Anaverdes Villa

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Melissa Spaeth conducted an unannounced annual visit on 8/01/2025 and was greeted by the Administrator Erwin Estrella and two staff members. LPA stated the purpose of the facility was to conduct an annual inspection. Staff confirmed there are six residents living at the facility. The facility is licensed for six non-ambulatory residents; three of which can be bedridden. The facility has been approved for six hospice residents. LPA and the staff member toured the facility at 10:00 am until 10:50 am. Common Areas – LPA observed the living room contained comfortable seating along with a television. The dining room area contained a dining room table and chairs. Kitchen – LPA observed the kitchen was neat and clean. The knives were securely locked in a kitchen cabinet. The facility contained a two day supply of perishable food and a seven day supply of non-perishable food items. A fire extinguisher is also located in the kitchen. The resident medications along with the first aid kit were locked in a kitchen cabinet. Resident Bedrooms - There are five bedrooms in the home which are furnished with a bed, linens, night stand, chest of drawers and a closet. Hallway Closets – LPA observed two hallway closets. Closet one is used for linens. Closet two was locked and contained hygiene, cleaning solutions and PPE supplies. Continued on 809-C Bathrooms - LPA observed the two bathrooms contained hand soap, paper towels, grab bars, and slip resistant mat. Water Temperature - LPA tested the water temperature at 10:55 am, which was 110 degrees F. Laundry Room – LPA observed the room was locked and contained washer, dryer and laundry detergent. Smoke/Carbon Monoxide Detectors – The detectors were tested at 10:50 am and were operable. Backyard - LPA observed the backyard which has a shaded area with seating. Garage - LPA observed the garage was locked. An additional refrigerator was located in the garage and contained additional food. The emergency water was stored in the garage. There were no safety issues to report. Delayed Egress Devices - LPA observed delayed egress devices on all exit doors and all devices were properly working. LPA reviewed client records at 11:05 am until 11:30 am. LPA reviewed staff records at 11:35 am until 12:00 pm. LPA reviewed the residents’ medications at 12:20 pm until 12:40 pm. There are no deficiencies to report. Exit interview was conducted and a copy of the signed report was sent via email due to technical difficulties.the state’s words, verbatim · CDSS document, Aug 1, 2025

Type of visit: Required - 1 Year

LPA Spaeth conducted an unannounced annual visit on 9/05/2024 and was greeted by the Administrator Erwin Estrella. LPA stated the purpose of the facility was to conduct an annual inspection. Staff confirmed there are four residents living at the facility. The facility is licensed for six non-ambulatory residents; three of which can be bedridden. The facility has been approved for six hospice residents. LPA and the caregiver toured the facility at 10:30 am until 11:00 am. Common Areas – LPA observed the living room contained comfortable seating along with a television. The dining room area contained a dining room table and chairs. Kitchen – LPA observed the kitchen was neat and clean. The knives were securely locked in a kitchen cabinet. The facility contained a two day supply of perishable food and a seven day supply of non-perishable food items. A fire extinguisher is also located in the kitchen. The resident medications along with the first aid kit were locked in a kitchen cabinet. Resident Bedrooms - There are five bedrooms in the home which are furnished with a bed, linens, night stand, chest of drawers and a closet. Hallway Closets – LPA observed two hallway closets. Closet one is used for linens. Closet two was locked and contained hygiene, cleaning solutions and PPE supplies. Bathrooms - LPA observed the two bathrooms contained hand soap, paper towels, grab bars, and slip resistant mat. LPA tested the water temperature at 10:55 am, which was 107.9 degrees F. Continued on 809-C Laundry Room – LPA observed the room was locked and contained washer, dryer and laundry detergent. Smoke/Carbon Monoxide Detectors – The detectors were tested at 11:30 am and were operable. Backyard - LPA observed the backyard which has a shaded area with seating. Garage - LPA observed the garage was locked. An additional refrigerator was located in the garage and contained additional food. The emergency water was stored in the garage. There were no safety issues to report. Delayed Egress Devices - LPA observed delayed egress devices on all exit doors and all devices were properly working. LPA reviewed client records at 11:30 am until 12:00 pm LPA reviewed staff records at 12:00 pm until 12:30 pm. LPA reviewed the residents’ medications at 1:00 pm. There are no deficiencies to report. Exit interview was conducted, appeal rights discussed, and a copy of the signed report was given to the Administrator.the state’s words, verbatim · CDSS document, Sep 5, 2024

Allegation investigated: Staff restrained residents in care.

Licensing Program Analyst Melissa Spaeth (LPA) and Lorena Casillas conducted an unannounced visit and was greeted by the Administrator, Erwin Estrella. LPA Spaeth stated the purpose of the visit was to investigate a complaint investigation regarding the allegation listed above. The Administrator confirmed there are four residents. It is alleged that staff have restrained residents in care. LPA Spaeth and LPA Casillas conducted a tour of the facility at 3:10 to 3:30 pm. LPAs observed a resident was freely walking on their own through the facility. Two residents were waching television in the family room and a resident was resting in their room. LPA's observed there were no restraint devices in each of the residents' rooms. During the tour, LPAs did not observe any health or safey issues. Unsubstantiated LPA Casillas reviewed the residents files at 3:10 pm until 3:30 pm. LPA Spaeth interviewed three of the four residents and two caregivers. Residents 1, 2, and 3 unanimously confirmed they have never been restrained in any way since living in the facility. LPA was unable to interview Resident 4. LPA Spaeth interviewed the two caregivers. S1 and S2 stated they have never restrained a resident while in care. Both staff members also confirmed that the Administrator has never instructed staff to restrain a resident while in care. Based upon LPAs observations and interview of staff and residents, the complaint is unsubstantiated. Exit interview conducted and a copy of the report was given to the Administrator.the state’s words, verbatim · CDSS document, Mar 11, 2024 · control 31-AS-20240311142157

Allegation investigated: Facility staff are stealing from resident. Facility did not provide resident’s POA with proper notice of rate increase.

