Sunvalley Residential Care Home

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

Type of visit: Required - 1 Year

On 11/20/2025 at 10:50 AM, Licensing Program Analyst (LPA) L. Alexander arrived unannounced to conduct 1-Year Annual Required inspection. LPA met with Caregiver, Marjoy Bacuyag and explained the purpose of the visit. Marjoy Bacuyag phoned the administrator, Keith Mauer to inform. The facility’s fire clearance was approved for six (6) residents in which all may be non-ambulatory. Hospice waiver approved for two (2) residents. Administrator certificate #7027929740 expires 08/08/2026. Keith arrived approximately 30 mins later. LPA toured facility including but not limited to bedrooms, bathrooms, kitchen, common area and backyard. The facility consists of six (6) total bedrooms that are occupied by the residents. All outdoor and indoor passageways are kept free of obstruction. There are no bodies of water observed. A comfortable temperature is maintained at 73 degrees Fahrenheit. LPA observed lighting in all rooms are adequate for the comfort and safety of the residents. The hot water temperature in the residents’ shared bathroom was measured at 105 degrees Fahrenheit. Residents’ bathrooms are equipped with grab bars and non-skid mats. There is a minimum of one week supply of nonperishable and 2-day of perishable foods. Centrally stored medication and sharps were locked and inaccessible to residents. LIC809-C LIC809-C (Page 2) Smoke and carbon monoxide detectors were in operating condition during visit. Fire extinguisher was last serviced on 07/22/2025. Emergency Disaster Plan was last posted on 11/20/2025. First aid kit was observed to be complete. Emergency disaster drill was last conducted on 11/12/2025. LPA reviewed four (4) residents records. LPA reviewed five (5) staff records and all staff have current first aid training and associated to the facility. LPA reviewed all four (4) resident’s medications. Updated copies of the following documents were requested for facility file and are to be submitted to CCL by 11/27/2025: LIC 308 Designation of Administrative Responsibility - Reviewed LIC 309 Administrative Organization - Reviewed LIC 500 Personnel Report - Reviewed LIC 610E Emergency Disaster Plan - Reviewed Liability Insurance - Reviewed Current Administrator’s Certificate - Reviewed The following deficiencies were observed (see LIC 809D) and cited from the California Code of Regulations, Title 22 and/or Health and Safety Code Failure to correct deficiencies by POC date may result in additional Civil Penalties. Exit interview conducted. Appeal Rights and a copy of this report provided.the state’s words, verbatim · CDSS document, Nov 20, 2025

The state marks this report as 5 pages; the online copy we transcribed has 4. You can request the full file from the county licensing office.

Type of visit: Required - 1 Year

On 11/14/2024 at 3:15 PM, Licensing Program Analyst (LPA) L. Alexander arrived unannounced to conduct 1-Year Annual Required inspection. LPA met with Caregiver, Marjoy Bacuyag and explained the purpose of the visit. Marjoy called Administrator, Keith Mauer, to inform. The administrator arrived 15 mins later. The facility’s fire clearance was approved for capacity of six (6) in which all may be non-ambulatory. Hospice waiver approved for two (2) residents. Administrator Certificate #606274274 expired 08/09/2024. Administrator submit certificate renewal and provided check dated 11/07/2024. LPA toured facility with Keith including but not limited to bedrooms, bathrooms, kitchen, common area and backyard. The facility consists of total six (6) bedrooms which six (6) bedrooms are occupied by the residents. All outdoor and indoor passageways are kept free of obstruction. There are no bodies of water observed. A comfortable temperature is maintained at 72 degrees Fahrenheit. LPA observed lighting in all rooms are adequate for the comfort and safety of the residents. The hot water temperature in the residents’ shared bathroom was measured at 105 degrees Fahrenheit. Residents’ bathrooms are equipped with grab bars and non-skid mats. There is a minimum of one week supply of nonperishable and 2-day of perishable foods. Smoke and carbon monoxide detectors were in operating condition during visit. Fire extinguishers was last serviced on 02/08/2024. Emergency Disaster Plan was last posted on 01/08/2024. First aid kit was observed to be complete. Emergency disaster drill was last conducted on 08/28/2024. LIC809-C Continued (Next Page) LIC809-C Continued... LPA reviewed four (4) residents records. LPA reviewed five (5) staff records and 5 of 5 have current first aid training and associated to the facility. The following deficiencies were observed (see LIC 809D) and cited from the California Code of Regulations, Title 22 and/or Health and Safety Code Failure to correct deficiencies by POC date may result in additional Civil Penalties. THE FOLLOWING DEFICIENCIES WERE OBSERVED DURING VISIT: At 3:32 PM LPA observed unlocked medications and scissors located in top kitchen drawer. Updated copies of the following documents were requested for facility file and are to be submitted to CCL by 11/21/2024: LIC 308 Designation of Administrative Responsibility - Reviewed LIC 309 Administrative Organization LIC 500 Personnel Report LIC 610E Emergency Disaster Plan - Reviewed Liability Insurance Exit interview conducted. Appeal Rights and a copy of this report provided.the state’s words, verbatim · CDSS document, Nov 14, 2024

