Alondra Home

Type of visit: Required - 1 Year

On 01/14/25, Licensing Program Analysts (LPA) M. Yang arrived unannounced to conduct an annual visit. LPA introduce self, stated the purpose of the visit and request to meet with Administrator. LPA met with staff Edison Pascual. Licensee Jethronel Lazaga was called and arrived shortly during visit. LPA toured facility with Licensee. All six residents were present during inspection. Two residents were observed sitting at the dining tablet and four residents observed in their bedroom during inspection. The facility was observed to be at a comfortable temperature, clean, in good repair, and no passageway obstructions or fire hazards were observed inside or outside. Temperature maintained for refrigerator at 37 degrees F and freezer at 0 degrees F. An adequate supply of perishable and non-perishable food was observed. At 09:35AM, a knife observed in the kitchen sink unlocked. Medication cup filled with medication tablets were observed unlock in kitchen drawer. Laundry detergent was observed unlocked in the laundry room. Fire extinguishers were observed with a service date of 01/06/25 throughout the facility. Last fire drill conducted on 11/15/25. All bedrooms were observed to have required furnishings and with adequate lighting. Bathrooms were properly equipped and operational. All bathrooms are observed with securely fastened grab bars and non-skid mats. Hot water tested maintained at 112.1 degree F in bathroom 1 and range at 109.2 and 111.7 degree F in shared bathroom. Outside of facility toured and observed to be free of debris. Adequate outdoor seating observed for residents. Side gate observed self-closing. Medications observed locked in medication cabinet. MARs were reviewed and medications were checked. All residents’ files were reviewed to have all required documents. Carbon monoxide and smoke detectors were tested and observed to be operational. A deficiency and an immediate Civil Penalty was assessed. See Lic 421IM is being cited on the attached Lic 809D in accordance to California Code of Regulations, Title 22, Division 6. Exit Interview conducted. The following documents are requested and submitted to Fresno CCL by: 01/20/25. Forms requested: Lic 308, Lic 500, Lic 610E, and current liability insurance. A copy of this report and appeal rights were provided to the Licensee, whose signature on this form confirms receipt of this report.the state’s words, verbatim · CDSS document, Jan 14, 2026

Allegation investigated: Staff did not ensure adequate supervision was provided resulting in resident sustaining an injury while in care Staff handled resident in a rough manner Staff did not ensure resident was spoken to in an appropriate manner Staff did not ensure resident received medical attention in a timely manner

On 07/01/25, Licensing Program Analyst (LPA) M. Yang arrived unannounced subsequent complaint investigation and deliver findings on the above allegations. LPA introduce self, stated the purpose of the visit, and met with Licensee/ Administrator Jethronel Lazaga. The Department conducted interviews, reviewed records, and toured the facility. Records and interviews confirms two staff were working when alleged staff did not ensure adequate supervision resulting in resident sustaining an injury while in care. Staff provided first aid to R1 when observed with a scratch on resident head. Based on interviews conducted, there was insufficient evidence to prove or disprove that staff did not ensure resident was spoken to in an appropriate manner. Therefore, the preponderance of evidence standard has been met; therefore the above allegations are found to be UNSUBSTANTIATED. Exit Interview conducted. A copy of this report was provided to Licensee. Unsubstantiatedthe state’s words, verbatim · CDSS document, Jul 1, 2025 · control 24-AS-20250613155013

Type of visit: Case Management - Deficiencies

On 07/01/25, Licensing Program Analyst (LPA) M. Yang arrived to conduct an unannounced subsequent complaint investigation and met with Licensee/ Administrator Jethronel Lazaga. During the course of the investigation, LPA toured the facility and reviewed residents’ record. The department observed R1 and R1 laying in bed using a half bed rails on 06/16/25 during a initial complaint visit. Deficiency is being cited on the attached 809D in accordance to California Code of Regulations, Title 22, Division 6. An exit interview was conducted. A copy of this report and appeal rights was provided to Licensee, whose signature on this form confirms receipt of this report.the state’s words, verbatim · CDSS document, Jul 1, 2025

From the deficiency page — Deficiency type: Type B · Section cited: CCR 87608(a)(3) · Plan of correction due date: Jul 7, 2025

87608 (a)(3) A written order from a physician indicating the need for the postural support shall be maintained in the resident’s record. The licensing agency shall be authorized to require other additional documentation if needed to verify the order. This requirement is not met as evidenced by: Based on observation and records reviewed, R1 and R2 uses half bed rail on hospital bed with no doctor’s order, which poses/posed a potential health and safety and personal rights risk to the resident in care.the state’s words, verbatim · CDSS document, Jul 1, 2025

Plan of correction: Licensee shall obtain doctor orders for R1 for full rail if physician indicates the need for full rail. Doctor orders for R4 and R5 indicate the need for half bed rail and if physician do not indicate the need for half bed rail, hail rail must be removed by POC due date 07/07/25.

