A Paradise Elderly Home

Type of visit: Required - 1 Year

On 03/20/26 Licensing Program Analyst (LPA) Villegas conducted an unannounced annual required inspection visit using the CARE Inspection Tool. LPA met with the Director Yolanda Bernardo, as the purpose of the visit was explained. The facility is licensed to operate for (5) non-ambulatory residents of which (3) may be bedridden elderly residents ages 60 and above. The facility is approved for (3) hospice residents. Facility fees are current, liability insurance is active (Tady's insurance CL27002401 exp: 8/14/26), and Administrator certificate is active (7007045740 exp: 12/2/26). The facility is a single-story home and consists of the following: (3) resident bedrooms, (2) bathrooms (1) for residents and (1) for visitors and staff, staff working area, living room, kitchen, dining room, attached garage which houses the washer and dryer, and an additional refrigerator for extra food storage and an outdoor shaded area. bedrooms were checked, mattresses and box springs were in good condition, adequate lighting, plenty of dresser and closet space was observed. Bathroom toilets and water faucets worked properly, shower was free of mold/mildew, and there are sufficient toiletries accessible to clients. The water temperature properly measured between 105-120 F.. A supply of perishable and non-perishable food was observed, toxins and knifes were stored and inaccessible to residents, no weapons nor bodies of water on the premises, exits and walkways are free of debris/hazards. LPA conducted a records review of (5) residents records, (5) Resident Medication Administration Records and (4) staff records, no observe any discrepancies at the time of visit. First aid kit observed, 2 fire extinguishers fully charged, carbon monoxide and smoke detectors are operational, fire/emergency drill was completed on 2/27/26. Exit interview conducted, and a copy of this report was provided.the state’s words, verbatim · CDSS document, Mar 20, 2026

Allegation investigated: Staff does not assist resident with toileting. Staff withholding resident's personal belongings. Staff are not meeting resident's dietary needs. Staff do not communicate effectively with resident.

This report supersedes the report dated 05/22/2025 and does not change the findings. On 06/18/2025, Licensing Program Analyst (LPA) Socorro Leandro conducted an unannounced continuation complaint investigation visit regarding the allegations listed above. LPA met with Licensee/Administrator, Yolanda Bernardo and the purpose of the visit was explained. LPA was granted entry to the facility. Unsubstantiated Investigation consisted of the following: On 05/22/2025, a facility tour was conducted, interviews were conducted, and records were reviewed. The facility tour consisted of R1’s bedroom, garage, kitchen and food supply. Interviews conducted consisted of 3 staff interviews [Staff 1 (S1) to Staff 3 (S3) were interviewed] and 1 resident interview [Resident 1 (R1) was interviewed]. Resident 1’s records were reviewed which consisted of Admission Agreement dated 05/05/2025, Physicians Report dated 05/05/2025, Safeguards for Property Valuables dated 05/05/2025, and other pertinent documents. Facility records were also reviewed such as Register of Facility Residents dated May 2025 and Personnel Report dated 05/22/2025. On 06/17/2025, 3 witnesses were interviewed [Witness 1 (W1) to Witness 3 (W3) were interviewed]. On 06/18/2025, a tour of the kitchen was conducted, food supply was observed, and resident bedrooms were toured. Investigation revealed the following: Allegation: “Staff does not assist resident with toileting”, it is being alleged that the facility does not assist residents with their toileting needs. Interviews conducted with R1 reveled the following: 1 out of 1 resident denied the allegation. Interviews conducted with S1 to S3 revealed the following: 3 out of 3 staff denied the allegation. Interviews conducted with W1 to W3 revealed the following: 3 out of 3 witnesses denied the allegation. Based on the department’s interviews this allegation is unsubstantiated. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur, therefore the allegation is unsubstantiated. Allegation: “Staff withholding resident's personal belongings”, it is being alleged that the facility does not give residents access to their personal belongings. Interviews conducted with R1 reveled the following: 1 out of 1 resident denied the allegation. Interviews conducted with S1 to S3 revealed the following: 3 out of 3 staff denied the allegation. Interviews conducted with W1 to W3 revealed the following: 3 out of 3 witnesses denied the allegation. Resident 1’s records reviewed revealed the following: Safeguards for Property Valuables (SPV) was signed by R1 and dated 5/5/2025, moreover, the department observed that the property valuables were stored in the garage as stated on the SPV. Observations on 05/22/2025 and 06/18/2025, reveled the following: residents have their personal belongings (i.e. clothing items and personal hygiene items) in their bedrooms and residents have access to their personal belongings. Based on the department’s observations, interviews, and records reviewed this allegation is unsubstantiated. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur, therefore the allegation is unsubstantiated. Allegation: “Staff are not meeting resident's dietary needs”, it is being alleged that residents’ dietary needs are not being meet resulting in frequent blood sugar drops. Interviews conducted with R1 revealed the following: 1 out of 1 resident agreed with allegation, but R1 also explains that the staff tries to provide them with the food they would like to eat. Interviews conducted with S1 to S3 revealed the following: 3 out of 3 staff denied the allegation. Interviews conducted with W1 to W3 revealed the following: 3 out of 3 witnesses denied the allegation. Observations on 05/22/2025 and 06/18/2025, reveled the following: there is enough food in the facility for 2 weeks, and there is meat, vegetables and carbohydrates in the facility. Observations of R1 on 05/22/2025, revealed the following: staff provided R1 with a bowl of vegetables and R1 ate the food that was provided to them. Resident 1’s records reviewed revealed the following: Physicians Report signed and dated 4/1/2025 does not state that R1 has a special diet. Based on the department’s observations, interviews, and records reviewed this allegation is unsubstantiated. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur, therefore the allegation is unsubstantiated. Allegation: “Staff do not communicate effectively with resident”, it is being alleged that residents do not understand staff when they speak to them. Interviews conducted with R1 revealed the following: 1 out of 1 resident agreed with allegation, but R1 also explains that staff attempts to speak to them in a slow manner and that is when R1 is able to understand staff. Interviews conducted with S1 to S3 revealed the following: 3 out of 3 staff denied the allegation. Interviews conducted with W1 to W3 revealed the following: 3 out of 3 witnesses denied the allegation. Observations of interviews conducted with staff on 05/22/2025, revealed the following: the department interviewed staff in English and staff answered questions in English, additionally, the department was able to understand staffs’ answers. Observations of staff interacting with residents on 05/22/2025, revealed the following: the department observed staff speaking with R1, moreover, the department observed staff communicating with residents in care. Based on the department’s observations, interviews, and records reviewed this allegation is unsubstantiated. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur, therefore the allegation is unsubstantiated. No deficiencies were cited. An exit interview was conducted, and a copy of this report was left with the Licensee/Administrator, Yolanda Bernardo.the state’s words, verbatim · CDSS document, Jun 18, 2025 · control 11-AS-20250515083836

