Amariah Home Care

Type of visit: Annual/Random

Licensing Program Analyst (LPA) Marisela Garcia-Centeno conducted an unannounced visit to conduct a Required Annual Inspection. The facility file was reviewed prior to the visit. LPA was welcomed by Caregiver, Mary Phets, to whom LPA identified herself to, and discussed the purpose of the visit. During the visit, LPA conducted a quick tour, met staff and the residents in care. LPA introduced herself as their new LPA for the faculty. The required annual inspection was conducted on February 2, 2026. LPA reviewed the POCs due on March 2, 2026 with staff. An exit interview was conducted with Caregiver ,Mary Phets to whom a copy of this report, and the Licensee/Appeal Rights (LIC9058 03/22) were provided during today’s visit.the state’s words, verbatim · CDSS document, Feb 12, 2026

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Dang Nguyen conducted an unannounced visit to conduct a Required Annual Inspection. The facility file was reviewed prior to the visit. LPA was welcomed by, identified himself to, and discussed the purpose of the visit with Licensee/Administrator Joseph P. Alvela. According to the facility’s license: The facility has a maximum capacity of six (6) residents, of whom all may be ambulatory or non-ambulatory. Up to one (1) resident may be bedridden, if they in Bedroom #3. Up to six (6) residents may be under hospice care at a time. Per LPA observation, LIC602 Physician’s Reports, and staff interviews: During today’s inspection, there were a total of six (6) residents in care, of whom all were non-ambulatory. One (1) of the residents was also under hospice care. The facility was clean, sanitary, and in good repair. Pathways were free of obstruction and slip hazards. Resident bedrooms contained the required furnishings. Doors, windows and screens, toilets, and showers were working. Extra linens and hygiene supplies were present. The facility had sufficient space and equipment to facilitate dining, laundry, visitation, meetings, and resident activities. The facility’s ambient internal temperature was complaint at 72 F. Hot water temperature at taps normally accessible to residents were compliant in temperature. Refrigerators and freezers used to preserve perishable foods and medication were complaint in temperature. There were at least (2) days of perishable food and at least seven (7) days of non-perishable food present, all safely stored. Cooking/dining equipment and utensils were present and in good condition. [CONTINUED ON LIC 809-C, 1 of 2] [CONTINUED FROM LIC 809] The facility did not have a swimming pool (or similar body of water). The fireplace was screened, as required. There were no open-faced heaters, toxic chemicals/poisons, or other hazardous objects accessible to clients. Smoke detectors, carbon monoxide detector, emergency lighting, night lights, and facility telephone were all working. The facility’s license did not include endorsements for delayed-egress doors or secured perimeter, and neither of these were present. There was a locked area for storage of medication. Confidential records were stored in secure areas. Required licensing postings were observed in visible areas of the facility. Per the Licensee, no firearms or ammunition were kept at the facility. Licensee presented proof of current business liability insurance. During a review of resident records, LPA observed, and manager interview confirmed: Licensee did not within the last twelve (12) months hold a meeting/conference with the responsible person and other appropriate parties for four (4) of six (6) residents [Resident #1 (R1) through Resident #4 (R4)], for the purpose of reviewing and updating the resident’s written record of care / care plan, as was required. [See LIC811 Confidential Names List for a description of select person identifiers used in this report.] For two (2) of six (6) residents [R2 and Resident #5 (R5)], Licensee did not have documentation in the resident’s record of an annual routine visit with the resident’s licensed medical professional within the last twelve (12) months, as was required. Two (2) of six (6) residents had Restricted Health Conditions (as defined in CCR 87614) for which they required some caregiver monitoring and/or assistance: R3 and R4 were both diabetic, using both glucometer-testing and Insulin flex-pen administration. While care staff displayed some skill/knowledge on how to care for diabetes, Licensee did not arrange for (and document) that a licensed medical professional (such as a nurse) provided the facility’s caregivers “hands-on instruction in both general procedures and resident-specific procedures,” as was required. Additionally, R1 was under hospice care, but Licensee did not arrange for (and document) that hospice agency personnel (such as the resident’s assigned hospice case manager nurse) provided “training specific to the current and ongoing needs of the individual resident receiving hospice care,” prior to the start of hospice care at the facility for R1, as was required. [CONTINUED FROM LIC 809-C, 2 of 2] [CONTINUED FROM LIC 809-C, 1 of 2] During a review of personnel records, LPA observed, and manager interview confirmed: Three (3) of three (3) direct care staff [Staff #1 (S1), Staff #2 (S2), and Staff #3 (S3)] did not complete the minimum twenty (20) hours of continuing training within the last twelve (12) months, as required. [Regulation requires twenty (20) hours per direct care staff, of which at least eight (8) hours must be on Dementia care, and at least four (4) hours must be related to postural supports, restricted health conditions, and hospice care.] Additionally, two (2) of three (3) direct care staff who pass medications (S1 and S3) did not complete eight hours of in-service training on medication-related issues in the last twelve (12) months, as required. Four (4) deficiencies were cited per California Code of Regulations, Title 22, and two (2) deficiencies were cited per California Health and Safety Code (see the attached LIC809-D pages). Plans of Correction were jointly formed with the Licensee. An exit interview was conducted with Licensee/Administrator Joseph P. Alvela, to whom a copy of this report, the LIC809-D pages, the LIC811 Confidential Names List, and the Licensee/Appeal Rights (LIC9058 03/22) were provided during today’s visit.the state’s words, verbatim · CDSS document, Feb 2, 2026

