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Type of visit: POC

Licensing Program Analyst (LPA) Michael Tea made an unannounced visit for the purpose of conducting a Plan of Corrections Inspection for deficiencies issued on 10/24/2025 during the required annual inspection conducted by LPA Tea. LPA was greeted and granted entry by facility staff. Administrator (AD) Marilou Leal arrived shortly to assist with the visit and explained the purpose of the inspection. LPA Tea toured the facility to check the deficiencies that have been corrected with the administrator. LPA checked the stove top burners and they are properly working and light up. LPA inspected the bathroom and observed the broken mirror wall was dismantled and replaced with a new mirror. The wall in the bathroom was repainted. LPA notice the new PUB475 poster in the front entry way. LPA Tea will periodically check up on the facility to ensure compliancy. Based on LPA Tea's observation on today's visit, the Plan of Corrections has been fulfilled by the assigned POC due date, thus clearing the Type B deficiencies CCR 87468(c)(2)(A) and 87303(a). An exit interview was conducted with Administrator Marilou Leal and a copy of this report was provided to the facilitythe state’s words, verbatim · CDSS document, Nov 20, 2025

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Michael Tea conducted an unannounced visit. The purpose of today’s visit was to conduct the Annual Required inspection. LPA Tea was greeted and granted entry into the facility by caregivers and explained the reason for the visit. Administrator (AD) Marilou Leal arrived shortly to assist with the visit. Facility is licensed for four non-ambulatory residents, two ambulatory residents with a hospice waiver for one. Currently there are five residents. LPA Tea reviewed five resident files and three staff files. Resident files and staff files contained all required documentation. Annual staff training is still being completed at the time of visit. AD Leal’s administrator certificate expires on January 30, 2027. LPA Tea along with the Administrator toured the facility. LPA toured the physical plant, checked food service, and the first aid kit. The facility is a single-story home that consists of 5 resident bedrooms, 1 caregiver room, 3 bathrooms, living room, dining room, kitchen, and attached garage. LPA observed smoke detectors/carbon monoxide in common areas and bedrooms are operational. Resident bedrooms had the required furniture, bed linens and closet/drawer space to accommodate each resident comfortably. Resident bathrooms were checked. The glass mirror in the main bathroom has cracks. Toilets and water faucets worked properly, grab bars were secure and shower was free of mold/mildew. Water temperature measured around 118.4 Fahrenheit degrees. Resident bath towels, toiletries and personal hygiene supplies were adequately stocked at time of visit. Common areas were clean and clear of hazards; doorways were free of obstructions. First aid kit had the required elements including dressing, bandages, thermometer, tweezers and scissors. Kitchen was inspected. Perishable and non-perishable food supply was checked and adequately stocked at time of visit. LPA observed sharps are locked and secured in a kitchen cabinet. LPA observed toxin substances (Annual Report continued on LIC809C) locked and inaccessible to clients in the garage. The fire extinguishers in the kitchen are fully charged. Kitchen appliances were mostly operational except one of the gas range burners on the stove did not work. LPA toured the outside grounds and there is ample seating with shade and two exit gates on both sides of the facility are self-latching and operational. There is a barbecue grill used during the summers. LPA observed emergency supplies, food and water in the garage. Facility provides activities based on resident interests. The residents goes for walks around the neighborhood, watch television, listen to music, reading books and newspapers and crafting bracelets and necklaces. They also go on outings, like shopping on Saturdays and church on Sunday and eat lunch together outside. At the time of annual visit, residents were watching television in the living room. LPA reviewed medication storage and administration. Medications are stored in a locked cabinet. Medications are being administered per physician orders. All P&I Funds are accounted for and there are no discrepancies. LPA interviewed residents regarding their quality of care and spoke to staff present regarding care provided. The following deficiencies are being cited per Title 22 Division 6 of the California Code of Regulations. An exit interview was conducted with Administrator Marilou Leal and a copy of these reports were given to the facility along with a copy of the LIC 858; 859;809-D, 9102 and Appeal Rights.the state’s words, verbatim · CDSS document, Oct 24, 2025

The state marks this report as 6 pages; the online copy we transcribed has 5. You can request the full file from the county licensing office.

