Anza Home Care

Type of visit: Required - 1 Year

On 05/17/2025, the California Department of Social Services (CDSS) – Community Care Licensing Division (CCLD) staff conducted an unannounced Required – 1 Year Inspection to the above-named facility and met with Caregiver, Jesus Marie Quibote. The purpose of the visit was explained and the LPA was allowed entry to the facility. The facility is licensed to operate for (1) non-ambulatory and cleared for (5) bedridden elderly residents ages 60 and above. The facility is approved for (6) hospice residents. The Annual Licensing Fees are current. Facility Layout: The facility is a single-story house located in a main street. It consists of the following: 5 resident bedrooms; 2 common full bathrooms; 1 staff bedroom; 1 great room which consist of a living room area, dining room area, and kitchen area; 1 attached garage with a laundry area; and a backyard outside patio area. Outside Grounds: were toured no bodies of water were observed, walkways around the home were not cleared of hazards (pictures were taken). Kitchen Area/Facility Food: The facility has supplies of nonperishable foods for a minimum of one week and fresh perishable foods for a minimum of two days. Knives and toxins were kept inaccessible to residents in care. There is fire extinguisher near the kitchen and it was last serviced on 03/26/2025. There were food items that were not of good quality (pictures were taken). For example, some food items best by date had passed, freezer burn meats, and spoiled vegetables. The refrigerators/freezers were not clean (pictures were taken). There is a landline telephone in the kitchen. Great Room: There is activity work available to residents, for example puzzles and painting materials. There is no videoconferencing device available to residents. The sliding window door is in disrepair. Resident Bedrooms: 5 out of 5 resident bedrooms were toured. There is adequate lighting, plenty of dresser and closet space observed. Walls and floors were clean and in good condition. Room 1’s exit door is in disrepair. Bathrooms: Toilets, showers, and water faucets worked properly, grab bars were secure, and a non-skid mat was in place. Adequate lighting and toiletries are accessible to residents. The hot water temperature measured 116.4 Fahrenheit. Medications: were inaccessible to residents in care. Garage: is not clear of hazards, there is a pile of items, supplies, and equipment that made it impossible to walk around the garage (pictures were taken). Miscellaneous: Documents are posted as mandated. The Liability Insurance, Infection Control Plan, Emergency Disaster Plan, Emergency Disaster Drills, Plan of Operation, Fire Inspection were not present in the facility to review. 2 staff records were reviewed, 2 out of 2 staff records were incomplete. Staff 1 (S1) did not have a CPR/First Aid Certificate, Health Screening Report, and is not associated with the facility. Staff 2 (S2) did not have a Tuberculosis Test Result. 4 resident records were reviewed, 4 out of 4 resident records did not have current and complete records. Resident 1 (R1) did not have an Admission Agreement and Doctors Order for a Full Bedrail, and incomplete Home Health records and Appraisal. Resident 2 (R2) did not have an Admission Agreement. Resident 3 (R3) had an incomplete Admission Agreement and Home Health records, and did not have a Doctors Order for Half Bedrails. Resident 4 (R4) did not have a Doctors Order for Half Bedrails and an Admission Agreement, and had incomplete Home Health records. Deficiencies are being cited based on observation, interviews conducted, and record review in accordance with the California Code of Regulations, Title 22, see LIC809Ds. A civil penalty is being provided regarding staff association. An exit interview was conducted, Plans of Corrections were reviewed and developed. A copy of this report and appeal rights were discussed and left with the Caregiver, Jesus Marie Quibote.the state’s words, verbatim · CDSS document, May 17, 2026

Type of visit: Required - 1 Year

On 06/09/25 Licensing Program Analyst (LPA) Yolanda Rosser conducted an unannounced visit to the above facility. The purpose of today’s visit was to conduct the one- year inspection. LPA met Administrator, Shalani Ramos and the purpose of the visit was explained. The facility is licensed to serve 1 non- ambulatory residents age 60 and above and fire cleared for 5 bedridden residents and a hospice approved for 6 residents. The facility does not handle any of the residents’ money. This home is a single story home consisting of: (6) resident bedrooms, (1) staff room (2) Full bathroom, living room, kitchen, dining area, laundry room (located in the attached garage) and an outdoor shaded patio area. LPA toured the Resident bedrooms each 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, shower was free of mold/mildew and a non-skid mat was in place, water temperature measured between 111 degrees F. Resident bath towels, toiletries and personal hygiene supplies were adequately stocked. Common areas were clean and clear of hazards; doorways were free of obstructions. Kitchen was checked and observed to be within Title 22 regulations. Perishable and non-perishable food supply was checked. All cleaning solutions, hazardous items, and medications were securely locked and inaccessible to residents. Smoke detectors were working properly and fire extinguisher was fully charged. Carbon monoxide detector was operational. First Aid kit was available. Outside grounds were toured and no bodies of water were observed. Walkways around the home were clear of hazards. There are no security bars or weapons on the premises. Exit interview was conducted and copy of report was provided to Shalani Ramos.the state’s words, verbatim · CDSS document, Jun 9, 2025

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Sparkle Day conducted an unannounced visit to the above facility. The purpose of today’s visit was to conduct the one- year inspection. LPA met with staff Patricia Chanco, caregiver and spoke with Shalani Ramos via phone and the purpose of the visit was discussed. Ms. Ramos indicated that she is the Co-Administrator and is awaiting a new license including her name. The facility is licensed to serve 1 non- ambulatory residents age 60 and above and fire cleared for 5 bedridden residents and a hospice approved for 6 residents. The facility does not handle any of the residents’ money. This home is a single story home consisting of: (6) resident bedrooms, (1) staff room (2) Full bathroom, living room, kitchen, dining area, laundry room (located in the attached garage) and an outdoor shaded patio area. LPA toured the 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, shower was free of mold/mildew and a non-skid mat was in place, water temperature measured between 116.1F. Resident bath towels, toiletries and personal hygiene supplies were adequately stocked. Common areas were clean and clear of hazards; doorways were free of obstructions. Kitchen was checked and observed to be within Title 22 regulations. Perishable and non-perishable food supply was checked. All cleaning solutions, hazardous items, and medications were securely locked and inaccessible to residents. Smoke detectors were working properly and fire extinguisher was fully charged. Carbon monoxide detector was operational. First Aid kit was available. Outside grounds were toured and no bodies of water were observed. Walkways around the home were clear of hazards. There are no security bars or weapons on the premises. Deficiencies cited under California Code of Regulations (Title 22, Division 6, Chapter 8), LPA observed the following deficiencies: -On 4/25/24 at 9:00 AM LPA reviewed resident records and observed that R#2 and R#3 did not have current physician reports. LPA asked Shalani Ramos about the records who indicated they are in the process of getting the physician reports. On 4/24/2024 at 11:00 am LPA toured the backyard and found the ramp surrounding the home in poor condition. The Ramp has weak spots that were unsafe. LPA asked Shalani Ramos about the ramp and she indicated they are in the process of finding someone to replace the ramp. On 4/24/2024 at 11:10 am LPA toured the inside of facility and observed that R#3 has full bed rails and is not a hospice residents. LPA asked Shalani Ramos regarding the rails and she indicated she has a doctors prescription for the rails but it is not in the residents file. An exit interview was conducted and a copy of Report and Appeal Rights provided.the state’s words, verbatim · CDSS document, Apr 25, 2024