A Serene Senior Living

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Ruth Martinez is conducting this unannounced visit for the purpose of completing an annual required inspection. LPA arrived at the facility and was greeted and granted entry by staff. LPA explained the nature of the visit. There are six (6) residents at the facility and there are no residents receiving hospice services currently. Dianna Manalo, Administrator arrived at the facility and met with LPA. LPA verified Administrator has a current and active certificate. LPA accompanied by staff began the tour of the inside and outside of the facility. LPA observed required department postings throughout the facility. Facility stays within the capacity limitations. There is a minimum of one week of non-perishables foods and two days of perishables foods available. There is additional food storage in a spare refrigerator in the garage. The facility is maintained at a comfortable temperature. LPA inspected that medication is centrally stored in a safe locked storage cabinet located in the kitchen. LPA reviewed medication and observed medication was labeled and stored inaccessible to residents in care. LPA inspected the facility bathrooms and LPA measured the hot water temperature which measured 108.8 Fahrenheit degrees. All bathrooms observed to have a supply of soap, toilet paper and towels. Bathrooms are equipped with required safety measures such as non-skid mats and grab bars. Lighting is sufficient to ensure safety and comfort. The facility is equipped with sufficient hand hygiene, cleaning, and disinfecting supplies. LPA observed that toxic chemicals, cleaning solutions and disinfectants are stored locked underneath kitchen sink, laundry unit and in the garage which is inaccessible to residents in care. The facility has an available clean supply of linens. LPA inspected residents’ bedrooms which had sufficient lighting to Continued on LIC809-C ensure safety and comfort. All bedrooms observed to have all required components. Storage space is provided for residents in their bedroom. Smoke detectors/carbon monoxide detectors were tested and found to be operational. LPA toured the outside of the facility and observed outdoor passageways are free of obstructions. LPA observed there are shaded seating areas for residents’ enjoyment in the backyard of the facility. LPA observed a fire extinguisher with service date of March 28, 2026, charged and mounted in the dining room. Fire drills are conducted every three months, LPA verified fire drill logs are kept and last drill was conducted June 23,2026. LPA began review of records. LPA reviewed three resident records. All the required documentation was present and reviewed in the residents’ files. LPA reviewed two employee records. All employees present have a criminal record clearance and are associated to the facility. LPA observed records reviewed have a current First Aid certificate. LPA as a reminder provided annual fee dues information. Based on the observations made during today’s visit, no deficiencies were noted today in the areas inspected per Title 22 Division 6 of the California Code of Regulations. This report was reviewed with the Administrator, and a copy of this report was provided to the facility.the state’s words, verbatim · CDSS document, Jul 8, 2026

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Jessica Cho arrived at the facility unannounced for the purpose of conducting the Required 1-Year annual evaluation using the CARE Inspection Tool. LPA was greeted and granted entry by Caregiver Raquel Pamintuan after stating the reason for the visit. Administrator (Admin) Ray Santianez arrived on premise and remained at the facility to assist with the inspection. Admin has a valid administrator's certificate expiring on August 18, 2027. The following was observed during the inspection: This is a single story property located in a residential neighborhood comprised of six resident bedrooms and two resident bathrooms. Facility operates within the conditions and limitations specified on the license. LPA observed six residents in care of which one is receiving hospice service. LPA observed two caregivers on duty and verified fingerprint clearance and association statuses including the administrators. LPA along with Admin toured the interior portion of the facility. All common areas were inspected which includes the laundry room and attached two car garage. The fireplace is appropriately screened in the living room. LPA inspected all the resident bedrooms. The resident bedrooms' were appropriately furnished, beds and bedding supplies were in good condition, adequate lighting was provided, and sufficient storage space for each residents' personal belongings were observed. All bathrooms were found be in compliance, clean, and operational. The hot water temperature in both bathrooms measured at 105.4 and 105.0 degrees Fahrenheit. Toxins, disinfectants, sharps, and medications were secured and inaccessible. LPA observed ample two-day supply of perishables and seven-day supply of non-perishable food. LPA toured the exterior portion of the facility. The outdoor passageway is free of obstruction. The two exit gates on each side of the property were operational, and there were sufficient seating and shading in the patio area. The outdoor shed which holds storage items remains secured. The two fire extinguishers were mounted, charged, and serviced on April 16, 2025. The auditory devices and smoke/carbon monoxide detectors were tested and operational. LPA observed the emergency food/water and supplies in the kitchen and garage. The first aid kit had all necessary elements. Emergency drills are conducted quarterly of various scenarios with the last date on August 2, 2025. The Complaint Poster (PUB475) poster was posted in the entry way in the correct size requirement. LPA reviewed six out of six resident files and two personnel files in which no discrepancies were found. Facility maintained all hospital and bed rail orders. Medications were audited for two out of six residents and no discrepancies were found. Based on the observations made during today's visit, no deficiencies are being cited. An Advisory Note is being issued. An exit interview was conducted with Administrator Ray Santianez, and a copy of this report was provided at exit.the state’s words, verbatim · CDSS document, Sep 23, 2025

The state marks this report as 4 pages; the online copy we transcribed has 3. You can request the full file from the county licensing office.

