inside and out. LPA toured the kitchen and pantry areas. LPA observed there to be a perishable food supply of at least two days and a non-perishable food supply of at least seven days. LPA observed the first aid kit and found it to be complete. LPA observed there to be locked cabinets for sharp objects. LPA toured the laundry room and observed there to be locked cabinets for cleaning supplies. LPA toured two out of two resident bathrooms. Each bathroom had functioning lights and available soap and paper towels. The bathroom sink water temperatures measured at 108 F and 110 F. LPA toured three out of three bedrooms. Each bedroom had working lights and available bedding and clothing storage areas. During visit, the smoke detectors in the hallways and resident bedrooms were tested and functioned properly when tested. LPA toured the outside area and observed the outdoor exit to be clear of obstructions. LPA reviewed four out of four resident records and Centrally Stored Medication and Destruction Records and found them to be complete. LPA reviewed five staff records and found them to be complete. See LIC809-C page for more information. Page 1 of 2. LPA Marrufo requests that the following records be updated and copies sent to the department by 09/16/2026: LIC500 Personnel Report LIC308 Designation of Administrative Responsibility Liability Insurance LIC610E Emergency Disaster Plan No deficiencies were cited at this time as per California Code of Regulations Title 22. This report was reviewed with Clarence Rillera and a copy of this report was provided. Page 2 of 2.the state’s words, verbatim · CDSS document, Sep 9, 2026

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) David Marrufo conducted an unannounced Required - 1 Year visit and met with Clarence Rillera. During visit, LPA Marrufo toured the facility inside and out. LPA toured the kitchen area and and the pantry areas. LPA observed there to be a perishable food supply of at least two days and a non-perishable food supply of at least seven days. LPA observed the first aid kit and found it to be complete. LPA toured three out of three resident bedrooms. Each bedroom had working lights and available bedding and clothing storage areas. LPA toured two out of two resident bathrooms. Each bathroom had working lights and available soap and paper towels. The showers had anti-slip mats. The water temperatures in the bathroom sinks ranged from 114 F to 115 F. LPA tested the smoke and carbon monoxide detectors in the hallways and bedrooms and each detector functioned properly when tested. LPA toured the outside area of the facility and observed the outdoor exit to be clear of obstructions. LPA reviewed four out of four resident records, including Centrally Stored Medication and Destruction Records, and found them to be complete. LPA reviewed two staff records and found them to be complete. See LIC809-C page for more information. Page 1 of 2. LPA Marrufo requests that the licensee submit the following updated forms to Community Care Licensing by 09/12/2025: LIC610 Emergency Disaster Plan LIC500 Personnel Report Current copy of the General Liability Insurance Certificate. No deficiencies were cited at this time as per California Code of Regulations Title 22. This report was reviewed with Clarence Rillera and a copy of this report was provided. Page 2 of 2. END REPORTthe state’s words, verbatim · CDSS document, Sep 5, 2025

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) David Marrufo conducted an unannounced Required 1 Year visit and met with Ellis Pascual. During visit, LPA toured the facility inside and out. LPA toured the facility kitchen and food storage areas and observed a perishable food supply of at least two days and a non-perishable food supply of at least seven days. LPA observed the facility first aid kit and found it to be complete. LPA toured three out of three resident rooms. Each room had functioning lights and available bedding and clothing storage areas. The smoke detectors in each room and in the hallway were tested and found to function properly. LPA toured two out of two facility bathrooms. Each bathroom had working lights and available soap and paper towels. The water temperatures in both bathroom sinks were 112 F. LPA toured the outside area and found it to be clear of obstructions. LPA reviewed 4 resident records and Centrally Stored Medication and Destruction Records and found them to be complete. LPA reviewed 3 staff records and found them to be complete. No deficiencies were cited at this time as per California Code of Regulations Title 22. This report was reviewed with Ellis Pascual and a copy of this report was provided.the state’s words, verbatim · CDSS document, Sep 13, 2024

Type of visit: Case Management - Other

Licensing Program Analyst (LPA) David Marrufo conducted an unannounced Case Management visit and met with Clarence Rillera. The purpose of the visit was to conduct a health and wellness check with resident R1, who was transferred to the facility on 04/30/2024 when R1's previous facility ceased operation. During visit, LPA Marrufo observed and interviewed R1. LPA Marrufo observed R1's bedroom and observed R1's personal belongings in the bedroom. LPA Marrufo observed R1's medications and reviewed R1's resident records. No deficiencies were cited at this time as per California Code of Regulations Title 22. This report was reviewed with Clarence Rillera and a copy of this report was provided.the state’s words, verbatim · CDSS document, May 10, 2024