A Diablo Assisted Living 1

Type of visit: Required - 1 Year

On 11/05/2025 at 11:45AM, Licensing Program Analysts (LPAs) Andrew Christy and James Sampair arrived unannounced for the Required 1 Year inspection. LPAs met with administrator Nina Villanueva and explained the purpose of the visit. The facility is currently at capacity with six (6) residents. The LPAs toured the facility inside and outside. The LPA inspected the kitchen, common areas, bedrooms, bathrooms, and the exterior of the facility. The facility was clean, appropriately furnished, and well lit. More than the 2 days of perishable and 7 days of nonperishable food supplies were available. No body of water was on the facility grounds. Medications are centrally stored. Bathrooms and showers were observed to be fully functioning and clean. Carbon monoxide and smoke detectors were operational. The fire extinguisher was last serviced on 09/27/2024. Inside temperature was 74.0 degrees Fahrenheit and the hot water temperature in the resident bathroom was 127.6 degrees Fahrenheit. The LPAs reviewed 5 resident and 5 staff files, all found to be complete. The Emergency Disaster Plan was last reviewed 01/07/2025. Quarterly emergency drills were last conducted 09/09/2025. Medications and the Medication Administration Record (MAR) were reviewed and no errors were found. Continued on LIC809C..... Continued from LIC809..... The following deficiencies were cited during the inspection: At 12:05PM, one of the resident's rooms was inaccessible and cannot be walked around due to multiple unopened packages, clutter, trash, and other various items. At 12:30PM, the hot water in the residents' bathroom measured to 127.6 degrees Fahrenheit. At 12:45PM, the facility fire extinguishers were found to have been last serviced 09/27/2024. Deficiencies are cited per Title 22 California Code of Regulations and listed on LIC809D. Failure to submit proof of corrections (POC) by plan of correction due date and/or any repeat deficiencies within a 12-month period may result in civil penalties. Exit interview conducted. A copy of this report, along with appeal rights, was provided to the administrator.the state’s words, verbatim · CDSS document, Nov 5, 2025

Type of visit: Post Licensing

On 1/21/2025 at 1:30 PM, Licensing Program Analyst (LPA) James Sampair arrived for this unannounced Post Licensing Inspection. Upon entry to the facility, the LPA told Caregiver Aileen Tica the purpose of the visit. The LPA toured the facility inside and outside. The LPA inspected the kitchen, common areas, bedrooms, bathrooms, and the exterior of the facility. The facility was clean, appropriately furnished, and well lit. More than the 2 days of perishable and 7 days of nonperishable food supplies were available. No body of water was on the facility grounds. Medications are centrally stored. Bathrooms and showers were observed to be fully functioning and clean. Carbon monoxide and smoke detectors were operational. The fire extinguisher was last serviced on 09/27/2024. Inside temperature was 71.4 degrees Fahrenheit and the hot water temperature was 110.9 degrees Fahrenheit. The LPA reviewed 5 resident and 5 staff files. No citations were issued. Exit interview conducted and a copy of this report provided.the state’s words, verbatim · CDSS document, Jan 21, 2025

Type of visit: Prelicensing

On 12/03/2024 at 8:30 AM, Licensing Program Analysts (LPAs) James Sampair and David Doidge arrived unannounced to conduct a change of ownership prelicensing visit. Upon entry into the facility, the LPAs informed Applicants Ninia Villanueva and Maricel Evangelista of the purpose of the visit. The LPAs toured the facility inside and outside. The LPAs inspected the kitchen, common areas, bedrooms, bathrooms, and the exterior of the facility. The facility was clean, appropriately furnished, and well lit. More than the 2 days of perishable and 7 days of nonperishable food supplies were available. No body of water was on the facility grounds. Medications are centrally stored. Bathrooms and showers were observed to be fully functioning and clean. Carbon monoxide and smoke detectors were operational. The fire extinguisher was last serviced on 09/25/2024. Inside temperature was 71 degrees Fahrenheit and the hot water temperature was 110 degrees Fahrenheit. Facility passed this prelicensing inspection. Component III training was provided for the Applicants. Final review of the application to be completed by the Central Applications Bureau analyst. Exit interview conducted and a copy of this report provided to the Applicant.the state’s words, verbatim · CDSS document, Dec 3, 2024

Type of visit: Office

Facility Type: RCFE Application Type: CHOW Capacity: 6 Census (if any clients in care): 6 COMP II Participants: Maricel Evangelista (Administrator/Board Member) & Ninia Villanueva (Board Member) Interview Method: Virtual interview via Microsoft Teams On November 04, 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, Nov 4, 2024