Above and Beyond Home Care

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Martha Arroyo arrived at the facility unannounced to conduct a required annual visit. Upon arrival, there were two (2) staff and five (5) residents present. The LPA was greeted by the Administrator, Analyn Cervantes and the reason for the visit was explained. During today’s visit, the LPA discussed with administrator the facility's plan of operation. Administrator reported that they have received an email from the Central Application Bureau that the new location is licensed. Administrator reported that they will be relocating within two week. LPA requested that the Administrator notify LPA once all residents have relocated so that a closure visit could be made to finalize closure of this facility. During today's visit LPA observed facility's infection control plan posted. The plan was reviewed. The facility’s policies and procedures as it pertains to infection control are adequate. At approximately 11:40 a.m., the LPA along with the Administrator toured the physical plant areas inside and outside to ensure compliance with Title 22 Regulations. The following was observed: Common Areas: At the time of the visit, furniture in the common areas was observed to be in good condition. The facility maintained a comfortable temperature. The LPA observed the fire extinguisher to be fully charged with a recharge date of 08/11/2026. Required postings were observed throughout the common space. The LPA observed a fireplace adequately covered at the time of the visit. There is a working telephone on premises. (Continue to LIC809C) Bedrooms: There are five (5) bedrooms for resident use. One (1) bedroom is designated as double / shared occupancy, and four (4) bedrooms are designated as private rooms. All resident rooms were observed to be furnished appropriately with linens, appropriate furnishings, and sufficient lighting. The LPA observed a closet with additional clean linens and towels for resident use. Personal hygiene items were observed locked and inaccessible to residents at the time of the visit. No staff bedroom on premises. 24-hour wake staff at all times. Restrooms: There are two (2) restrooms for resident use. Bathrooms were clean and sanitary and in operating condition with grab bars and non-skid surfaces. The bathrooms were sufficiently stocked with supplies and paper towels. The hot water temperature was measured in both bathroom and they measured within the required range of 105 – 120 degrees Fahrenheit (116.2-117). Kitchen: The LPA inspected the kitchen/food service area. Knives and sharps were observed locked and inaccessible in a kitchen drawer. Kitchen appliances were in operable condition. The facility has a sufficient supply of perishable and non-perishable food. Refrigerator and food pantry were checked for proper labels and expiration dates. Garage: The garage was locked and inaccessible to residents at the time of the visit. The LPA observed an adequate amount of emergency food and water. Washer and dryer were observed inside the garage. Detergents and cleaning supplies were observed in a locked cabinet. Backyard: The backyard has a covered patio area with patio furniture for resident use. All passageways were observed to be clear of any obstructions. There is one (1) side gate with latching mechanisms. No bodies of water noted at the time of the visit. No hazards/obstruction observed inside or out. Records: The LPA began record review at approximately 12:30 p.m. Five (5) resident files were reviewed for, but not limited to, the following: signed admission agreements, current medical assessments with TB results, LIC627(c) Consent for Treatment form, and current needs and services plan. All files were complete. (Continue to LIC809C) Four (4) personnel files including the Administrator’s file were reviewed for, but not limited to: personnel records, health assessments, criminal record clearances, first aid/CPR training, and the appropriate yearly training. All files were in order. Medications: Medications review began at approximately 2:15p.m. The medications are centrally stored in a locked cabinet adjacent to the kitchen. All medications including PRNs were labeled, stored, and locked inaccessible to residents in care. Medication appear to be given as prescribed at the time of the visit. Interviews were conducted with one (1) staff and two (2) residents. No concerns reported during today's visit.. Exit interview conducted. Report was reviewed and a copy was provided.the state’s words, verbatim · CDSS document, Aug 11, 2026