Type of visit: Required - 1 Year

On 02/13/25, Licensing Program Analysts (LPA) M. Yang arrived unannounced to conduct an annual visit. LPA introduce self, stated the purpose of the visit and request to meet with Administrator. LPA was greeted by staff Juliet Madiclum. LPA toured facility with Staff Eufemia Caridad. Licensee Jethronel Lazaga was called and arrived later during visit. LPA toured facility with Licensee. All six resident were present during inspection. The facility was observed to be at a comfortable temperature, clean, in good repair, and no passageway obstructions or fire hazards were observed inside or outside. Fire extinguisher was observed with a service date of 01/06/25 throughout the facility. Temperature maintained for refrigerator at 37 degrees F and freezer at 0 degrees F. An adequate supply of perishable and non-perishable food was observed. Expired non-perishable food was observed. Knives were observed in kitchen drawer unlock. Cleaning supplies observed unlocked under kitchen sink, in laundry room, in the garage, and in the garage chemical cabinet. All bedrooms were observed to have required furnishings and with adequate lightening. Bathrooms were properly equipped and operational. All bathrooms are observed with securely fastened grab bars and non-skid mat. Chemical bottle and a medication bottle were observed under bathroom sink unlock near room 5. Outside of facility toured and observed to be free of debris. Adequate outdoor seatings observed for residents. Side gate observed self-closing. Medications observed unlocked in medication closet. MARs were reviewed. All residents’ and sample of staff files were reviewed to have all required documents. Carbon monoxide and smoke detectors were tested and observed to be operational. Technical Support Program (TSP) assistance was offered to Licensee. Licensee accepted TSP referral. A deficiency and an immediate Civil Penalty was assessed. See Lic 421BG is being cited on the attached Lic 809D in accordance to California Code of Regulations, Title 22, Division 6. Exit Interview conducted. The following documents are requested and submitted to Fresno CCL by: 02/21/25. Forms requested: Lic 308, Lic 500, Lic 610E, current liability insurance, and current Administrator certificate. A copy of this report and appeal rights were provided to the Licensee, whose signature on this form confirms receipt of this report.the state’s words, verbatim · CDSS document, Feb 13, 2025

Allegation investigated: Uncleared staff providing care to residents

On 05/13/24, Licensing Program Analyst (LPA) M. Yang arrived unannounced to conduct an initial complaint inspection. LPA introduce self, stated the purpose of the visit, and met with Licensee 1 (L1) Jethronel Lazage. Licensee 2 (L2) Cecilia Lazaga arrived shortly. LPA conducted interviews and received copies of records. Facility is licensed as of March 2024. S1 and S2 was at the facility prior to facility being licensed. All staff working at the facility are associated and fingerprinted cleared. Based on LPA record reviewed and interviews which were conducted, the allegation of uncleared staff providing care to residents, the preponderance of evidence standard has not been met, therefore the allegation is found to be UNSUBSTANTIATED. An exit interview was conducted, and a copy of this report was provided to the L1, whose signature confirms received of this report. Unsubstantiatedthe state’s words, verbatim · CDSS document, May 13, 2024 · control 24-AS-20240509161036

Type of visit: Prelicensing

On 03/01/24, Licensing Program Analysts (LPA) M. Yang conducted an announced Pre-licensing / Component III Inspection. LPA introduced self, stated the purpose of the visit and was allowed entry into the facility. LPA met with Licensee 1(L1) Ceilia “Cece” Lazaga and Licensee 2 (L2) Jethronel Lazaga. The facility is a 5 bedroom, and 2 bathroom home and fire clearance were granted for 6 non-Ambulatory for a total capacity of 6. LPA toured the facility with L1 and L2. There are no residents present during this inspection. Facility was free from ground obstructions and odor free. Common areas were observed to have adequate seating and lighting available. Medications will be locked in activity room closet. First aid kit was observed and contained all required items. Kitchen was toured and observed to have dishes, plates, and utensils. Knives will be kept locked in kitchen drawer. Refrigerator temperature maintained at 37 degrees F and freezer maintained at 0 degree F. Adequate non-perishable and perishable food supplies observed. LPA observed an extra supply of bed linens, towels, and personal hygiene products. Bedrooms were observed to have the required furnishing and are ready for occupancy. Hot water temperature ranged between 109.9 to 110.8 degrees F in bathroom 1 and between 109 to 109.9 degrees F in master bathroom. Cleaning supplies and chemicals observed to be locked in garage cabinet and under kitchen sink. A fire extinguisher was observed and had a service date of 11/13/23. Smoke detectors and carbon monoxide were observed to be operational during this inspection. Outside of facility toured. Exits were open and free of obstructions. LPA observed side gate to be self-latching and free debris. Component III was conducted during today's pre-licensing visit. We have found that the applicant has met all pre-licensing requirements. LPA will submit documentation to CAB in Sacramento for final review prior to license being issued.the state’s words, verbatim · CDSS document, Mar 1, 2024

Type of visit: Office

Facility Type: RCFE Application Type: Initial Capacity: 6 Interview Method: Telephone interview On 2/27/2024, applicant/administrator participated in COMP II. Identification of the applicant and administrator was verified through interview questions based on photo ID and other identifying personal information. During COMP II, applicant and administrator confirmed that they have read and understand community care facility licensing laws included in the Health and Safety Codes and the California Code of Regulations Title 22. Signed LIC 809 with copy of photo ID have been obtained. During COMP II, CAB analyst confirmed Applicant/Administrator’s understanding of following areas: 1. Facility operation: License type, client/resident populations, and program 2. Admission Policies 3. Staffing requirements & Training 4. Restrictive/Prohibited Health Conditions 5. General provisions 6. Emergency Preparedness 7. Complaints & Reporting 8. Pre-licensing readinessthe state’s words, verbatim · CDSS document, Feb 27, 2024