Andrea's Elderly Care Facility 1

Type of visit: POC

Licensing Program Analyst (LPA) Maria (Mita) Partoza, conducted an unannounced Proof of Correction (POC) visit to address the deficiencies that were cited during the annual inspection conducted on January 23, 2026. LPA met with Licensee (LIC) Felina Roque and designated Administrator (DADM) Catherine Valle. During POC visit, LPA verified records and training compliance for the fire, earthquake and disaster drill training. LPA advised ADM to continue to ensure that all records, fire, earthquake and disaster drill training are up to date to ensure the health, safety of persons in care. POC reviewed and cleared the Type A and B deficiencies cited on January 23, 2026, under California Code of Regulation (CCR) Title 22 87412(a) and 87465 (a) and Health and Safety Code (HSC) 1569.695 (c). During today's visit, February 3, 2026, Licensee submitted an application to change the administrator from Jowell Valdez to Catherine Valle. No deficiency cited during today's inspection. An exit interview was conducted with Licensee Felina Roque and Designated Administrator Catherine Valle. end of reportthe state’s words, verbatim · CDSS document, Feb 3, 2026

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Maria (Mita) Partoza conducted an unannounced annual required inspection and met with designated administrator (DADM) Catherine Valle and stated the purpose of the visit. Administrator Jowell Valdez was not available at the time of the visit due to prior commitment and corporate secretary/licensee Felina Roque arrived at the facility at 11:54 a.m. The facility is licensed to serve adults 60 and over; up to 12 may be non-ambulatory. 7 maybe bedridden in bedrooms, 2,3,4,7 8 and 9, and a hospice waiver for 5. LPA observed residents and staff present. Facility has a capacity for 12 and current census is 8. 2 out of 8 residents were at the dining room having breakfast when LPA arrived. 5 out of 8 were in their room, having breakfast, watching TV and 1 out 8 was asleep. 3 staff were present assisting residents. LPA toured the facility, including common areas, resident rooms, kitchen, bathrooms, driveway, and outdoor spaces and storage areas. Indoor temperature was within regulation of 65°F. The kitchen was sanitary and organized; knives and chemicals were locked. Food supply met requirements (2 days perishable, 7 days non-perishable). Kitchen water temperature measured at 113.3°F. Bathroom water temperature ranged from 116.6°F to 118.7°F. Refrigerator & freezer temperature is within regulation range of 40°F and freezer is at 0°F. page 1 of 2 see LIC 809C Bathrooms are equipped with grab bars and non-skid mats; resident rooms have adequate storage. medications were locked and inaccessible to residents; first aid kit was complete. Outdoor areas were free of hazards; laundry appliances were functional, and cleaning supplies were secured. Fire, smoke, and carbon monoxide systems were operational; hallways were clear and well-lit. LPA reviewed 4 resident (R1 to R4) and 3 staff (S1 to S3) records, centrally stored medication and destruction record, admission agreements, care plans, health screenings, and training. Based on record review, 4 out of 4 resident record did not have the current centrally medication and destruction record available for LPA to verify and inspect. 3 Out of 3 staff record review have a fingerprint and criminal background clearance, 2 out of 3 staff have a valid 1st aid/CPR certificate. 1 out of 3 staff record is not available for review at the time of the visit. DADM stated S3 record is being updated and was left at home by DADM, S1 stated he/she has a 1st aid/CPR certificate that is valid, however, it was left at home and no one is able to take a photo for LPA to verify the information. S1 and S2 did not have proof of training at the time of the visit. S2 stated that he/she recently started at the facility on 01/19/2026 and is in the process of being trained. S2 stated that he/she was trained by another facility that he/she works for. S1 & S3 did not have proof of training at the time of the inspection. Based on the facility record review, the facility conducted the disaster, fire and earthquake drill training on 02/10/2025, and have not conducted disaster drill training for each shift since 02/10/2025. The facility is equipped with smoke, carbon monoxide and fire alarm system and 2 fire extinguisher that was inspected on 10/06/2025. Deficiencies were cited during today's visit based on the California Code of Regulations (CCR) Title 22 (See LIC 809D). An exit interview was conducted with licensee Felina Roque and designated administrator (DADM) Catherine Valle and a copy of the report and appeals rights was provided. end of report page 2 of 2the state’s words, verbatim · CDSS document, Jan 23, 2026

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Santino Fortes conducted an unannounced annual inspection, and met with Administrator (ADM) Catherine Valle. ADM stated facility has 3 staff and 9 clients. LPA toured the facility inside and out. There were 8 single resident rooms, 2 shared rooms, 1 staff rooms, 1 living room, and Kitchen. LPA observed resident rooms each equipped with a chair, night stand, sufficient lighting and chest of drawers. Room temperature was 72.6 degrees F. Hot water temperature was measured from resident bathroom at 119.8* F 119.8* F and kitchen 119.5* F. LPA observed the first aid kit to be complete. The facility was equipped with smoke and carbon monoxide detectors, that functioned properly when tested. Fire extinguishers were serviced on 10/1/24. The facility conducted a fire drill on 2/10/25. Restrooms observed to have non skid flooring. LPAs observed perishable food supply of at least two days and non-perishable food supply of at least seven days. Refrigerator temperature was observed at 40* F and Freezer temperature was 0*. LPA observed medication storage, knives storage, and cleaning product storage locked and inaccessible to clients in care. The front and back yards of the facility were inspected. Outdoor exits and walkways were unobstructed. Facility has 1 storage shed, observed storing wheelchairs, unused mattresses, and office supplies. LPA observed Facility License and Resident Personal rights were posted. LPA reviewed facility records for 3 staff, 3 clients and observed to be complete. LPA reviewed 3 client’s medications, centrally stored medication records and observed to be complete. No deficiencies were cited during today's visit as per California Code of Regulations Title 22. Exit interview was conducted with ADM. This report was reviewed and a copy was provided to ADM for signature.the state’s words, verbatim · CDSS document, Feb 27, 2025

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Manuel Monter conducted an unannounced annual inspection visit, and met with Licensee (LN) Felina Roque. During the visit, LPA observed 11 residents and 3 staff. LPA toured the facility inside out with LN which included the Living room, kitchen, dining room, 3 restrooms and 9 residents bedrooms. The staff area of the facility was also inspected. The front yard and backyard were inspected. There was no obstruction to block the walkways. Two-day perishable food supplies and seven day nonperishable food supplies were observed. LPA observed the medication storage area, knives storage area, and cleaning product storage area as locked and inaccessible to residents in care. Room temperature was at 70 degrees F, and hot water temperature was measured at 118 degrees F in resident bathrooms. Fire extinguisher was serviced in October 20, 2023. The facility was equipped with smoke and carbon monoxide detectors. Smoke detectors was tested by LN, and were functional. LPA observed facility first aid kit and requested to review facility fire/earthquake drill log. LN stated the last drill conducted was last month, but LN stated they don't have a log. LPA reviewed facility records for 3 residents. While reviewing residents R1-R3 records, LPA observed R1 and R3 did not have a weight record. Resident R2 is missing two months of weight record documentation. LPA reviewed 3 resident medications and centrally stored medication records. LPA reviewed facility records for 3 staff. LPA conducted interviews with 2 staff (S1 to S2) and 2 residents (R1-R2). Deficiencies are being cited during today's visit, see LIC 809-D. This report was reviewed with Licensee Felina Roque and a copy of the signed report was provided. Appeal Rights were provided.the state’s words, verbatim · CDSS document, Feb 14, 2024