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Michael Tea conducted an unannounced visit. The purpose of today’s visit was to conduct the Annual Required inspection. LPA Tea was greeted and granted entry into the facility by caregivers Tiburcia Dancel and Manuel Delvo and explained the reason for the visit. Administrator (AD) Marilou Leal arrived shortly to assist with the visit. Facility is licensed for four non-ambulatory residents, two ambulatory residents with a hospice waiver for one. Currently there are five residents. Around 1:29 PM, LPA Tea reviewed five resident files and two staff files. There were discrepancies noted in the review of resident and staff files. AD Leal administrator certificate expires on January 31, 2025. LPA Tea along with the Administrator toured the facility at 2:25 PM. LPA toured the physical plant, checked food service, and the first aid kit. The facility is a single-story home that consists of 5 resident bedrooms, 1 caregiver room, 3 bathrooms, living room, dining room, kitchen, and attached garage. LPA observed smoke detectors/carbon monoxide in common areas and bedrooms and are operational. Resident bedrooms had the required furniture, bed linens and closet/drawer space to accommodate each resident comfortably. Resident bathrooms were checked. Toilets and water faucets worked properly, grab bars were secure and shower was free of mold/mildew. Water temperature measured around 119.6 F degrees. Resident bath towels, toiletries and personal hygiene supplies were adequately stocked at time of visit. Common areas were clean and clear of hazards, doorways were free of obstructions. First aid kit had the required elements including bandages, thermometer, and scissors. The only item missing were the tweezers, which the AD Leal will purchase. Kitchen was inspected. Perishable and non-perishable food supply was checked and adequately stocked at time of visit. LPA observed sharps are supposed to be locked in a kitchen cabinet but was not secured at the time of LPA’s observation during facility tour. Staff immediately locked up the sharps upon LPA’s discovery. LPA also observed toxin substances to be locked and inaccessible to clients in care locked and secured in cabinets in the garage. The fire extinguishers throughout the facility were fully charged. Kitchen appliances are operational during today's visit. Annual Inspection continued on LIC809-C LPA toured the outside grounds and there is ample seating with shade and two exit gates on both sides of the facility are self-latching and operational. There is a barbecue grill used during the summers. LPA observed emergency supplies, food and water in the garage. Facility provides activities based on resident interests. The residents goes for walks around the neighborhood, watch television, listen to music, reading books and newspapers and crafting bracelets and necklaces. They also go on outings, like shopping on Saturdays and church on Sunday and eat lunch together outside. At the time of annual visit, residents were seen crafting, reading newspapers and watching television in the living room. LPA reviewed medication storage and administration. Medications are stored in a locked cabinet. Medications are being administered per physician orders. All P&I Funds are accounted for and there are no discrepancies. LPA interviewed residents regarding their quality of care and spoke to staff present regarding care provided. The following deficiencies are being cited per Title 22 Division 6 of the California Code of Regulations. An exit interview was conducted with Administrator Marilou Leal and a copy of these reports were given to the facility along with a copy of the LIC 858; 859;809-D, 9102 and Appeal Rights.the state’s words, verbatim · CDSS document, Dec 2, 2024

The state marks this report as 6 pages; the online copy we transcribed has 3. You can request the full file from the county licensing office.

Type of visit: POC

Licensing Program Analysts (LPAs) Claudia Gutierrez and William Vanegas made an unannounced visit for the purpose of conducting a Plan of Correction (POC) inspection. LPAs were greeted and granted entry by Staff Manuel Deldo. LPAs met with Staff Tiburica Dancel and explained the purpose of the inspection. LPAs are following up on deficiencies cited on August 2, 2024. Deficiencies 87468.1(a)(3) and 87468.1(a)(16) were cited due to violation of resident’s personal rights. Licensee Marilou Leal indicated personal rights training would be conducted for all facility staff by POC date August 3, 2024. During today’s visit, two of two staff present indicated staff training had yet to be conducted and is scheduled to take place on today’s date at 1 p.m. Based on today’s observations, two deficiencies are being re-cited per Title 22 Division 6 of the California Code of Regulations. An exit interview was conducted and a copy of this report and appeal rights was left at the facility.the state’s words, verbatim · CDSS document, Aug 15, 2024

From the deficiency page — Deficiency type: Type A · Section cited: CCR 87468.1 · Plan of correction due date: Aug 16, 2024

(a) Residents in all residential care facilities for the elderly shall have all of the following personal rights: (3) To be free from punishment, humiliation, intimidation, abuse, or other actions of a punitive nature... This requirement is not met as evidenced by: Based on S1 and Licensee admission, LPA determined that staff threatened client, which poses an immediate safety and personal rights risk to persons in care.the state’s words, verbatim · CDSS document, Aug 15, 2024

Plan of correction: Licensee stated staff training will be conducted regarding resident personal rights and a copy provided to LPA via email by POC.

