Locust Guest Home

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Alviso conducted a Required - 1 Year visit, on 07/14/26 at approximately 11:00am, and met with Bernadette Fabricante, Administrator. LPA observed three (3) caregivers on duty, Wima, Ronald, and Ilanah. Facility has a fire clearance approval for six (6) non-ambulatory. Facility has an approved dementia plan of operation. There is an approved hospice waiver for three (3) only. Facility has a required infection control plan. Facility has an emergency and disaster plan as required. LPA reviewed five (5) resident files. Medication records were reviewed, and medication was observed to be centrally stored. LPA reviewed four (4) staff files. Staff reviewed all had current and required first aid certification and CPR certification. All staff had required criminal record clearance. LPA reviewed staff annual training, and medication training for those staff that assist residents' with medications. LPA provided a technical violation 9102, to the Administrator Bernadette Fabricante, see the following: 87463(h)(1) Reappraisals- The licensee shall request that all residents receive an annual routine visit with a licensed medical professional once every twelve months, either in person or by video appointment. Documentation of the annual routine visit, such as a visit summary, shall be added to the resident's record. LPA discussed the above regulation requirements with the Administrator Bernadette Fabricante during the annual inspection, 7/14/2026. Administrator Bernadette stated their understanding to the LPA of the above regulation. Continued on LIC809C.. The LPA toured the home with the Administrator Bernadette. The exits were all free and clear of obstructions. All medications were locked up and inaccessible to residents in care. All cleaners/disinfectants were locked up and inaccessible to residents in care. The facility had a sufficient supply of food. Sufficient supply of hygiene products, linens, soaps/cleaners/disinfectants, furnishings, paper products, and personal protective equipment (PPE). All bathrooms had non-slip mats/non-slip flooring for resident use. All bathrooms had grab bars for residents use. All common areas, resident rooms, hallways, and bathrooms had sufficient lighting for resident's use. The home was at a comfortable temperature. The home was observed to be clean and orderly. The backyard was observed to have all walkways and ramp clear as required, and the fire exit gate opened free and clear as required. The front of the home has a private fenced large gated patio area. Hot water was measured at 108.4 degrees Fahrenheit, which is within regulation. LPA discussed the hot water is not to be over 120. degrees, and not to be under 105. degrees Fahrenheit. LPA is requesting the following documents be updated and submitted by 8/14/26: LIC308 - Designation of Administrator Responsibility LIC500 - Personnel Report LIC610 (9 page)- Emergency Disaster Plan- update as needed- submit a copy Copy of Current Liability Insurance Copy of Infection Control Plan- update as needed- submit a copy LIC400- Affidavit of Client Cash Resources (all facilities must fill this out) Copy of Bond if handling cash, per LIC400 Resident Roster No deficiencies cited during today's inspection. Exit interview was held with Administrator Bernadettethe state’s words, verbatim · CDSS document, Jul 14, 2026

Type of visit: Required - 1 Year

On 06/06/2025 at approximately 09:35AM, Licensing Program Analyst (LPA) Ali Deniz arrived unannounced to conduct 1-Year Required visit of this licensed Residential Care Facility for The Elderly (RCFE). LPA was greeted by administrator Bernadette Fabricante. Facility has an approved fire clearance and capacity for 6 non-ambulatory residents. The facility currently approved for capacity of 6 residents. Facility has an approved hospice waiver for 3 individuals. Upon arrival, LPA was informed that there were 4 residents in care and 2 staff members on-site. Facility is a 1 story building with 5 Resident bedrooms, 2 bathrooms, and common spaces. At approximately 10:20AM, LPA and Licensee toured the building and grounds which was found to be clean and in good repair. LPA observed all walkways and exits to be unobstructed. All notices that are required to be posted have been posted and are in a highly visible area. LPA observed activity supplies for resident use. The amount of fresh and nonperishable foods is within regulation. Facility kitchen, refrigerators and freezers were clean, and food was stored properly. Staff were in the process of preparing breakfast in the kitchen at the time of this inspection. Water temperature measured 107.6 degrees F and 113.2 F which is within regulation between 105- and 120-degrees F at faucets accessible to residents. Bathrooms have required non-skid surfaces and grab bars. Cleaning products and knives are stored in a locked cabinets in the kitchen. There is adequate space and furniture on the patio for outdoor activities. Fireplace is observed with a screen. Continued on LIC809-C… Continued from LIC809… Fire extinguishers inspected and charged on 06/21/2024. Carbon Monoxide and smoke detectors were present and in order. There was enough lighting in all common areas, resident rooms, and hallways. Medication is centrally stored and secure in a cabinet in the dining room. At approximately 10: 50AM, LPA reviewed 3 resident records and found 3 of 3 residents have current care plans, signed admission agreements, and physician's orders report on file. Medication records are thorough and contained physician's orders for each resident. At approximately 11:05PM, LPA reviewed 3 staff records. 3 of 3 records did contain documentation of completed training records as required. Evidence of current first aid and CPR training were current. LPA was presented with proof of current CPR & 1st Aid certification for all staff. Administrator Certificate is for Bernadette Fabricante #7002274740 expires 09/26/2025. LPA reviewed the facility emergency disaster plan. The plan outlines evacuation routes, which are shown on facility sketch and has alternative meeting locations. Facility has supplies enough to operate for more than 72 hours in an emergency. Facility conducted and documented a disaster drill on 05/27/2025. Updated copies of the following documents were requested for facility file and are to be submitted to CCL by due date of 06/16/2025: LIC 308 Designated LIC 500 Personnel Summary LIC 610 Emergency Disaster Plan Copy/Proof of Updated Certificate of Liability Insurance No deficiencies were observed in the areas inspected, No citations were issued during today’s visit. Exit interview conducted. Copy of report provided to Licensee. Signature on form confirms receipt of documents.the state’s words, verbatim · CDSS document, Jun 6, 2025

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA), Araceli Canela arrived at Locus Guest Home unannounced for the purpose of conducting a Required-1 year inspection. LPA met with care staff Ron and Wilma Gulapa. Administrator, Julius Ramirez was not available but co-administrator, Bernadette Fabricante arrived a few minutes later. This facility is licensed for 6 non-ambulatory residents, with approval for 3 Hospice and no bed ridden. LPA toured the home and found the home to be at a comfortable temperature with all exits free from obstruction. The home was found clean and organized. There are a total of five bedrooms in the home and all bedrooms are approved to be used by residents. There is no room available for staff and facility understands and has awake staff. Smoke detectors and carbon monoxide detectors are operational. The fire extinguisher located in the laundry room was observed charged and serviced June 2023. There are auditory alerts on exit doors which were tested and functional. Water temperature in the resident bathrooms were tested and found to be within appropriate range of 105-120 degrees. Bathrooms have required non-skid surfaces and grab bars. Cleaning products and knives are stored in a locked cabinets in the kitchen. There is adequate space and furniture on the patio for outdoor activities. Fire place is observed with a screen. There was a 7 day supply of non-perishable foods. There are adequate dishes, glasses and silverware. There is a locked cabinet that stores residents' medications. Resident and staff files are located and locked in the Credenza. LPA reviewed staff have the required proof of CPR/1st aid that expires 4/12/2025. Resident files were reviewed. Continue report see LIC809-C Administrator and LPA discussed their Emergency Disaster Plan and Infection Control Plan. Licensee/Administrator to submit the current following documents by 7/17/2024: · 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- is current to 5/2025 and a copy was provided during visit. No citations issued during todays inspection.the state’s words, verbatim · CDSS document, Jun 19, 2024