Allegation investigated: Staff does not assist resident with toileting. Staff withholding resident's personal belongings. Staff are not meeting resident's dietary needs. Staff do not communicate effectively with resident.

On 5/22/2024 at around 10:30 AM, Licensing Program Analyst (LPA) Socorro Leandro conducted an unannounced complaint investigation visit regarding the allegations listed above. LPA met with Licensee/Administrator, Yolanda Bernardo and the purpose of the visit was explained. LPA was granted entry to the facility. Unsubstantiated Investigation consisted of the following: On 5/22/2025, a facility tour was conducted, interviews were conducted, and records were reviewed. The facility tour consisted of R1’s bedroom and garage. Interviews conducted consisted of 3 staff interviews [Staff 1 (S1) to Staff 3 (S3) were interviewed] and 1 resident interview [Resident 1 (R1) was interviewed]. Resident 1’s records were reviewed which consisted of Admission Agreement dated 5/5/2025, Physicians Report dated 5/5/2025, Safeguards for Property Valuables dated 5/5/2025, and other pertinent documents. Facility records were also reviewed such as Register of Facility Residents dated May 2025 and Personnel Report dated 5/22/2025. Investigation revealed the following: Allegation: “Staff does not assist resident with toileting”, it is being alleged that the facility does not assist R1 with their toileting needs. Interviews conducted with R1 reveled the following: 1 out 1 resident denied the allegation. Interviews conducted with S1 to S3 revealed the following: 3 out 3 staff denied the allegation. Based on the department’s interviews this allegation is unsubstantiated. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur, therefore the allegation is unsubstantiated. Allegation: “Staff withholding resident's personal belongings”, it is being alleged that the facility is withholding R1’s personal belongings. Interviews conducted with R1 reveled the following: 1 out 1 resident denied the allegation. Interviews conducted with S1 to S3 revealed the following: 3 out 3 staff denied the allegation. Resident 1’s records reviewed revealed the following: Safeguards for Property Valuables (SPV) was signed by R1 and dated 5/5/2025, moreover, the department observed that the property valuables were stored in the garage as stated on the SPV. Based on the department’s interviews and records reviewed this allegation is unsubstantiated. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur, therefore the allegation is unsubstantiated. Allegation: “Staff are not meeting resident's dietary needs”, it is being alleged that the facility does not meet the dietary needs (special diet) of R1. Interviews conducted with R1 revealed the following: 1 out 1 resident agreed with allegation, but R1 also explains that the staff tries to provide them with the food they would like to eat. Interviews conducted with S1 to S3 revealed the following: 3 out 3 staff denied the allegation. Resident 1’s records reviewed revealed the following: Physicians Report signed and dated 4/1/2025 does not state that R1 has a special diet. Based on the department’s interviews and records reviewed this allegation is unsubstantiated. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur, therefore the allegation is unsubstantiated. Allegation: “Staff do not communicate effectively with resident”, it is being alleged that R1 does not understand staff when they speak to them. Interviews conducted with R1 revealed the following: 1 out 1 resident agreed with allegation, but R1 also explains that staff attempts to speak to them in a slow manner and that is when R1 is able to understand staff. Interviews conducted with S1 to S3 revealed the following: 3 out 3 staff denied the allegation. Observations of interviews conducted with staff revealed the following: the department interviewed staff in English and staff answered questions in English, additionally, the department was able to understand staffs’ answers. Based on the department’s interviews and records reviewed this allegation is unsubstantiated. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur, therefore the allegation is unsubstantiated. No deficiencies were cited. An exit interview was conducted, and a copy of this report was left with the Licensee/Administrator, Yolanda Bernardo.the state’s words, verbatim · CDSS document, May 22, 2025 · control 11-AS-20250515083836