Allegation investigated: Licensee moved residents to a unlicensed location

Licensing Program Analyst (LPA) Zabel Chochian conducted a subsequent complaint visit to deliver investigation finding. Upon arrival LPA met with Staff Reynante Cervantes. The reason for the visit was At approximately 11:45A.M., LPA and staff toured the facility and observed five residents at the facility with two staff on duty. Following is the summary of the allegation and investigation finding: On 05/06/2026, Community Care Licensing Division received information regarding the above allegation. On 05/08/2026, LPA Chochian conducted a complaint visit to the facility. LPA and Administrator toured the facility at approximately 5pm. During the tour LPA met with and interviewed all residents. LPA requested copies of records relevant to case. Regarding allegation: “Licensee moved residents to an unlicensed location”: (Continue to Lic9099c) Unfounded Information was received that all residents of this facility were moved to another location (unlicensed). Interview conducted with the reporting party, staff and residents revealed that residents of this facility never moved to another location. Residents denied ever moving to another location. Administrator reported that they never moved any resident to another location. Administrator stated that the licensee is in the process of submitting a relocation application since they have decided not to renew the lease for this property which will end in 11/2026. Administrator stated that the new property is secured and they are currently working on submitting a relocation application for the new location and once approved the residents will then relocate. Residents interviewed confirmed having been notified about the anticipated relocation to another property. Interview with the reporting party revealed that the allegation was not correct and the information provided was that the facility is anticipating on moving resident to another location not that they have been moved. Based on the information obtained, the allegation is deemed UNFOUNDED at this time. A finding of unfounded means that the allegation is either false, could not have happened, and/or is without a reasonable basis. Exit interview conducted. A copy of the report was provided.the state’s words, verbatim · CDSS document, May 17, 2026 · control 29-AS-20260506092313

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Martha Arroyo arrived at the facility unannounced to conduct a required annual visit. Upon arrival, there were two (2) staff and five (5) residents present. The LPA was greeted by the Administrator, Analyn Cervantes and the reason for the visit was explained. Entrance interview conducted. At approximately 9:40 a.m., the LPA along with the Administrator toured the physical plant areas inside and outside to ensure there are no health and safety hazards and facility is in compliance with Title 22 Regulations. The following was observed: Kitchen: The LPA inspected the kitchen/food service area at 09:53 a.m. Knives and sharps were observed locked and inaccessible in a kitchen drawer. Kitchen appliances were in operable condition. The facility has a sufficient supply of perishable and non-perishable food. Refrigerator and food pantry were checked for proper labels and expiration dates. Common Areas: At the time of the visit, furniture in the common areas was observed to be in good condition. The facility maintained a comfortable temperature. The LPA observed the fire extinguisher to be fully charged with a recharge date of 08/11/2025. Required postings were observed throughout the common space. The LPA observed a fireplace adequately covered at the time of the visit. There is a working telephone on premises. No hazards/obstruction observed inside or out. Report Continued on LIC 809C... Report Continued from LIC 809... Restrooms: There are two (2) restrooms for resident use. Bathrooms were clean and sanitary and in operating condition with grab bars and non-skid surfaces. The bathrooms were sufficiently stocked with supplies and paper towels. Starting at 09:48 a.m., the hot water temperature was measured in both bathroom and they measured within the required range of 105 – 120 degrees Fahrenheit. Bedrooms: There are five (5) bedrooms for resident use. One (1) bedroom is designated as double / shared occupancy, and four (4) bedrooms are designated as private rooms. All resident rooms were observed to be furnished appropriately with linens, appropriate furnishings, and sufficient lighting. The LPA observed a closet with additional clean linens and towels for resident use. Personal hygiene items were observed locked and inaccessible to residents at the time of the visit. No staff bedroom on premises. 24-hour wake staff at all times. Garage: The garage was locked and inaccessible to residents at the time of the visit. The LPA observed an adequate amount of emergency food and water. Washer and dryer were observed inside the garage. Detergents and cleaning supplies were observed in a locked cabinet. A second refrigerator was observed with additional food; properly stored. Backyard: The backyard has a covered patio area with patio furniture for resident use. All passageways were observed to be clear of any obstructions. There is one (1) side gate with latching mechanisms. No bodies of water noted at the time of the visit. Records: The LPA began record review at approximately 10:10 a.m. Five (5) resident files were reviewed for, but not limited to, the following: signed admission agreements, current medical assessments with TB results, LIC627(c) Consent for Treatment form, and current needs and services plan. All files were complete. Report Continued on LIC 809C... Report Continued from LIC 809C... Four (4) personnel files including the Administrator’s file were reviewed for, but not limited to: personnel records, health assessments, criminal record clearances, first aid/CPR training, and the appropriate yearly training. All files were in order. The current Administrator’s Certificate is valid until 01/08/2027. During today's visit, the LPA conducted interviews with one staff and one resident. No concerns were noted. Infection Control / Emergency Disaster Planning: During today’s visit, the LPA reviewed the facility's infection control plan. The facility’s policies and procedures as it pertains to infection control are adequate. The LPA also reviewed the facility's emergency disaster plan, which was observed to be complete and recently reviewed/updated. Emergency disaster drills conducted quarterly as per regulation; the last one was conducted on 07/09/2025. Medications: Medications review began at approximately 12:50 p.m. The medications are centrally stored in a locked cabinet adjacent to the kitchen. Refrigerated medications were observed in a locked box inside the second refrigerator inaccessible to residents in care. All medications including PRNs were labeled, stored, and locked inaccessible to residents in care. Medication appear to be given as prescribed at the time of the visit. Exit interview conducted. Report was reviewed and a copy was provided.the state’s words, verbatim · CDSS document, Aug 24, 2025