From the deficiency page — Deficiency type: Type A · Section cited: CCR8768.1(a)(16) · Plan of correction due date: Aug 16, 2024

To receive or reject medical care or other services. This requirement is not met as evidence by: Based on Licensee admission, they did not provided medical care to R1, after they sustained a fall resulting in an injury, which poses an immediate health and safety risk to persons in care.the state’s words, verbatim · CDSS document, Aug 15, 2024

Plan of correction: Licensee immediately called 911, and emergency services arrived to transport R1 to hospital. Licensee stated staff training will be conducted regarding resident personal rights and a copy provided to LPA via email by POC.

Allegation investigated: Staff threatened client

An unannounced Complaint Investigation was conducted on this day by Licensing Program Analyst (LPA) Claudia Gutierrez regarding the allegation mentioned above. LPA met with Licensee Mary Lou and discussed the purpose of the inspection. During the visit, LPA interviewed Resident 1 (R1), Staff 1 (S1), and Licensee. During their interview, R1 stated that Staff 1 (S1) accuses them of staring while S1 is cooking. Per R1, “a few days ago” they were sitting at the dining table in the facility, when S1’s husband suddenly appeared to confront R1 and told them, “You better stop staring at my wife in the kitchen" and threatened R1 with a closed fist. R1 stated they are not familiar with S1’s husband and they do not know him. During their interview, S1 stated they called their husband because R1 was staring at them. S1 stated their husband arrived at the facility and told R1 to stop staring.(Cont. LIC9099-C) Substantiated During their interview, Licensee confirmed they were aware S1 called their husband and S1’s husband had arrived at the facility and told R1, "stop staring at my wife." Per Licensee, they there present at the facility and informed S1 they should not have called their husband. Based on S1 and Licensee admission, LPA determined that staff threatened client. The preponderance of evidence standard has been met; therefore, the above allegation is found to be substantiated. Deficiencies are being cited per Title 22 Division 6 of the California Code of regulations. (See LIC9099-D). An exit interview was conducted and copy of this report, and appeal rights were left at the facility.the state’s words, verbatim · CDSS document, Aug 2, 2024 · control 22-AS-20240726162500

From the deficiency page — Deficiency type: Type A · Section cited: CCR 87468.1 · Plan of correction due date: Aug 3, 2024

(a) Residents in all residential care facilities for the elderly shall have all of the following personal rights: (3) To be free from punishment, humiliation, intimidation, abuse, or other actions of a punitive nature... This requirement is not met as evidenced by: Based on S1 and Licensee admission, LPA determined that staff threatened client, which poses an immediate safety and personal rights risk to persons in care.the state’s words, verbatim · CDSS document, Aug 2, 2024

Plan of correction: Licensee stated they will conduct staff training regarding resident personal rights immediately and a copy provided to LPA via email by POC.

Type of visit: Case Management - Deficiencies

Licensing Program Analyst (LPA) Claudia Gutierrez conducted an unannounced Case Management inspection in conjunction with investigation into complaint number 22-AS-20240726162500. LPA met with Licensee Mary Lou Leal and explained the purpose of the inspection. During the course of the investigation, deficiencies were observed. During interviews, Resident 1 (R1) stated they fell yesterday in the front courtyard. Per R1, they requested staff help them carry two bags, but staff declined, and as they attempted to walk out the front door of the facility with the two bags, they fell. LPA observed R1 had a swollen thumb with discoloration and had a leg boot brace. R1 provided LPA with pictures of their knee with blood, and blood running down their leg. Per R1, Licensee stated she would take them to the emergency room but stated she did not have time yesterday. During their interview, Licensee confirmed R1 had fallen yesterday and sustained the injury on their thumb and knee. LPA inquired why medical attention was not sought, and Licensee stated she did not have time to take R1 yesterday and would not have time to take them today. Based on observations made during this inspection, deficiencies are being cited per Title 22 Division 6 of the California Code of Regulations. Immediate civil penalty is also being assessed. See the attached LIC421IM. An exit interview was conducted, and a copy of this report and appeal rights was left at the facility.the state’s words, verbatim · CDSS document, Aug 2, 2024

From the deficiency page — Deficiency type: Type A · Section cited: CCR 87468.1 · Plan of correction due date: Aug 3, 2024

(a) Residents in all residential care facilities for the elderly shall have all of the following personal rights: (16) To receive or reject medical care or other services. This requirement is not met as evidence by: Based on Licensee admission, they did not provided medical care to R1, after they sustained a fall resulting in an injury, which poses an immediate health and safety risk to persons in care.the state’s words, verbatim · CDSS document, Aug 2, 2024

Plan of correction: Licensee immediately called 911, and emergency services arrived to transport R1 to hospital. Licensee stated they will conduct staff training regarding resident personal rights immediately and a copy provided to LPA via email by POC.