Casa Isabella II

We haven’t transcribed this report yet. The complete document is on the state’s site.

Type of visit: Required - 1 Year

At approximately 12:45 PM, Licensing Program Analyst (LPA) Robert Frank arrived unannounced to conduct a Required 1 Year visit and was greeted by Caregiver (CG) Sombito. Administrator Art Villegas arrived at 1:15 PM. Casa Isabella II is Licensed as a Residential Care Facility for the Elderly (RCFE). The facility is a single story ranch house. The facility has an approved fire clearance for six (6) non-ambulatory residents. The facility has a Hospice Waiver for three (3) residents. Upon arrival, LPA was informed that there were four (4) residents in care and two (2) staff members on-site. LPA reviewed the Facility's Staff Roster and found that all staff on-site were background cleared and associated to the facility per regulation. At approximately 1:05 PM, LPA toured the facility. All exits were clear and unobstructed. The facilities one (1) fire extinguisher was last serviced and tagged in 12/2024. LPA observed that there were no functioning lights in the bathroom attached to the semi-private room at the rear of the facility. This deficiency will be cited. The remainder of the facility was observed to be sufficiently lighted. LPA inspected five (5) 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. LPA observed an unsecured bottle of "Gorilla Glue" in the bathroom attached to the semi-private room at the rear of the facility. This deficiency will be cited. All other 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 does have emergency food and supplies to meet the "72 hour shelter in place" requirements. Hot water temperatures for a sample of sinks in facility were observed to exceed the Title 22 regulations of 105 to 120 degrees Fahrenheit. Sample of sinks tested were at 142.7, 126 and 140.1 degrees Fahrenheit. This deficiency will be cited. Facility smoke detectors and carbon monoxide detectors were tested and observed to be operational. Continued on 809-C... ...Continued from 809 Administrator Villegas stated the facility is conducting fire and emergency drills monthly. However, LPA observed that the required Emergency Disaster Drill log was not at the facility; however LPA was able to view a picture of the Disaster Drill Log. A Technical Violation will be issued for this deficiency. At approximately 1:55 PM, LPA reviewed two (2) resident files. One (1) of two (2) resident files for Resident 1 (R1) were observed to not have a current LIC 625 Appraisal/Needs and Service Plan. LPA further observed that R1 did not have an LIC 603 Pre-Admission Appraisal form. These deficiencies will be cited. All other required documentation was observed to be present in the resident's files. LPA reviewed two (2) staff files. All staff files were observed with all required documentation including First Aid and CPR certification and proper training documentation. During the facility inspection LPA observed unsecured medications in a night stand in the walk in closet located off the bathroom attached to the semi-private room at the rear of the facility. This deficiency will be cited. LPA spot checked Medication for two (2) residents. With the exception of the unsecured medications previously mentioned, LPA observed all medications to be centrally stored, secure and with proper documentation. The facility does not handle resident’s monies for personal and incidental items. Art Villegas’s Administrator Certification 7019452740 is current with an expiration date of 6/9/2027. LPA requested the following documents be submitted to Community Care Licensing by 11/2/2025: LIC 500 Personnel Report LIC 610E Emergency Disaster Plan Proof of Liability Insurance Deficiencies are cited from the California Code of Regulations (CCRs), and/or the Health and Safety Code. Failure to correct the cited deficiency, on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment. Exit interview conducted. Copy of report, LIC-809Ds, Plan of Corrections, LIC 9102, 811 Confidential Names and Appeal Rights discussed and provided to Administrator. Signature on form confirms receipt of documents.the state’s words, verbatim · CDSS document, Oct 2, 2025

The state marks this report as 9 pages; the online copy we transcribed has 7. You can request the full file from the county licensing office.

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Canela arrived unannounced, to conduct an Annual Required 1 YR inspection and was greeted by two care staff. Licensee/Administrator, Art Villegas arrived a few minutes later. This home is licensed for up to 6 non-ambulatory residents with a Hospice waiver approved for 3 of the residents. LPA toured facility and grounds and observed all required signs posted in common areas. Facility was found to be at a comfortable temperature with all exits free from obstruction. Facility has at least two days supply of perishable and one week of non-perishable foods that are stored properly. All exit doors have working auditory devices to alert staff. Smoke detectors and carbon monoxide detectors were operational. Fire drills are conducted every three months and the last drill was documented on 12/5/2024 . Fire Extinguisher was fully charged. Water temperature in the resident bathroom was tested and found to be at 109 degrees and within appropriate range of 105-120 degrees. The bedrooms are all furnished as required. Bathrooms were clean and sanitary with non-skid mats/floors and grab bars. Resident and staff files are located and locked in office. LPA reviewed all resident files and were found to be complete and organized with current medical assessments and appraisal. Staff files were reviewed and found complete with proper fingerprint clearances, health screenings, proof of required annual training and CPR/1st Aid certificates expiring 12/2026. Administrator certificate for Art Villegas #6052479740 expires, June 9, 2025. Continue report See LIC809-C Licensee/Administrator to submit all the below documents to LPA by 1/20/2025 · LIC 308 Designation of Facility Responsibility · LIC 500 Personnel Report- · LIC 610E Emergency Disaster Plan · LIC 9020 Register of Facility Residents Infection Control Plan of Operation (If changes) Copy of Liability Insurance- Copy of Administrator Certificate No citations issued during todays inspection.the state’s words, verbatim · CDSS document, Dec 19, 2024

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Canela arrived unannounced, to conduct an Annual Required 1 YR inspection and was greeted by care staff, and Licensee/Administrator, Art Villegas. LPA toured facility and grounds and observed all required signs posted in common areas. Infection control practices are present. Facility has a 30-day supply of PPE. Facility has also submitted their Infection Control plan, which is a part of their Plan of Operation. Facility was found to be at a comfortable temperature with all exits free from obstruction. Facility has at least two days supply of perishable and one week of non-perishable foods, LPA reminded facility to use proper freezer bags to store items that are not in the original container. Fire Extinguishers were fully charged, and have proof of service on 12/14/2023. Smoke detectors and carbon monoxide detectors were operational. Fire drills are conducted every three months.. Water temperature in the resident bathroom was tested and found to be within appropriate range of 105-120 degrees. Exit doors have auditory alarms to alert staff. The bedrooms are all furnished as required. Bathrooms were clean and sanitary with non-skid mats/floors and grab bars. Resident and staff files are located and locked in office. LPA reviewed resident files and staff files. Staff have proof of required annual training and CPR/1st Aid certificates expiring 12/2024. Continue report See LIC809-C LPA discussed Emergency Disaster Plan and Infection Control Plan. LPA went over Community Care Licensing links that LPA will email to facility to view informational PINS, Guardian and quarterly updates. During todays visit, LPA requested facility to review and get clarification on resident R1 ambulatory status and update LPA by 12/21/2023. LPA also provided guidance and forms needed to be submitted to Community Care Licensing for any changes in the facility ambulatory/non-ambulatory/bedridden room use. Licensee/Administrator to submit all the below documents to LPA by 1/20/2024 and LPA will review and update file. · 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) Copy of Liability Insurance- Copy of Administrator Certificate No citations issued during todays inspection.the state’s words, verbatim · CDSS document, Dec 15, 2023