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Dang Nguyen conducted an unannounced visit to conduct a Required Annual Inspection. The facility file was reviewed prior to the visit. LPA was welcomed by, identified himself to, and discussed the purpose of the visit with Caregiver Mary Phets. LPA then met with Licensee and Administrator Joseph Alvela, who arrived later during the visit. According to the facility’s license, the facility has a maximum capacity of six (6) residents, of whom all may be ambulatory or non-ambulatory, and one (1) may be bedridden (in Bedroom #3 only). According to LIC602 Physician’s Reports, staff interviews, and LPA observation: During this annual inspection, there were a total of five (5) residents in care [Resident #1 (R1), Resident #2 (R2), Resident #3 (R3), Resident #4 (R4), Resident #5 (R5)], of whom all were non-ambulatory, per their respective doctors. [See LIC811 Confidential Names list pages for a description of select person identifiers used in this report.] The facility’s license did not include endorsements for delayed-egress doors or secured perimeter, and neither of these were present. During this inspection, LPA interviewed all residents and multiple staff. LPA reviewed the care records for all residents and the personnel and training files for all current staff. LPA also toured the interior and exterior of the facility and inspected all common areas and bedrooms. The facility was clean, sanitary, and in good repair. Pathways were free of obstruction and slip hazards. Resident bedrooms contained the required furnishings. Doors, windows and screens, toilets, and showers were working. Extra linens and hygiene supplies were present. The facility had sufficient space and equipment to facilitate dining, laundry, visitation, meetings, and resident activities. [CONTINUED ON LIC 809-C, 1 of 2] [CONTINUED FROM LIC 809] The facility’s ambient internal temperature was complaint at 79 F. Hot water at taps accessible to residents were also compliant in temperature: Kitchen Sink was 108.5 F, Bathroom #1 Sink was 107.2 F, and Bathroom #2 Sink was 108.1 F. The facility’s refrigerators and freezers, which were used to preserve perishable foods, were also all compliant in temperature. There were at least (2) days of perishable food and at least seven (7) days non-perishable food present, all safely stored. Cooking/dining equipment and utensils were present. No pools or bodies of water observed on the premises. The facility's fireplace was screened. There were no open-faced heaters accessible to residents. Smoke detectors, carbon monoxide detector, emergency lighting, night lights, and facility telephone were all working. Confidential records were stored in locked areas. Required licensing postings were observed in visible areas of the facility. Per the Licensee, no firearms or ammunition were kept at the facility. Licensee presented proof of current business liability insurance. According to their respective LIC602 Physician’s Reports: R1, R2, and R3 were diagnosed with Dementia, while R4 and R5 were diagnosed with Mild Cognitive Impairment (MCI). Even so, R4 was determined by their doctor to be at risk if “allowed direct access to personal grooming and hygiene items.” Per the doctors, none of R1 through R5 could safely store their own prescription medications. Interviews of facility staff showed all residents required staff assistance with storing and taking their medications. Also, per their doctors, none of R1 through R5 would be safe if they left the facility unassisted. During today’s visit, LPA observed a non-locking drawer in the facility’s kitchen, which contained four (4) bottles of prescription laxative medications and one (1) bottle of cough medicine, all belonging to residents. LPA was able to take out these bottles with staff noticing. [LPA subsequently directed staff to relocate the medicine bottles to a different cabinet that was able to be locked.] Left out in the kitchen was one (1) unattended bottle of dishwashing soap; this needed to be locked when not in active use by staff because of what R4’s doctor wrote about them on their LIC602 (see above). Also, inside the shower of one the facility’s two shared bathrooms was one (1) unattended spray bottle containing a cleaning chemical; this toxin needed to be secured from all residents. LPA was able to take and manipulate these bottles without staff noticing. [LPA subsequently directed staff to relocate these bottles to locked cabinets.] [CONTINUED ON LIC 809-C, 2 of 2] [CONTINUED FROM LIC 809-C, 1 of 2] Licensee had previously installed auditory door chime devices (i.e., “staff alert devices”) on each of its exterior exit doors, as required when caring for persons diagnosed with Dementia. However, during today’s visit, LPA observed that facility staff had manually switched the devices “Off,” rendering them inoperable on six (6) of eight (8) exterior exit doors. [LPA manually switched these devices back to the “On” position and verified they were working.] During review of client records, LPA observed, and manager interview confirmed: Licensee did not maintain current Primary Care Physician (PCP) name, address, and contact information for R2, R3, and R4. Licensee also did not maintain current designated Dentist name, address, and contact information for R1 through R5. Also, Licensee did not maintain a record of body weights for R1 through R5. (Regulation required Licensee to “regularly observe” clients for changes in physical condition, to include “unusual weight gains or losses.”) During review of personnel/training records, LPA observed, and manager interview confirmed: Licensee did not have proof that S1 through S3 had received training on Personal Protective Equipment (PPE) within the last year, as was required. Licensee also did not have proof of completion of disaster drills within the last calendar year. (Regulation required Licensee to drill each shift at least once per quarter). Six (6) deficiencies were cited per California Code of Regulations, Title 22, and one (1) deficiency was cited per California Health and Safety Code (refer to the LIC 809-D pages). Plans of Correction were jointly developed with the Licensee. LPA also issued Technical Assistance (TA) regarding refresher training for staff on California Mandated Reporting requirements (refer to the LIC9102-TA page). An exit interview was conducted with Licensee and Administrator Joseph Alvela, to whom a copy of this report, the LIC 809-D pages, the LIC9102-TA page, the LIC811 Confidential Names List, and the Licensee/Appeal Rights (LIC9058 03/22) were provided during today's visit.the state’s words, verbatim · CDSS document, Feb 24, 2025