Type of visit: Required - 1 Year

On 02/20/25, at 1:30pm, Licensing Program Analyst (LPA) Perry Scott conducted an unannounced annual required inspection visit using the CARE Inspection Tool. LPA met with the Director, Yolanda Bernardo, and the purpose of today’s visit was explained. The facility is licensed to operate for (5) non-ambulatory residents of which (3) may be bedridden elderly residents ages 60 and above. The facility is approved for (3) hospice residents. None of the residents have Restricted Health Care Conditions and none utilizes postural supports or protective devices. The facilities’ annual fees are current. The facility is a single-story home and consists of the following: three (3) resident bedrooms, two (2) bathrooms one (1) of which is for residents and one (1) is for visitors and staff, staff working area, living room, kitchen, dining room, attached garage which houses the washer and dryer, an additional refrigerator for extra food storage and an outdoor shaded area. LPA conducted a records review of four (4) residents records, four (4) staff records, and reviewed the facility disaster plan. All resident & staff records were complete. The facility disaster plan was current and in compliance with Title 22 at the time of visit. The fire/emergency drill was completed on 12/31/24. LPA reviewed (4) Resident Medication Administration Records and did not observe any discrepancies at the time of visit. The facilities administrator certificate was current and expires on 12/2/2026. LPA observed that the facility has current liability insurance which expires on 08/14/2025. All resident rooms were checked, mattresses and box springs were in good condition, adequate lighting, plenty of dresser and closet space was observed, walls and floors were clean and in good repair, bed linens, comforters and bath towels were fully stocked. Bathrooms were found to be within Title 22 regulation, toilets and water faucets worked properly, shower was free of mold/mildew, there is adequate lighting, and sufficient toiletries accessible to clients. The water temperature measured between 105-116.6F degrees. Report Continued On LIC 809-C Perishable and non-perishable food supply was checked and adequately stocked at time of visit. Carbon monoxide detector was observed and operational. Smoke detectors were working properly, two (2) fire extinguishers were fully charged, one (1) located and mounted in the hallway and one (1) located in the garage, toxins and knives were locked and inaccessible to clients. Medications were centrally stored and properly locked, first aid kit was checked and fully stocked, first aid manual was up to date. A landline was observed. Outside grounds were toured and no bodies of water were observed. Exits/ Walkways around the home were free of debris and hazards. During today’s visit no deficiencies were observed. An exit interview was conducted, and a copy of the Facility Evaluation Report was provided to Director, Yolanda Bernardo.the state’s words, verbatim · CDSS document, Feb 20, 2025