Type of visit: Case Management - Deficiencies

On 02/21/2024 at 11:55 am, Licensing Program Analyst (LPA) Lori Alexander arrived unannounced to conduct Case Management visit. LPA met with Administrators, Keith & Stephanie Mauer and explained the purpose of the visit. LPA conducted an Annual Inspection on 12/14/2023 and cited facility. The original Plan of Correction (POC) was scheduled for 01/11/2024. The administrator requested an additional 30 Day extension on 01/08/2024 in which LPA L. Alexander granted the request and confirmed that the new due date is 02/09/2024. Due to LPA L. Alexander was not able to return to the facility for a POC visit, LPA returned to recite and cite for new deficiencies. LPA L. Alexander conducted an Annual Inspection on 12/14/2023 and cited facility for the following: CCR 87411(f) Personnel Requirements – General – Health Screening and TB - deficiencies not cleared HSC 1569.695(c) - Fire Drill - deficiency cleared CCR 87412(b)(3)(B) Personnel Records - deficiencies cleared CCR 87705(c)(6) Care of Persons with Dementia – Appraisals -deficiency cleared CCR 87705(f)(1) Care of Persons with Dementia – Toxic Chemicals –cleared during visit on 12/14/2023 HSC 1569.618(c)(3) First Aid and CPR – deficiency cleared LIC 809 Continued... LIC809-C Continued... LPA L. Alexander conducted an Annual Inspection on 12/14/2023 and will recite and cite facility for the following today: CCR 87411(f) Personnel Requirements – Health Screening and TB Results for S1, S2, S5 CCR 87705 (5) Care of Persons with Dementia - Medical Assessment for R1 CCR 87458 (a) Medical Assessment - Medical Assessment for R5 HSC 1569.605 Liability insurance; coverage requirements $1,000,000.00 each injury occurrence to $3,000,000.00 total aggregate occurrence The following deficiencies were observed (see LIC 809D) and cited from the California Code of Regulations, Title 22 and/or Health and Safety Code. Failure to correct deficiencies by POC date may result in additional Civil Penalties. Exit interview conducted. Appeal Rights and a copy of this report provided.the state’s words, verbatim · CDSS document, Feb 21, 2024

From the deficiency page — Deficiency type: Type B · Section cited: CCR 87411(f) · Plan of correction due date: Mar 18, 2024

(f) All personnel, including the licensee and administrator, shall be in good health, and physically and mentally capable of... This requirement is not met as evidenced by: Based on interview and record review, the licensee did not comply with the section cited above in by not having health screening for S1, S2, S5 and TB tests for S2 which poses a potential health, safety or personal rights risk to persons in care.the state’s words, verbatim · CDSS document, Feb 21, 2024

Plan of correction: Administrator agreed to obtain health screening for S1, S2, S5 and TB test results for S2. Administrator will submit a copy of health screening with TB test result to CCLD by POC date.

From the deficiency page — Deficiency type: Type B · Section cited: CCR87705(5) · Plan of correction due date: Mar 18, 2024

87705 Care of Persons with Dementia (5) Each resident with dementia shall have an annual medical assessment ... This requirement is not met as evidenced by: Based on interview and record review, the licensee did not comply with the section cited above in by not having an updated annual medical assessment for R1 which poses a potential health, safety or personal rights risk to persons in care.the state’s words, verbatim · CDSS document, Feb 21, 2024

Plan of correction: Administrator agreed to obtain updated Physician's Report for R1 and submit a copy to CCLD by POC due date.

