Nena & Ray's Guest Home Inc. #1

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Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Contreras arrived unannounced to conduct a required annual inspection and was greeted by administrator (Admin) Aileen Bryant. Facility is an Adult Residential Care Facility for the Elderly with an approved fire clearance for capacity of 6 (six) residents. There are currently (4) four residents in care. LPA toured the building and grounds which was found to be clean and at a comfortable temperature. LPA observed all walkways and exits to be unobstructed. All required postings were in a highly visible area. Fire extinguishers were charged and last inspected 12/ 19/2025. Fire alarms detector are hard wired and inspected by the fire department. Carbon monoxide alarms all tested and operational. Outdoor furniture accessible for resident use. First water temperature check measured at 123 degrees not within regulation at faucets accessible to residents within the allowable range of 105 to 120 degrees F. Second faucet accessible to residents measured at 105 degrees F. LPA advised admin to lower water heater from first faucet and conducted a second water check. All faucets found to be within temperature. Facility has total of 3 water heaters. Resident bathroom observed to have bath mat and grab bar. Communal towels found in resident bathrooms, LPA advised hand towels to be removed from all restrooms (Technical A. given). Disaster drills are being conducted quarterly. All bedrooms were equipped with required furnishing. Facility had an ample supply of linens, towels and extra hygiene products for residents. LPA observed at least a 2 day supply of perishable and 7 day supply of non-perishable foods. Snacks accessible for residents. Emergency food was observed to meet the 72 hour emergency supply. Facility kitchen, refrigerators and freezers were clean, and food was stored properly with expiration dates noted. Toxins are locked and inaccessible to residents. Sharps and knives were locked in kitchen drawer. Phone accessible for resident use. Continued onto 809C.. continued from 809.... LPA conducted a file review for 4 of 4 residents. LPA conducted file review for 4 staff. All required documentation found to be up to date. LPA and Admin conducted a spot check of medication and medication records, all records up to date. Medication is centrally stored and locked. Facility handles cash for 4 residents. All P&I found to be safe and not commingled. Updated copies of the following documents were requested for facility file and are to be submitted to CCL within 30 days of this visit: LIC500- Personnel Report (Retrieved during visit) LIC308- Designation of Responsibility Liability Insurance (Retrieved during visit) Surety Bond (Retrieved during visit) No deficiencies cited for today's visit. Exit interview conducted and report read with Administratorthe state’s words, verbatim · CDSS document, Mar 26, 2026

Type of visit: Required - 1 Year

At approximately 9:00 AM, Licensing Program Analyst (LPA) Robert Frank arrived unannounced to conduct a Required 1 Year visit. House Manager (HM) Aileen Bryant arrived at 9:10 AM. Administrator Magdalena Casuga arrived at 9:20 AM Nena & Ray's Guest Home Inc. #1 is Licensed as a Residential Care Facility for the Elderly (RCFE). The facility is a single story ranch house that shares a common courtyard with Nena & Ray's Guest Home Inc. #2. The facility has an approved fire clearance for six (6) residents. Four (4) residents may be non-ambulatory. Upon arrival, LPA was informed that there were four (4) residents in care. LPA reviewed the Facility's Staff Roster and found that all staff on-site were background cleared and associated to the facility per regulation. LPA toured the facility with HM Bryant. All exits were clear and unobstructed. The facility's fire extinguishers were last serviced and tagged on 1/28/2025. Fire Department inspected and cleared the fire alarm system in 2/2025. The facility was sufficiently lighted. LPA inspected resident bedrooms and found all to have sufficient lighting and furnishings as required per Title 22 Regulations. There was a sufficient supply of both perishable and nonperishable foods as required by Title 22 Regulations. There was an appropriate supply of cleaning products, linens, hygiene products and paper products available for residents. Toxins were observed to be stored inaccessible to residents. Facility has an infection control plan as required. The facility has a required emergency disaster plan. The facility is conducting fire and emergency drills quarterly. The last disaster drill was conducted on 3/15/2025. The facility does have emergency food and supplies to meet the "72 hour shelter in place" requirements. Hot water temperatures for all sinks in facility were found to be within Title 22 regulations of 105 to 120 degrees Fahrenheit. Facility smoke detectors and carbon monoxide detectors were tested and observed to be operational. Continued on 809-C ...Continued from 809 LPA reviewed four (4) resident files. Four (4) of four (4) resident files were observed to be well organized and thorough with all required documentation. LPA reviewed four (4) staff files. All staff files were observed to be well organized with all required documentation including First Aid and CPR certification and proper training documentation. LPA spot checked Medication for residents. LPA observed all medications to be centrally stored, secure and with proper documentation. Residents' monies for personal and incidental (P&I) items were spot checked and observed to be secure and balanced to P&I logs. Magdalena Casuga’s Administrator Certification 7034412740 is current with an expiration date of 11/06/2025. LPA requested the following documents be submitted to Community Care Licensing by 5/17/2025: LIC 500 Personnel Report LIC 610E Emergency Disaster Plan Proof of Liability Insurance No deficiencies cited during today's visit. Exit interview conducted. Copy of report discussed and provided to HM Bryant. Signature on form confirms receipt of documents.the state’s words, verbatim · CDSS document, Apr 17, 2025

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Araceli Canela arrived unannounced to conduct a Required - 1 Year inspection and met with, Aileen Bryant (S1) Co-Administrator and Administrator/Licensee, Magdalena Casuga. This facility is licensed for a total of 6 in which 4 of the residents may be non ambulatory. Facility does not have approval for bedridden, or Hospice. There are currently 4 residents living in the home. LPA toured facility and grounds and observed facility is at a comfortable temperature, with all exits free from obstruction. Facility has more than two days of perishable and one week of non-perishable foods and items were found to be stored properly. Facility has emergency water available. Water temperature was logged at 109.2 and within the required range of 105-120 degrees F. Fire Extinguisher was found to be charged, and serviced 1/30/2024. Smoke alarms and Carbon monoxide detector are operational. Facility has ceiling fire sprinklers that are serviced yearly. Facility last fire drill was conducted on 3/9/24. LPA reviewed a resident and some staff files. Staff have the required training CPR/1st aid expires 3/23/26 for staff S1. Facility uses the centrally store log and the Medication Administration Record (MARs). Residents medication is separated in small closed boxes per resident and include an additional list of medication list attached to the top of the container as extra precaution. LPA toured the wrap around outdoor yard that is fenced. Facility has sensor motion Lights throughout the yard and in the facility hallways and/or night lights. Administrator certificate for Magdalena "Nena" Casuga #6004227740 expires 11/6/2025. Continue see LIC809-C The yard has plenty of space, shade for activities and/or visitors and a table with chairs. LPA discussed the Emergency Disaster Plan and Infection Control Plan. Licensee/Administrator to submit the current following documents by 5/19/2024: · LIC 308 Designation of Facility Responsibility · LIC 500 Personnel Report · LIC 400 Affidavit Regarding Client/Resident Cash Resources · LIC 610E Emergency Disaster Plan · LIC 9020 Register of Facility Residents Infection Control Plan of Operation (If changes) Liability Insurance No citations issued during todays inspection.the state’s words, verbatim · CDSS document, Apr 19, 2024