Redwood Community

Type of visit: Required - 1 Year

At approximately 8:40 AM, Licensing Program Analyst (LPA) Robert Frank arrived unannounced to conduct a Required 1 Year visit. Administrator Antonio Martinez arrived at 9:00 AM. Redwood Community 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, two (2) of whom may be bedridden. The facility has a Hospice Waiver for two (2) residents. 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. At approximately 9:10 AM, LPA toured the facility with Administrator Martinez. All exits were clear and unobstructed. The facility's two (2) fire extinguishers were last serviced and tagged on 8/4/2025. Fire Department inspected and cleared the facility on 2/12/2026. The facility was 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. 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. Per regulations the facility should be conducting fire and emergency drills quarterly. The facility has not conducted any fire and emergency drills in 2026. This deficiency will be cited. 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 observed to be operational. Continued on 809-C... ...Continued from 809 At approximately 9:45 AM, LPA reviewed four (4) resident files. Two (2) of four (4) resident files (for residents R1 & R3) were observed not to have current LIC 625 Appraisal/Needs and Services Plans. Two (2) of four (4) resident files (for residents R2 & R4) were observed not to have signed LIC 613C Personal Rights documents. These deficiencies will be cited. LPA reviewed five (5) staff files. Five (5) of five (5) staff files were observed with all required documentation including First Aid and CPR certification and proper training documentation. LPA audited Medication for two (2) residents. LPA observed all medications to be centrally stored, secure and with proper documentation. Antonio Martinez’s Administrator Certification 7020404740 is current with an expiration date of 11/17/2026. LPA requested the following documents be submitted to Community Care Licensing by 7/1/2026: LIC 500 Personnel Report LIC 610E Emergency Disaster Plan Updated Liability Insurance Policy 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, 811 Confidential Names and Appeal Rights discussed and provided to Administrator Martinez. Signature on form confirms receipt of documents.the state’s words, verbatim · CDSS document, Jun 5, 2026

The state marks this report as 6 pages; the online copy we transcribed has 5. You can request the full file from the county licensing office.

Type of visit: Required - 1 Year

At approximately 8:55 AM, Licensing Program Analyst (LPA) Robert Frank arrived unannounced to conduct a Required 1 Year visit and was greeted by Caregiver (CG) Karla Sanchez. Administrator Antonio Martinez arrived at 9:15 AM. Redwood Community 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 two (2) residents. Upon arrival, LPA was informed that there were four (4) residents in care and one (1) staff members on-site. At approximately 9:20 AM, 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 9:25 AM, LPA toured the facility with Administrator Martinez. All exits were clear and unobstructed. The facility's two (2) fire extinguishers were last serviced and tagged on 8/23/2024. Fire Department inspected and cleared the facility on 1/23/2025. The facility was sufficiently lighted. LPA inspected four (4) 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 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 At approximately 10:00 AM, LPA reviewed four (4) resident files. Four (4) of four (4) resident files were found to be well organized and thorough with all required documentation. LPA reviewed three (3) staff files. Two (2) staff members, S1 and S3 did not initial training documents in their files. This deficiency will be cited. One (1) staff member, S2 did not have a LIC 503 Medical Assessment. This deficiency will be cited. All other required documentation was present. LPA spot checked Medication for two (2) residents. 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. Antonio Martinez’s Administrator Certification 7020404740 is current with an expiration date of 11/17/2026. LPA requested the following documents be submitted to Community Care Licensing by 6/9/2025: LIC 500 Personnel Report LIC 308 Designation of Responsibility LIC 610E Emergency Disaster Plan 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, 811 Confidential Names and Appeal Rights discussed and provided to Administrator Martinez. Signature on form confirms receipt of documents.the state’s words, verbatim · CDSS document, May 9, 2025

The state marks this report as 7 pages; the online copy we transcribed has 5. You can request the full file from the county licensing office.