From the deficiency page — Deficiency type: Type B · Section cited: CCR 87458(a) · Plan of correction due date: Mar 18, 2024

87458 Medical Assessment (a) Prior to a person's acceptance as a resident, the licensee shall obtain and keep on file... Based on record review, the licensee did not comply with the section cited above in by not having an updated annual medical aseessment for R5 which poses a potential health, safety or personal rights risk to persons in care.the state’s words, verbatim · CDSS document, Feb 21, 2024

Plan of correction: Administrator agreed to obtain an updated Physician's Report and submit to CCLD by POC due date.

From the deficiency page — Deficiency type: Type B · Section cited: HSC1569.605 · Plan of correction due date: Feb 26, 2024

Liability insurance; coverage requirements...all residential care facilities for the elderly,...shall maintain liability insurance Based on interview and record review, the licensee did not comply with the section cited above in by not having adequate liability insurance which poses a potential health, safety or personal rights risk to persons in care.the state’s words, verbatim · CDSS document, Feb 21, 2024

Plan of correction: Administrator agreed to get the Evidence of Coverage for Liability Insurance and send a copy to CCLD by POC due date.

Type of visit: Required - 1 Year

On 12/14/2023 at 2:15PM, Licensing Program Analyst (LPA) Lori Alexander arrived unannounced to conduct 1-Year Annual Required inspection. LPA met with Administrator, Keith Mauer and explained the purpose of the visit. The facility’s fire clearance was approved for 6 non-ambulatory residents. LPA toured facility with Keith including but not limited to bedrooms, bathrooms, kitchen, common area and backyard. The facility consists of 8 total bedrooms which 6 bedrooms are occupied by the residents and 2 bedroom is occupied by staff. All outdoor and indoor passageways are kept free of obstruction. There are no bodies of water observed. A comfortable temperature is maintained at 75 degrees Fahrenheit. LPA observed lighting in all rooms are adequate for the comfort and safety of the residents. The hot water temperature in the residents’ shared bathroom was measured at 106.9 degrees Fahrenheit. Residents’ bathrooms are equipped with grab bars and non-skid mats. There is a minimum of one week supply of nonperishable and 2-day of perishable foods. Centrally stored medication and sharps were locked and inaccessible to residents. Smoke detectors and carbon monoxide detector were in operating condition during visit. Fire extinguisher was last serviced on 01/06/2023. Emergency Disaster Plan was last posted on 01/13/2023 . First aid kit was observed to be complete. LIC 809-C Continued.... LIC809 Continued.... At 3:00PM, LPA reviewed 5 residents records. At 4:30PM, LPA reviewed 6 staff records and 1 out of 6 have current first aid training and associated to the facility. The following deficiencies were observed (see LIC 809D) and cited from the California Code of Regulations, Title 22 and/or Health and Safety Code Failure to correct deficiencies by POC date may result in additional Civil Penalties. THE FOLLOWING DEFICIENCIES WERE OBSERVED DURING VISIT: At 2:32PM LPA observed Lactulose Solution and Metamucil unlocked in lower kitchen cabinet At 2:36PM LPA observed Emergen-C unlocked in upper kitchen cabinet At 2:42PM LPA observed Clorox Wipes unlocked on kitchen counter At 2:45PM LPA observed Tide, Fabuloso, Clorox Bleach, floor cleaner unlocked in unlocked garage At 3:05PM LPA observed ladder, wood planks and screen door located on outside grounds in backyard Updated copies of the following documents were requested for facility file and are to be submitted to CCL by 12/21/2023: LIC 308 Designation of Administrative Responsibility LIC 309 Administrative Organization LIC 500 Personnel Report LIC 610E Emergency Disaster Plan Liability Insurance Current Administrator’s Certificate Exit interview conducted. Appeal Rights and a copy of this report provided.the state’s words, verbatim · CDSS document, Dec 14, 2023

The state marks this report as 18 pages; the online copy we transcribed has 6. You can request the full file from the county licensing office.