Allegation investigated: Licensee unlawfully initiated a resident eviction.

Licensing Program Analyst (LPA) Dang Nguyen conducted an unannounced visit to investigate the above complaint allegation. LPA was welcomed by, identified himself to, and discussed the purpose of the visit with Caregiver Mary Phets. LPA also spoke via phone with Licensee Joseph Alvela during today’s visit. It was alleged that Licensee unlawfully initiated an eviction action against Resident #1 (R1). [See LIC811 Confidential Names List for a description of R1.] CCLD’s investigation involved an unannounced facility tour / welfare check, a review of facility records and electronic correspondence, and interviews pertinent facility staff and outside sources. [CONTINUED ON LIC 9099-C] Substantiated [CONTINUED FROM LIC 9099] On 02/26/2024, Licensee sent a cell phone text message R1 and their responsible person (RP). [R1 and their RP were not served a written letter.] In this text message, which CCLD obtained, Licensee wrote that R1 had experienced “mobility changes” and that they required “2 person assist for all activities [of daily living].” Licensee further wrote that R1 needed to move out by “the end of March or until you find a suitable place in or close to that date.” Licensee’s text message did not contain the elements, disclosures, and supporting documents which are required during eviction action. Written notice of the planned action was not provided to CCLD, as was required. Interviews of Licensee, facility line staff, and outside sources, which were supported by care records, showed: R1 moved into the facility around two years ago. Since the time R1 moved in, to the present time, R1 has continuously relied on a wheelchair for mobility and required a hoyer-lift machine to transfer from bed to wheelchair, and vice versa. Per the Licensee, they did not conduct a recent reappraisal of R1’s care needs. They confirmed to LPA that R1’s inherent mobility and transferring abilities have not recently changed; rather, the overall caregiver staffing pool at the facility has diminished, making caring for R1 more challenging. Based on interviews and records, a preponderance of evidence exists to show that Licensee’s unlawfully initiated an eviction action against R1. The allegation is therefore substantiated. One (1) deficiency was cited per California Code of Regulations, Title 22 (refer to the attached LIC 9099-D). A Plan of Correction was jointly developed with the Licensee. An exit interview was conducted with Alvela, to whom a copy of this report, the LIC 9099-D, the LIC811 Confidential Names List, and the Licensee/Appeal Rights (LIC9058 03/22) were provided.the state’s words, verbatim · CDSS document, Mar 11, 2024 · control 08-AS-20240307134151