Type of visit: Prelicensing

Licensing Program Analyst (LPA) Cuadra arrived announced to conduct a Pre-licensing Subsequent Facility Inspection and met with Applicant Antonio Martinez. A pre-licensing inspection was completed on 05/31/2024. During today’s visit LPA observed the following items: * Bedroom #1 has required furniture: bed, chair, lamp, and dresser. * Bathroom #1 vent is rewired and/or replaced. * Bedroom #2: Patchwork by the faceplate is painted. * Bedroom #3 and #4 auditory signal alarms are installed on the door to alert staff. * Bedroom #4 has regular bed in room. * Bedroom #5 and #6 metal plate for closet door handle was installed. * Half Bath cover installed in the ceiling. * All bathrooms skid mats were placed in shower. * Deck area debris was removed. * Side gate bottom latch was removed. * Water heater adjusted (110.7, 109.9 and 109.2), it is delivering required temperature of 105 to 120 F degrees as stated per regulation. Applicant has satisfied all requirements in accordance with Title 22, California Code of Regulation. LPA will notify Application Unit Pre-licensing inspection is complete to proceed with the process of license. Pre-Licensing items needed to be repaired have been resolved. Pre-Licensing is now complete. No deficiencies cited at today’s inspection. Exit interview conducted with Applicant and a copy of this report was given.the state’s words, verbatim · CDSS document, Jun 6, 2024

Type of visit: Prelicensing

Licensing Program Analysts (LPA) Cuadra and Jacky Macias arrived announced to conduct a pre-licensing inspection and was greeted by Applicant, Antonio Martinez Jr. Facility currently does not have residents in care. Once obtained, applicant will submit proof of required liability insurance. The facility consists of a single story residence with a total of 6 bedrooms, 1 half bath, 2 full bathrooms, administration office, laundry room located in the garage, kitchen, dining room, and living room as common areas. Hospice waiver for two residents. The facility received a fire clearance approval on 3/7/2024 by the County of Sonoma Fire and Emergency Services Department for six [6] non-ambulatory residents in rooms 1-6, which two may be bedridden in rooms #3 and #4. LPAs advised applicant to submit a revised STD850 Fire Clearance request form due to some clarification needed regarding bedroom clearance for two bedridden residents. LPAs have notified analyst in the application unit and applicant as well. Applicant contacted the Fire Department to revise current fire clearance. Administrator certificate for applicant Antonio Martinez #6053650740 expires on 11/17/2024. At approximately 9:30am LPAs/Applicant toured the building and grounds. The facility was found to be at a comfortable temperature. LPAs observed emergency supply of non-perishable food and water. All resident rooms #2-6 are furnished per regulation with a bed, lamp, and bedside table, except bedroom #1 that has required furniture not set up yet. Garage houses storage, laundry, and emergency supply of water. Cleaning supplies will be stored in a secured cabinet located in the garage. Administration office has locked cabinet that will be used for medication and file storage. Side deck connecting to Bedroom #3 has access through the fence line to the neighbors house. Water temperatures read at: 127.7, 128.4 and 132.0 degrees F which needs to be adjusted to 105-120 F degrees as stated per regulation. Continued on LIC809C... Continued from LIC809... Items in kitchen that need to be addressed are: * kitchen cabinet locks to be installed for knives to be inaccessible to residents in care. Items required to be repaired/addressed before licensure: * Bedroom #1 needs the bed, chair, lamp, and dresser. * Bathroom #1 needs vent rewiring and/or replacement. * Bedroom #2: Patchwork by the faceplate needs to be painted. * Bedroom #3 and #4 need auditory signal alarms to be installed on the door. * Bedroom #4 needs a regular bed instead of half rail bed currently in room. * Bedroom #5 and #6 need the metal plate for closet door handle. * Half Bath needs the cover in the ceiling. * All bathrooms skid mats available need to be placed in shower. * Deck area has debris that needs to be removed. * Side gate needs bottom latch to be removed. * Water heater needs to be adjusted to deliver required temperature of 105 to 120 F degrees as stated per regulation. Smoke and carbon monoxide detectors present and functioning. Two [2] fire extinguishers present and last serviced on 08/18/2023. First aid kit present with all required items. LPAs observed all required postings including the CCL Complaint Poster, Long Term Care Ombudsman Poster, Resident's Rights, and the rights to Resident and Family Councils. Night lights in hallway present. Activity calendar and sample of menu submitted to the Centralized Application Unit (CAB). Applicant agreed to notify Community Care Licensing once all repairs and personal accommodations are completed. LPAs will conduct a subsequent visit to confirm required repairs had been completed. LPA will notify CAB analyst. LPAs/Applicant reviewed and completed Component III orientation. Exit interview conducted with Applicant and a copy of this report given.the state’s words, verbatim · CDSS document, May 31, 2024

Type of visit: Office

Facility Type: RCFE Application Type: Initial Capacity: 6 Census (if any clients in care): 0 COMP II Participants: Martinez, Antonio Jr - Applicant/Administrator Interview Method: Virtual interview (Skype, Go To Meeting, etc) On 04/25/2024, 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, Apr 25, 2024