Licensing Program Analyst (LPA) Abeye Duguma conducted an unannounced subsequent complaint visit to this facility to investigate the above allegations. LPA met with the administrator, Erwin Estrella, and explained the reason for the visit. --- Facility staff are stealing from resident It was alleged that former facility staff stole money from Resident #1 (R1) via ATM card. To investigate the allegation on 02/25/2021, LPA Shira Stamps interviewed other parties. On 11/14/2023, LPA Duguma interviewed two (02) staff from 12:00 PM - 1:00 PM and three (03) out of four (04) residents from 1:00 PM – 2:00 PM. LPA Duguma was unable to interview one (01) out of four (04) residents. During interviews with other parties, they stated that $2,300.00 was stolen from R1 by staff and that upon speaking with the Administrator, the facility explained that the staff was terminated. (CONT. 0n LIC9099-C) Substantiated During interviews with staff, Staff #1 (S1) stated that R1 gave the former staff their ATM card of their own free will and that staff took money out thinking that it was ok because it was out of the kindness of R1’s heart, however, S1 stated that all money was returned to R1 and that the issue was resolved. Staff #2 (S2) was not employed at the time of the incident and is unaware of the allegation and did not know R1. During interviews with residents, all interviewed residents stated that their belongings have never gone missing, or any resources taken from them. Based on interviews, there is enough information to verify the allegation, therefore, the allegation is SUBSTANTIATED at this time. Pursuant to Title 22 Division 6 Chapter 8 of the CA Code of Regulations, the following deficiencies were cited (refer to LIC 9099-D): --- Facility did not provide resident’s POA with proper notice of rate increase. It was alleged that facility did not inform the Authorized Representative of the monthly rate increase. To investigate the allegation on 02/25/2021, LPA Shira Stamps requested documents. On 11/14/2023, LPA Duguma interviewed two (02) staff from 12:00 PM - 1:00 PM. Upon review of R1’s records the Admissions Agreement indicates that R1’s Authorized Representative is their daughter and facility was unable to produce proof that a letter was issued to the representative notifying them of the basic rate adjustment from $3000.00 per month to $3200.00 per month. Furthermore, the Admissions Agreement does not clearly state the average monthly rate increase or average monthly percentage increase. During interviews with staff, Staff #1 (S1) stated that the daughter is not the Authorized Representative and that the resident does not need one as R1 did not have dementia. Staff #2 (S2) was not employed at the time of the incident and is unaware of the allegation and did not know R1. Based on record reviews and interviews, there is enough information to verify the allegation, therefore, the allegation is SUBSTANTIATED at this time. Pursuant to Title 22 Division 6 Chapter 8 of the CA Code of Regulations, the following deficiencies were cited (refer to LIC 9099-D): No other health and safety hazards noted during the visit. Exit interview conducted and a copy of the report was issued. S1 stated that hospice services would clean the scratch, apply ointment and bandage twice a week or more if needed. During interviews with residents, all interviewed residents stated that staff provide timely medical treatment and assistance when needed. Based on interviews, there is not enough information to verify the allegation. Therefore, the allegation is UNSUBSTANTIATED at this time. No other health and safety hazards noted during the visit. Exit interview conducted and a copy of the report was issued.the state’s words, verbatim · CDSS document, Nov 14, 2023 · control 31-AS-20210216115041

From the deficiency page — Deficiency type: Type B · Section cited: CCR 87217(a) · Plan of correction due date: Nov 17, 2023

Safeguards for Resident Cash, Personal Property, and Valuables (a)...if a resident incapable of handling his own cash resources, as documented by the initial... appraisal, is accepted for care,... cash resource shall be safeguarded in accordance with the regulations in this section. This requirement is not met as evidenced by; Based on interviews&record review, Physicians Report shows R1 was incapable of handling cash resources yet facility did not safeguard R1’s cash resources which poses a potential health, safety or personal rights risk to residents in care.the state’s words, verbatim · CDSS document, Nov 14, 2023

Plan of correction: The Licensee will review regulation and submit a written letter certifying that, moving forward, they will ensure to follow and adhere to CCR Title 22 87217 Safeguards for Resident Cash, Personal Property, and Valuables The written letter must be sent to the LPA by the POC due date. Note: Upon learning about the incident, Licensee reconciled by returning the stolen money in full to the resident.

From the deficiency page — Deficiency type: Type B · Section cited: HSC 1569.655(a) · Plan of correction due date: Nov 17, 2023

(a) If a licensee of a residential care facility for the elderly increases the rates of fees for residents or makes increases in any of its rate structures for services, the licensee shall provide no less than 60 days' prior written notice to the residents or the residents' representatives… This requirement is not met as evidenced by; Based on record review and interview the facility did not provide a written notification of the rate increase which is a potential health safety and personal rights risk to resident in care.the state’s words, verbatim · CDSS document, Nov 14, 2023

Plan of correction: The Licensee will review regulation and submit a written letter certifying that, moving forward, they will ensure to follow and adhere to Health & Safety Code 1569.655(a); The written letter must be sent to the LPA by the POC due date.