From the deficiency page — Deficiency type: Type B · Section cited: CCR 87224(a)(4) · Plan of correction due date: Mar 15, 2024

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… (4) If, after admission, it is determined that the resident has a need not previously identified and a reappraisal has been conducted pursuant to Section 87463, and the licensee and the person who performs the reappraisal believe that the facility is not appropriate for the resident.” This requirement was not met, as evidenced by: Based on records and interviews, Licensee initiated eviction proceedings against 1 of 5 residents (R1) on the basis of a need not previously identified, without performing a reappraisal pursuant to Section 87463 and providing a thirty (30) days written notice letter to the resident. This posed a potential personal rights risk to persons in care.the state’s words, verbatim · CDSS document, Mar 11, 2024

Plan of correction: During today’s visit, LPA provided Licensee with the full text of Regulation 87224 Eviction Procedures. Licensee agreed to notify R1 and their responsible person (via a letter) that due to the current staffing challenges at the facility, “voluntary relocation” of R1 is recommended as soon as possible, but there is no deadline set. Licensee agreed to arrange for at least two (2) staff to be present inside the facility during the typical hours when R1 needs to be transferred via hoyer lift in connection with their dialysis appointments (i.e., early mornings and early afternoons, every Monday, Wednesday, and Friday), hiring contracted caregivers from outside licensed home care organizations if needed. Licensee agreed to E-mail a copy of the letter and an updated LIC500 Personnel Report (to evidence the increased staffing) to LPA, by the POC due date.

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Liliana Silveira conducted an unannounced Required Annual Inspection. The facility file was reviewed prior to the visit. LPA was welcomed by, identified themselves to, and discussed the purpose of the visit with Caregiver Mary Phetsanghane. Administrator Joseph Alvela Jr. arrived shortly after. According to the facility’s license, the facility has a maximum capacity of six non-ambulatory residents, age 60 and over, 1 of which may be bedridden. The facility has a hospice waiver for 6. During today’s inspection, there were a total of 5 residents in care, and per medical records, all are non-ambulatory. This facility does not feature a secured perimeter or delayed egress doors. LPA, accompanied by the Administrator, toured the interior and exterior of the facility, and inspected each room. The facility was clean, sanitary, and in good repair. Pathways were free of obstruction and slip hazards. Client bedrooms contained the required furnishings. Doors, windows and screens, toilets, and showers were in working order. Extra linens and hygiene supplies were present, as well as Personal Protective Equipment. The facility had sufficient space and equipment to facilitate dining, laundry, visitation, meetings, and client activities. The facility’s ambient internal temperature was 74 F. Hot water temperature at taps accessible to clients were all compliant: Bathroom #1 sink was 114.9 F, Bathroom #2 sink was 115.8 F and Bathroom #3 sink, which had two sinks, were 112 F and 110.7 F. No pools or bodies of water were observed on the premises. Per Administrator Joseph Alvela Jr., no firearms or ammunition are kept at the facility. Smoke alarms, carbon monoxide detectors, emergency lighting, and facility telephone were all working. [CONTINUED ON LIC 809-C] [CONTINUED FROM LIC 809] First aid kit(s) were complete and readily accessible. Required licensing postings were observed in visible areas of the facility. LPA interviewed staff and residents. LPA reviewed staff and resident records/files. The interviews did not raise any significant licensing concerns. The reviewed files contained required documents. Confidential records were stored in locked areas. The Administrator also presented proof of current/active business liability insurance. No deficiencies were observed or cited during today's annual inspection. An exit interview was conducted with Joseph Alvela Jr, to whom a copy of this report and the Licensee/Appeal Rights (LIC9058 03/22) were provided during the visit.the state’s words, verbatim · CDSS document, Feb 8, 2024