Jade Villa Care Home

Type of visit: Prelicensing

Licensing Program Analyst (LPA) Mariana Agban conducted a Pre-Licensing Inspection with Administrator Pamela Rojas and Licensees Romeo Rojas, Jeffery Alvarez and Madeleine Ayllon . A Change in Ownership (CHOW) Application to operate a Residential Care Facility for the Elderly (RCFE) was received by Community Care Licensing (CCL) on 09/18/2025. A fire clearance was approved on 01/30/26, for two (2) non-ambulatory residents and four (4)bedridden residents, for a total capacity of six. The bedridden fire clearance is for rooms #1#2 and #3. A dementia plan of operation has been submitted. A hospice waiver has been requested for four (4) residents pending the Manager's approval. The smoke alarms and carbon monoxide detector are battery-operated and functional. The fire extinguisher is located in the kitchen with a service date of 05/27/2026. A tour of the physical plant was initiated at approximately 10:00 am and the following was observed: KITCHEN: The facility has a Kitchen area equipped with a refrigerator, microwave oven, and sink. Adequate supplies of perishable and nonperishable food and dining ware accommodated a maximum capacity of six (6). Medications are kept locked in the kitchen cabinets. BEDROOMS: The facility have five (5) bedrooms. Four (4) bedrooms are designated for residents' use. Bedrooms #1, #2, and #3 designated for four (4) bedridden residents. Bedroom#4 is designated for two(2) non ambulatory residents. LPA observed staff room next to the kitchen area. All bedrooms in use by the residents are furnished with beds, nightstands, chairs, dressers, bedding, and linen. The bedrooms have sufficient lighting and closet space. BATHROOMS: The facility has 2.5 bathrooms. There are two (2) bathrooms designated for residents' use. Both bathrooms were properly supplied and had functional fixtures. Hot water temperature was measured from the bathroom sink at 108.9 and 107.5 degrees Fahrenheit. No cleaning supplies or hazardous items were present in each bathroom during the inspection (Continue on 809C) COMMON AREAS: These included the living room and dining room. The living room was equipped with furniture, a television, tables, and chairs. The dining area has a large dining room table to accommodate six (6)residents. There is a functioning telephone on the premises in the living room. There is also an office/workstation area in the dining/kitchen area. LAUNDRY Area/GARAGE:The garage is used as extra storage. Access to the garage is from outside the facility. LPA observed the washer and dryer in good repairs. Laundry detergents will kept locked and inaccessible to the residents. Resident Files: LPA conducted a file review of random resident records to ensure compliance with licensing forms. Staff Files: LPA conducted a file review of the Administrator file to enure compliance with licensing form. SURROUNDING GROUNDS: The driveway, passageways, and entrance to the home were clear of obstruction. All entry and exit doors have a functional auditory alert when the doors open. The backyard of the facility has a patio and backyard furniture to accommodate the six (6) residents. The facility's backyard has sufficient yard space. The gate at the side of the home was checked to ensure no locks were installed, and that exits and passageways were clear for emergency evacuation. In addition to the Pre-Licensing inspection, a Component III power point presentation was also held. Pursuant to Title 22, Division 6 of the CA Code of Regulations, the facility's physical environment appears to be compliant and ready for licensure. CAB will be advised and a copy of this report provided.the state’s words, verbatim · CDSS document, May 29, 2026