Type of visit: Required - 1 Year

On 03/14/24 Licensing Program Analyst (LPA) Lizeth Villegas conducted an unannounced annual required visit using the CARE Inspection Tool. LPA met with the Director Yolanda Bernardo and the purpose of today’s visit was explained. The facility is licensed to serve two (2) ambulatory, and three (3) bedridden residents ages 60 and above. Fire cleared for two (2) bedridden residents in room #3 with the 3rd approved to be placed in either of the two remaining rooms. Hospice waiver approved for three (3) resident. Liability insurance active, annual fees are current, land line observed. The facility is a single story home and consists of the following: three (3) resident bedrooms, two (2) bathrooms one (1) of which is for residents and one (1) is for visitors and staff, staff working area, living room, kitchen, dining room, attached garage which houses the washer and dryer, an additional refrigerator for extra food storage and an outdoor shaded area. Resident bedrooms were checked, mattresses and box springs were in good condition, adequate lighting, plenty of dresser and closet space was observed. Bathroom toilets and water faucets worked properly, shower was free of mold/mildew, and there are sufficient toiletries accessible to residents. The water temperature properly measured between 105-120 F.. A supply of perishable and non-perishable food was observed, toxins and knifes were stored and inaccessible to residents, no weapons nor bodies of water on the premises, exits and walkways are free of debris/hazards. LPA conducted a records review of 2 staff records, 2 resident records, and 2 medication administration records, no discrepancies observed. Medications were centrally stored and properly locked, first aid kit was checked and fully stocked. The last fire was conducted on 02/26/24, 1 fire extinguisher fully charged, carbon monoxide and smoke detectors are interconnected and operational. Auditory alarms were observed. No deficiencies observed during visit. Exit interview conducted with Director Yolanda Bernardo, and a copy of this report was provided.the state’s words, verbatim · CDSS document, Mar 14, 2024

Allegation investigated: Staff did not assist resident with obtaining medical care. Staff did not ensure that resident's dietary needs were met. Staff did not monitor resident for change in condition.