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Martha Arroyo arrived at the facility unannounced to conduct a required annual visit today. Upon arrival, there were four (4) staff and five (5) residents present. LPA met with the Administrator, Analyn Cervantes and explained the reason for the visit. Entrance interview conducted. The LPA toured the physical plant areas inside and outside to ensure there are no health and safety hazards and facility is in compliance with Title 22 Regulations. The following was observed: KITCHEN: The LPA inspected the kitchen/food service area at 9:51 a.m. Knives and sharps were observed in a locked drawer next to the gas range. Kitchen appliances were in operable condition. The facility has a sufficient supply of perishable and non-perishable food. Refrigerator and food pantry were checked for proper labels and expiration dates. The kitchen faucet was measured for hot water temperature, and it measured 106.7 degrees Fahrenheit at 9:54 a.m. COMMON AREAS: At the time of the visit, furniture in the common areas was observed to be in good condition. The facility maintained a comfortable temperature. At 9:59 a.m., hardwired combination smoke and carbon monoxide detectors were tested, and all were functional at the time of the visit. Two (2) fire extinguishers were observed and fully charged on 08/09/2024. No fire clearance concerns were observed. The LPA observed required postings throughout the common space. Activities were observed in the common areas. LPA observed working auditory alarms at the time of the visit. Report Continued on LIC 809C... Report Continued from LIC 809... RESTROOMS: The two (2) resident restrooms were clean and sanitary and in operating condition with grab bars and non-skid surfaces. The bathrooms were sufficiently stocked with supplies and paper towels. Starting at 9:36 a.m., the water temperature was measured in both bathrooms, and they measured between 105- and 120-degrees Fahrenheit. BEDROOMS: There are four (4) total bedrooms in the facility; two (2) are designated as shared rooms and two (2) are designated as private resident rooms. All resident rooms were observed to be furnished appropriately with linens, appropriate furnishings, and sufficient lighting. LPA observed a closet with additional clean linens, blankets, and towels for resident use. There is a locked closet with resident’s personal hygiene items inaccessible to residents in care. No staff room on premises. GARAGE/BACKYARD: The garage was inaccessible to residents at the time of the visit. Washer and dryer were observed inside the garage. LPA observed a refrigerator with additional food for resident use. Laundry detergent was observed locked and inaccessible. LPA observed an adequate amount of emergency food and water. The backyard has a covered patio area with patio furniture including a table and chairs for resident use. All passageways were observed to be clear of obstructions. LPA observed one (1) self-latching gate. There were no bodies of water noted at the time of the visit. RECORDS: LPA reviewed Resident Records at 10:11 a.m. and Personnel Records at 11:05 a.m. Five (5) resident files were reviewed for, but not limited to, the following: signed admission agreements, current medical assessments with TB results, LIC627(c) Consent for Treatment form, and current needs and services plan. All records were in order. Four (4) personnel files and the current Administrator’s file were reviewed for, but not limited to: personnel records, health assessments, criminal record clearances, first aid/CPR training, and the appropriate training. Staff files were complete. The Administrator’s certificate is active and expires on 01/08/2025. Report Continued on LIC 809C... Report Continued from LIC 809C... INFECTION CONTROL/EMERGENCY DISASTER PLANNING: During today’s visit, the LPA reviewed the facility's infection control practices and the facility's emergency disaster plan. The facility’s policies and procedures as it pertains to infection control are adequate. Emergency disaster plan is updated annually as required. Emergency disaster drills are conducted quarterly, with the last drill conducted on 07/15/2024. MEDICATIONS: Medications review began at approximately 12:55 p.m. The medications are locked in a cabinet adjacent to the kitchen. Medications are labeled and checked for expiration dates. All medications including PRNs were labeled, stored, and locked inaccessible to residents in care. Medications appeared to be given as prescribed at the time of the visit. During today’s visit, LPA conducted interviews with one (1) staff and one (1) resident. LPA also obtained copies of Personnel Report, Resident Roster, Emergency Disaster Plan, and Limited Liability Insurance. No citations issued. Exit interview conducted. A copy of the report was provided.the state’s words, verbatim · CDSS document, Aug 22, 2024

Allegation investigated: Staff locked residents in the bathroom while in care. Staff acted inappropriately with other staff member in the presence of resident in care. Staff are sleeping in vacant resident room and common areas.

