Casa De Luz

Type of visit: Required - 1 Year

On 06/15/2026, Licensing Program Analysts (LPAs) Arielle Pascua and Sulma Lopez arrived unannounced at the facility at 9:51am. LPAs met with Staff 1, Terry Salcido and explained the purpose of the visit and requested Staff 1 to notify Facility Designated Administrator (FDA) of their arrival. Shortly after, FDA Jaime Rolando Andrade arrived at the facility. The purpose of the visit was to conduct the annual visit. Current census was 5. A brief interview with FDA Andrade was conducted. The facility serves up to 6 residents 60 and older. There are no dementia plan or hospice waivers on file. LPAs Pascua and Lopez reviewed 7 staff files and 5 resident files. All files were complete and up to date. FDA Andrade has an active administrator certificate #607797740 and expires on 08/07/2027. LPA Pascua reviewed an eviction notice at the time of the visit and deemed that the eviction notice was legal at this time. LPAs Pascua and Lopez reviewed medication administration records. It was discovered that 1 out of 5 Resident's MAR indicated that one of their medications were administered and not signed off by care staff. First aid kit was present and contained all the required components. LPAs spoke with FDA Andrade regarding best practices to ensure the MARs have been signed upon administration. A tour of the facility was conducted. LPAs reviewed the kitchen and observed sufficient amount of food in the facility. LPAs reviewed resident rooms and restrooms. Furnishings and grab bars were in good repair. Water temperature was adequate at 110 degrees in both restrooms. The fire extinguisher was serviced 06/10/26 by Jorgenson Co. LPAs observed the carbon monoxide and smoke detectors was working properly. LPAs conducted a tour of the backyard and observed no concerns. Fence and gates were in good repair. LPAs observed the linen storage and it contained adequate supply of extra bedsheets and towels. A tour of the garage was conducted. LPAs identified 2 large refrigerators which stored additional supply. LPAs also identified washer and dryer. Cleaning supplies were observed to be locked and inaccessible. The following documents were requested for review by this LPA: -LIC308, LIC400, LIC500, LIC610E A technical violation is being issued today for Section 87465(c)(3). Per California Code of Regulations (CCR) - Title 22, Division 6, Chapter 8, no deficiencies were observed. An exit interview was held, and a copy of the report was provided in-person.the state’s words, verbatim · CDSS document, Jun 15, 2026

Type of visit: Required - 1 Year

On 06/12/2025, Licensing Program Analyst (LPA) Arielle Pascua arrived unannounced to this facility to conduct an annual visit. LPA met with saff member(SM), Terri Salcido and explained the purpose of the visit. LPA asked that SM Salcido call the Facility Designated Administrator (FDA), Johanna West that CCL was present at this time. It was learned that FDA was no longer with the company. Shortly after, LPA met with the new Facility Designated Administrator, Jamie Rolando Andrade and explained the purpose of the visit. This facility is licensed to serve up to 6 elderly residents. Current census was 4. Upon arrival LPA Pascua observed 1 resident sitting outside and 3 other playing a card game at the dining table. Shortly after, all residents went out on a walk with facility staff. LPA reviewed 4 resident files. LPA reviewed 4 staff files. LPA reviewed 4 staff files The FDA does not have an active administrator certificate on file at this time. However, LPA had advised for the following documentation to update the administrator: -A letter from the licensee appointing the individual as the Administrator. -LIC 308 -Copy of the current Administrator certificate -Documentation verifying that the individual meets education/experience -LIC 200 signed by the licensee -LIC 500 -LIC 501 A tour was initiated. Fire extinguisher was serviced by Jorgenson Co and is valid until 06/09/2026. Smoke alarms and carbon monoxide were in good repair. It was observed that the facility has recently gone through major renovations, such as the facility bathrooms, resident bedrooms and back yard. It was observed that all resident bedrooms have been furnished with new bedroom furniture that meets the residents needs at this time. Kitchen area was toured. It was observed that there was a 2 day perishable and 7 day nonperishable food supply. Toxins and knives were made inaccessible at this time. Hot water was taken to ensure that it within the require regulatory standards between 105-120 degrees. Grab bars were present and in good repair. All living areas, dining areas, and other areas intended for resident use were toured and met the residents needs at this time. The garage area was toured, washer and dryer were identified. Laundry detergent, bleach, and all other cleaning supplies were observed to be locked and made inaccessible to the residents at this time. Additional food supply was also observed. A tour of the exterior physical plant was conducted. Perimeter fence, side gates, and exits was inspected and in good repair. It was observed that the facility was currently obtaining a new awning at this time. Medications were reviewed. First aid kit was reviewed and held all the required components. The following forms and documents were requested to be updated and submitted into CCL: -LIC 308 -LIC 400 -LIC 500 -LIC 610 -Liability insurance Per California Code of Regulations (CCR) - Title 22, Division 6, Chapter 8, no deficiencies were observed. An exit interview was held, and a copy of the report was provided.the state’s words, verbatim · CDSS document, Jun 12, 2025

Type of visit: Required - 1 Year

On 06/27/2024, Licensing Program Analyst (LPA) Arielle Pascua arrived unannounced to this facility to conduct an annual visit. LPA met with saff member(SM), Terri Salcido and explained the purpose of the visit. LPA asked that SM Salcido call the Facility Designated Administrator (FDA), Johanna West that CCL was present at this time. Shortly after, LPA met with FDA West and explained the purpose of the visit. This facility is licensed to serve up to 6 elderly residents. This facility does not currently have a dementia plan on file and does not have a hospice waiver. LPA reviewed 5 resident files. 3 out 5 resident files did not have an updated and current medical assessment. LPA reviewed 4 staff files. 3 out 4 staff did not have a current First Aid/CPR certificate on file. The FDA has a current administrator certificate #7025100740 and expires on 08/11/02025. A tour was initiated with FDA West. Fire extinguisher was serviced by Jorgenson Co and is valid until 06/12/2024. Smoke alarms and carbon monoxide were in good repair. A tour of the kitchen was conducted. LPA observed a sufficient amount of 7 day non-perishable food supply as well as 2 day perishable food supply in the main kitchen. Knives were observed to be locked and made inaccessible to the residents. Additional perishable food supply was identified in the garage. LPA observed a locked centralized stored medication cabinet. Along with FDR Andrade, LPA reviewed and compared medication with medication dispensing logs. LPA observed a locked cleaning supply cabinet. First aid kit was present and contained all the required components. Living room area, dining room, and all other areas intended for resident use were toured. Furniture and furnishings were observed to be in good repair and sufficient to meet resident needs at this time. A tour of 3 resident bedrooms were conducted. Resident furniture was observed to be sufficient to meet their needs at this time. A tour of the resident bathrooms were conducted. Hot water temperature was within the required range of 105-120 degrees. Grab bars were present. Laundry area was toured. Laundry detergent, bleach, and all other cleaning supplies were observed to be locked and made inaccessible to the residents at this time. A tour of the exterior physical plant was conducted. Perimeter fence, side gates, and exits was inspected. The following forms and documents were requested to be updated and submitted into CCL: -LIC 308 -LIC 400 -LIC 500 -LIC 610 -Liability insurance The following deficiencies were observed and cited on the following LIC 809-D pursuant to Title 22 Rules and Regulations, Health and Safety Code. Exit Interview was conducted, a copy of this report and appeals rights were provided to the Facility at the end of this visit.the state’s words, verbatim · CDSS document, Jun 27, 2024