On 1/30/24, Licensing program Analyst (LPA) Ernand Dabuet conducted a subsequent complaint investigation visit at this facility. LPA met with Administrator Yolanda Bernando and explained the purpose of the visit is investigate the allegations mentioned above. Investigation consisted of: Interview with Administrator, staff #1-#3 (S1-S3), residents #1--#4 (R1-R4) and witnesses #1 - #4 (W1-W4). Records reviews of (R1-R4) Emergency Identification, Physician's Report, Medication Admnistration Record, Pre-Placement appraisal, Admission. A reveiw of Resident and Staff Roster, Facility Menu and other pertinent documents associated with this complaint. A tour of the facility was performed. (Evaluation Report continues LIC 9099-C) Unsubstantiated INVESTIGATION REVEALED THE FOLLOWING: Allegation #1: Staff did not assist the resident with obtaining medical care. Allegation #3: Staff did not monitor resident for change in condition. The details of this complaint alleged that resident #1 (R1) was not assisted with medical care. The complainant reported that facility staff failed to obtain medical care for (R1) when it was required. On 11/06/23, according to the complainant, (R1) was constipated for three to four days and did not dispatch Emergency Medical Services (EMS) for (R1) to be medically assessed at a local hospital. The complainant reported that the facility staff is not cognizant of (R1’s) change in condition. On 01/30/24 between 9:20 am – 9:45 am, the Department interviewed Administrator #1 (A1) Yolanda Bernardo. (A1) expressed (R1) was admitted on 10/19/23 at the facility and was only under their care for (18) days. (R1) lived in a private home and was cared for by family members before entering A Paradise Elderly Home. On 11/06/23 (R1) was taken to Kaiser Permanente South Bay Medical Hospital for constipation. (A1) recalled while (R1) was visited by family members on 11/06/23, there was a concern for (R1's) medical attention. (R1) had not had the usual bowel movement for a couple of days. (A1) claimed that (R1) is on pro re nata (PRN) prescription for Miralax for constipation. (A1) asserted since (R1’s) admittance (R1) was having normal bowel movements five to six times daily. In accordance with the Medication Administration Record (dated: November 2023), (R1) was given (1) capful of Miralax mixed with 6oz of water each day between 11/01/23 and 11/06/23. (A1) declared that (R1) continued to have bowel movements from 11/01/23 through 11/06/23, but it was limited to a small amount of three times daily and not the usual five or six times a day. (A1) refuted the allegation the staff did not fail to seek medical treatment for (R1). (A1) argued (R1) was observed daily for vital signs and did not experience general weakness on 11/06/23. (A1) reasoned that (A1) did not contact (EMS) due to (R1) having only a limited amount of bowel activity. (A1) described (R1) was having bowel activity daily and (R1's) stool was normal. (A1) felt that the situation was not life-threatening and thus did not contact (EMS). (A1) stated it was the family member of (R1) who voluntarily called 911 for (EMS) service to transport (R1) to Kaiser Permanente Hospital. (A1) reported the incident on a Special Incident Report LIC 624 (dated: 11/08/23) to Community Care Licensing (CCL) that (R1) was hospitalized with family who ordered transport via (EMS) on 11/06/23. (Evaluation Report continues LIC 9099-C) (A1) communicated that she received a call from a family member on 11/08/23 while (R1) was still at the hospital under observation that (R1) would not be returning to the facility. (A1) claimed that the facility is cognizant of (R1’s) change of condition and that staff are fully trained. (R1) is being monitored around the clock and (R1’s) vitals are observed daily. On 01/30/24, between 11:30 am – 12:10 pm, the Department interviewed (3) out (3) staff #1-#3 verified that (R1) was being assisted with medical care accordingly. (S1-S3) affirmed that (R1) was given Miralax daily from 11/01/23 through 11/06/23 when (R1) started to reduce (R1’s) bowel excretion from five to six times daily to only three times daily. (S1-S3) confirmed that (R1) was not taken by (EMS) as (R1) did not perceive a need for immediate medical care and that (R1's) vital status was all normal. (S1-S3) asserted to be aware of (R1’s) current health conditions and is attentive in monitoring for (R1’s) health condition changes. On 01/30/24, between 9:45 am – 10:50 am, the Department interviewed (3) out (4) residents #2-#4 (R2-R4) who were complimentary of the staff care and supervision. (R2-R4) stated the facility provided proactive care, and staff responded and appropriately attended to residents. On 01/30/24, between 10:56 am - 12:19 pm, the Department interviewed (3) out of (4) family representatives witness #2 -#4 (W2-W4) verified that the facility staff is functional and engaging family representatives when obtaining medical care for the residents. (W2) stated (R2) no longer needed care and supervision and is now independent and is no longer at this facility. However, if (R2) required care and supervision again, this would be a place (W2) that would consider readmitting (R2) that is how good this place is commented by (W2). In light of the information gathered, the allegations mentioned above are not supported by sufficient evidence. Allegation #2: Staff did not ensure that resident's dietary needs were met. It is alleged that facility staff did not ensure that resident #1 (R1) dietary needs were met. The complainant reported that the facility served (R1) high-sodium food which caused (R1’s foot to swell, and was not provided with water to keep (R1) hydrated. On 01/30/24 between 9:20 am 9:45 am, the Department interviewed Administrator #1 (A1) Yolanda Bernardo. (A1) claimed (R1) was on a special diet “low sodium” according to (R1’s) Physician’s Report (dated: 10/10/23). (A1) was carefully observed for (R1’s) breakfast, lunch, and dinner meals. (Evaluation Report continues LIC 9099-C) (R1’s) meals consisted of fruits, vegetables, grains, proteins, dairy, and juices according to the facility menu (dated: October 2023 – November 2023). (A1) reported that all residents are entitled to in-between snacks with fruits, pudding, crackers, and liquid refreshments. On 01/30/24, between 11:30 am – 12:10 pm, the Department interviewed (3) out (3) staff #1-#3 all verified that (R1) was provided with low sodium meals daily. (S1-S3) reported that meals are well-balanced meals with proteins, carbs, fiber, vitamins, and liquids. On 01/30/24, between 9:45 am – 10:50 am, the Department interviewed (3) out (4) residents #2-#4 (R2-R4) who were satisfied with the meals and were not on any special diet. (R4) claimed the meals are good portions and there’s a variety. (R4) often would have to request salt (R4) preferred the food on the saltier flavor. On 01/30/24, between 10:56 am - 12:19 pm, the Department interviewed (3) out of (4) family representatives witness #2 -#4 (W2-W4) reported no concern or issues with the meals provided to the residents in care. On 01/30/24 between 11:20 am 11:30 am, the Department reached out to (R1) by telephone who was not available for an interview due to (R1’s) health condition. Witness #1 (W1) a conservator to (R1) did not want to be interviewed and did not want to release any information regarding these allegations. The Department reviewed (R1’s) Medication Administration Record (MAR) (date: October 2023 – November 2023). (R1) was prescribed Atenolol (1) tablet daily, Creon (3) capsule daily, and Miralax (1) capful daily. All these medications have side effects for swelling of legs, ankles, and joints, and dehydration (ref: MayoClinic.org). It was verified that all staff had been trained in the safe preparation of food. A separate investigation was conducted by Carson Sheriff Station on 11/14/23 and 11/5/23 and the investigation revealed no evidence of neglect/elder abuse. Based on the information provider, an inspection of the facility, observation, interviews, and analysis of records, the Department found no evidence to support the allegations mentioned above. Although the allegations may have happened or are valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur, as a result, the allegations are Unsubstantiated. An exit interview was conducted with Yolanda Bernardo, and a copy of the report was provided.the state’s words, verbatim · CDSS document, Jan 30, 2024 · control 11-AS-20231114103014