A-R Residential Care for Elderly

Type of visit: Required - 1 Year

On 7/15/2026 at around 11:00 a.m., Licensing Program Analyst (LPA) Kelly Nguyen arrived unannounced to conduct the required annual inspection and met with Assistant Administrator Alejandria Bautista. Administrator (ADM) Romulo Bautista was unavailable during the visit and authorized Alejandria to sign the report. LPA with Assistance Administrator inspected the facility inside and out, including but not limited to 4 resident rooms, 2 bathrooms, dining area, garage, and backyard. LPA observed a sufficient supply of perishable and nonperishable foods. Hygiene products, towels, sheets, and warm blankets were observed. Bathrooms were observed with grab bars and nonskid mats for the safety of residents. The fire extinguisher in the kitchen appears full and was last inspected on 8/19/2025. The first aid kit was complete. The last fire drill was conducted on 6/24/2026. Hot water temperature measured 109 degrees Fahrenheit. Smoke detectors and carbon monoxide detectors were in operation during the visit. Emergency disaster plan last updated on 1/3/2026. At 11:30 am, LPA reviewed 6 resident files and 4 staff files. 4 out of 4 staff have TB on file; LPA reviewed medication and log. No deficiencies were cited during the visit. Exit interview conducted and a copy of this report provided.the state’s words, verbatim · CDSS document, Jul 15, 2026

Allegation investigated: Staff refused resident re-entry to the facility

On this day, 5/26/26 at 10:00 am, Licensing Program Analyst (LPA) K. Nguyen arrived unannounced to investigate the above allegation and to deliver findings. LPA met with the Assistant Administrator, Alejandria Bautista. Administrator Romulo Bautista was not available during the visit. LPA explained the purpose of the visit via phone and received permission for Alejandria to sign the report. Allegation: Staff Refused Resident Re-Entry to the Facility – Substantiated During the course of the investigation, the Licensing Program Analyst (LPA) conducted interviews with Administrator Assistance and reviewed Resident 1 (R1) records, including, but not limited to, hospital discharge paperwork, facility records, admission agreement documents, and communication logs. It was alleged that facility staff refused the resident re-entry after the resident’s discharge from the hospital on 5/23/26. Report continued on LIC 9099c... Substantiated Report continued... Interviews conducted during the investigation revealed that the R1 attempted to return to the facility after being discharged from medical care; however, facility staff informed the resident and/or responsible parties that the resident could not return due to the R1's behavioral condition. Interviews with Administrator Assistance confirmed that the resident was not permitted re-entry at that time. Documentation reviewed by LPA did not indicate that the facility had completed the required eviction procedures or provided appropriate written notice in accordance with applicable regulations prior to refusing the resident’s return. Additionally, records reviewed did not support that the resident’s admission agreement had been lawfully terminated before the refusal of re-entry. Based on interviews conducted and records reviewed, the preponderance of evidence standard has been met; therefore, the allegation that staff refused the resident re-entry to the facility is Substantiated. An exit interview is conducted, and a copy of the report with appeal rights is provided.the state’s words, verbatim · CDSS document, May 26, 2026 · control 15-AS-20260522084539

From the deficiency page — Deficiency type: Type B · Section cited: CCR 87224(a) · Plan of correction due date: Jun 1, 2026

87224 Eviction Procedures (a) The licensee may evict a resident for one or more of the reasons listed in Section 87224(a)(1) through (5). Thirty (30) days written notice to the resident is required except as otherwise specified in paragraph (5) This requirement was not met as evidenced by: Based on record review, the licensee did not comply with the section cited above because the facility staff refused the resident re-entry after the resident’s discharge from the hospital on 5/23/26.the state’s words, verbatim · CDSS document, May 26, 2026

Plan of correction: Licensee/Administrator will submit a self-certified letter in agreeing to ensure that all residents are permitted re-entry to the facility unless lawful eviction and discharge procedures have been completed in accordance with California Code of Regulations and applicable laws. Submitted to CCLD by POC date.

Type of visit: Required - 1 Year

On 7/1/2025 at around 9:00am Licensing Program Analyst (LPA) Kelly Nguyen arrived unannounced to conduct an annual required inspection and met with Assistance Administrator Alejandria Bautista, and Administrator (ADM) Romulo Bautista. LPA with Assistance Administrator inspected the facility inside and out including but not limited to 4 resident rooms, 2 bathrooms, dining area, garage, and backyard. LPA observed sufficient supply of perishable and nonperishable foods. Hygiene products, towels, sheets and warm blankets were observed. Bathrooms were observed with grab bars and nonskid mat for safety of residents. Fire extinguisher in the kitchen appears full was last inspected on 8/15/2024. First aid kit was complete. Last fire drill was conducted on 6/10/2025. Hot water temperature measured at 108.3-degree Fahrenheit. Smoke detectors and carbon monoxide were in operating condition during visit. At 11:30 am, LPA reviewed 4 resident files and 4 staff files. 4 out of 4 staff have TB on files, LPA reviewed medication and log. Report continues on LIC 809c.. Updated copies of the following documents were requested for facility file and are to be submitted to CCL by 07/08/2027: LIC 500 Personnel Report LIC 308 Designation of Administrative Responsibility LIC 309 Administrative Organization LIC 400 Affidavit Regarding Client/Resident Cash Resources LIC 402 Surety Bond LIC 610E Emergency Disaster Plan No deficiencies cited during visit. Exit interview conducted and a copy of this report provided.the state’s words, verbatim · CDSS document, Jul 1, 2025

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Kelly Nguyen arrived unannounced to conduct an annual required inspection and met with Assistance Administrator Alejandria Bautista, and later Administrator (AD) Romulo Bautista. AD later left and gave verbal permission to AD assistance to sign the report. LPA with Assistance Administrator inspected the facility inside and out including but not limited to 4 resident rooms, 2 bathrooms, dining area, garage, and backyard. LPA observed sufficient supply of perishable and nonperishable foods. Hygiene products, towels, sheets and warm blankets were observed. Bathrooms were observed with grab bars and nonskid mat for safety of residents. Fire extinguisher in the kitchen appears full was last inspected on 8/18/23. First aid kit was complete. Last fire drill was conducted on 4/2/24. Facility has an updated disaster plan dated 4/2/2024. While conducting physical plant inspection, LPA observed the following: 1. at around 11:30 am, LPA observed unlock detergent and bleach unlock in the garage At 1:00 pm, LPA reviewed 5 resident files and 2 staff files. 2 out of 2 staff have TB on files, LPA reviewed medication and log. Deficiencies were cited per Title 22 California Code of Regulations. Exit interview conducted; Appeal Rights provided via email.the state’s words, verbatim · CDSS document, Jun 19, 2024