Type of visit: POC

Licensing Program Analyst (LPA) Kimberly Lyman conducted an unannounced Plan of Correction (POC) visit to follow up on deficiencies cited on 07/22/2024. LPA was greeted and granted entry into the facility and explained the reason for the visit. Administrator/ Licensee Minerva Sansano arrived during the visit. Deficiency cited under Title 22 Regulation 87465(h)(2) pertaining to Centrally Stored Medications has been cleared. Facility has discontinued pre-pouring medications and LPA observed medications in their original containers. Licensee has complied with the POC. Advisory note given 07/22/2024 indicated the following: Facility was checking blood pressure for medication administration. Facility has discontinued the practice. Exit gate appears broken. Facility has repaired gate. One out of six residents was missing an updated physician report. Facility has obtained updated physician report. Facility has been advised to remain in compliance with all items cited. Exit interview conducted and a copy of this report was left at the facility.the state’s words, verbatim · CDSS document, Aug 1, 2024

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Kimberly Lyman conducted an unannounced visit to A Serene Senior Living. The purpose of today’s visit was to conduct the Annual Required inspection. LPA was allowed entry into the facility and explained the reason for the visit. Facility is licensed for 6 non-ambulatory residents, one of which may be bedridden. Facility has an approved hospice waiver for 4 residents and the home currently has 6 residents, with 2 on hospice. Administrators Minerva Sansano and Ray Santianez arrived during the visit. Administrator Ray Santianez has an administrator certificate valid until 08/18/2025. LPA Lyman along with Caregiver Raquel Pamintuan toured the facility at 7:36 AM. LPA toured the physical plant, checked food service, first aid kit and reviewed records. Facility appears to be clean, safe, and sanitary. The home consists of six resident bedrooms, 2 common restrooms, one staff room, living room, dining room, and kitchen. Resident bedrooms had the required furniture, bed linens and closet/drawer space to accommodate each resident comfortably. LPA observed five residents with a half bed rails. Resident bathrooms were checked. Toilets and water faucets worked properly, grab bars were secure and shower was free of mold/mildew. Water temperature measured between 106.8 and 107.7 degrees F in all facility bathrooms. Resident bath towels, toiletries and personal hygiene supplies were adequately stocked at time of visit. Common areas were clean and clear of hazards, doorways were free of obstructions. Auditory exit alarms were operational during today's visit. First aid kit had all the elements including thermometer, tweezers and scissors as well as a first aid manual. LPA observed toxins are secured during today's visit. Kitchen was inspected. Perishable and non-perishable food supply was checked and adequately stocked at time of visit. Smoke detectors and Carbon Monoxide detectors are hardwired and tested operational during today's visit. Fire extinguisher is fully charged. Kitchen appliances are operational during today's visit. LPA toured the outside grounds and there is ample shaded seating for residents. Exit gates are unlocked and self latching. LPA observed ample emergency food and water supply. LPA reviewed the emergency disaster plan and infection control plan during the visit. Plans are thorough and complete. Facility provided documentation of last fire drill conducted on 04/24/2024. CONT ON LIC809-C DATED 07/21/2024. Facility provides activities in the form of exercise, games and music. At 8:30 AM, LPA reviewed six resident files and five staff files. Resident files contained required documents including admission agreements, physician reports and resident appraisals. Staff files reviewed contained required documentation of medical clearance/ TB, CPR training and criminal record clearance. Three out of five staff files do not have proof of training in the file. At 9:30 AM, LPA reviewed medication storage and administration. Medications are stored in a locked cabinet. Medications are being administered per physician order. LPA observed facility is pre-pouring medications for 48 hours. Based on the observations made during today's visit, the following violations are being cited per California Code of Regulations, Title 22, Division 6, Chapter 8. An exit interview was conducted and a copy of this report as well as appeal rights were discussed and provided with facility representative.the state’s words, verbatim · CDSS document, Jul 22, 2024