Licensing Program Analyst (LPA) Zabel Chochian conducted a subsequent complaint visit to the facility. The purpose of the visit is to conclude an investigation initiated by LPA Martha Arroyo on 09/20/2022. Upon arrival LPA met with staff and explained the reason for the visit. Staff contacted Licensee/Administrator who arrived shortly after LPA. Reason for visit was discussed with Mr. Albert Salunga. On 09/19/2022, Community Care Licensing Division received the above complaint allegations. Investigation into the allegations consist of records review on 09/20/2022, from 1:45-3 p.m. and 10/25/2023; interviews with staff, residents, and other potential witness on 05/14/2023 from approximately 11 a.m. – 2 p.m. and 10/25/2023, from approximately 11:45 a.m. - 2:30 p.m. Additional pertinent records were obtained and reviewed on 10/25/2023. Following is a summary of the allegations and investigation: Allegations) Staff locked resident in the bathroom while in care and staff acted inappropriately with staff member in the presence of the resident in care: (continue to LIC9099c) Unsubstantiated It was reported that on 08/18/2022 at approximately 8:00 a.m., Staff #1 (S1) was providing care in the bathroom to Resident #1 (R1) and when Staff #2 (S2) entered the bathroom and locked the door. It was further reported that S2 made inappropriate comments and touched S1 inappropriately and forced self onto S1. It was also alleged that when S2 locked the bathroom door R1 and S1 could not exit out the bathroom until S2 unlocked the door and left. Per the Personnel Schedule (LIC500) dated 06/01/2023, S1 was on schedule to work from 9 a.m.- 6 p.m. and S2 was on schedule to work the evening shift from 5 p.m. – 7 p.m. on alleged date of incident Thursday, 08/18/2022. However, although S2 was scheduled to be at the facility on the day of the alleged incident, interviews conducted reflected that S2 was not present during the alleged date/time of incident and instead was at an appointment with Staff #3 (S3). Additionally, S2 denied every speaking or making any inappropriate comments to S1. S2 further expressed that whenever S1 needed assistance providing care to residents in the bathroom, S2 would close the bathroom door to ensure residents are accorded privacy. During the course of the investigation, LPA attempted to contact S1 for interview on 5/14/2023 at approximately 11 a.m. , at 3 p.m. and 10 a.m. on 10/25/2023, however was not successful. Interviews conducted with other staff, residents and witnesses reflected that no residents were locked in the bathroom, nor had they ever witnessed any inappropriate comments/behavior by S2. Moreover, LPA obtained and reviewed a copy of the police report from the Simi Valley Police Department. The police report reviewed on 10/25/2023, confirmed that due to conflicting statements coupled with a lack of evidence indicated probable cause was not met to indicate a crime occurred. Based on the above information gathered although the allegations may be valid, there is insufficient evidence to support the allegations or that a violation occurred; therefore, the above allegations “staff locked resident in the bathroom while care” and “staff acted inappropriately with staff member in the presence of the resident in care” is deemed UNSUBSTANTIATED at this time. Allegation) Staff are sleeping in vacant resident room and common areas: It was alleged that staff are sleeping in the vacant room and common areas of the facility. Regarding this allegation staff were interviewed and denied the allegation. S2 stated that when the facility was under “A Loving Care Villa” staff did have a designated room. However, when S2 took over the facility all rooms were cleared for residents; therefore, staff were informed that they no longer stay at the facility. According to S2 the staff who were live- ins prior to the Change of Ownership (CHOW) quit because of that change. (Continue to LIC9099c) Staff schedules obtained on 09/20/2022 and 10/25/2023 revealed 24/7 staff coverage. Staff and residents interviewed indicated staff do not sleep in common areas or in vacant resident rooms. During facility visit on 10/25/2023, LPA observed facility resident rooms to be fully occupied by residents. Based on the above information gathered although the allegations may be valid, there is insufficient evidence to support the allegation or that a violation occurred; therefore, the above allegation “Staff are sleeping in vacant resident room and common areas” is deemed UNSUBSTANTIATED at this time. Exit interview conducted. A copy of the report was provided.the state’s words, verbatim · CDSS document, Oct 31, 2023 · control 29-AS-20220919114801