Ava Bella Care Home

Type of visit: Required - 1 Year

On 01/29/2026 at 12:00PM, Licensing Program Analyst (LPA) Andrew Christy arrived unannounced to conduct the 1-Year Annual Required inspection. LPA met with Administrator, Nicole Morales, and explained the purpose of the visit. The facility is currently at capacity with a max of six (6) residents.. LPA toured facility including but not limited to bedrooms, bathrooms, kitchen, common area and backyard. All outdoor and indoor passageways are kept free of obstruction. No bodies of water were observed. A comfortable indoor temperature is maintained at 71.0 degrees Fahrenheit. The hot water temperature in the residents’ shared bathroom was measured at 119.8 degrees Fahrenheit. LPA observed lighting in all rooms are adequate for the comfort and safety of the residents. Residents’ bathrooms are equipped with grab bars and non-skid mats. There is a minimum of one week supply of non-perishable and 2 day of perishable foods. Smoke detectors and carbon monoxide detectors were in operating condition during visit. Fire extinguisher was last serviced on 09/10/2025. At 1:30PM, LPA reviewed five (5) resident files and five (5) staff files. The emergency disaster plan was last reviewed 01/29/2026. Quarterly emergency drills were last conducted 01/28/2026. A review of resident medications and the Medication Administration Record (MAR) found no outstanding errors. Continued on LIC809C..... Continued from LIC809..... The following deficiencies were cited during the inspection: At 12:15PM, LPA noticed knives inn the kitchen not locked in the proper drawer. At 12:30PM, LPA saw scissors in an unlocked drawer in the living room. At 12:20PM, LPA noticed chemicals in an unlocked cabinet in the kitchen. at 1:45PM, during file review, it was found no staff were currently CPR/1st Aid certified. Deficiencies are cited per Title 22 California Code of Regulations and listed on LIC809D. Failure to submit proof of corrections (POC) by plan of correction due date and/or any repeat deficiencies within a 12-month period may result in civil penalties. Exit interview conducted. A copy of this report, along with Appeal Rights, was made available to the administrator.the state’s words, verbatim · CDSS document, Jan 29, 2026

Type of visit: Case Management - Annual Continuation

On 12/12/24 at 8:50AM, Licensing Program Analyst (LPA) K. Nguyen arrived unannounced to conduct an continuation of an annual required inspection upon arrival LPA met with Administrator Josephine Santos (Administrator certificate #6063810740 exp 6/23/26), and explained the purpose of the visit. LPA reviewed 5 resident files and 3 staff files. LPA interviewed 2 residents and 2 staff. The following deficiencies were observed: · medicine unlocked inside the small cabinet on the table- Cleared but Repeated Violation from 1/27/24. · Cleaning supplies/ detergent left unlocked under shared resident bathroom and common bathroom- Cleared. · Knives left unlocked in on the kitchen counter- Cleared. The deficiencies were observed (see LIC809D) and cited from the California Code of Regulation, Failure to submit proof of corrections (POC) by plan of correction due date and/or any repeat deficiencies within a 12-month period may result in civil penalties. *An immediate $250.00 civil penalty will be assessed on today's date for reported violation within 12month. * Exit interview conducted. A copy of the LIC421FC, this report and appeal rights provided.the state’s words, verbatim · CDSS document, Dec 12, 2024

Type of visit: Required - 1 Year

On this day at around 1:30 pm, Licensing Program Analyst (LPA) K. Nguyen arrived unannounced to conduct an annual required inspection upon arrival LPA was greeted by care staff, Armand Devera. LPA spoke with Administrator Josephine Santos (Administrator certificate #6063810740 exp 6/23/26). Josephine was not available during inspection LPA explained to Josephine the purpose of the visit. Josephine gave verbal permission for care staff Armand to sign the report. During the visit, LPA inspected the facility inside and out including but not limited to resident bedrooms, bathrooms, kitchen, dining area, garage and backyard. There was sufficient supply of perishable and non perishable foods. The facility room temperature was observed set at 72 Fahrenheit. There was sufficient supply of linen, warm blankets, sheets and towels available for use of the residents. A fire extinguisher that appeared full and was last serviced on 8/21/2024 was observed. The facility has a first aid kit that appeared complete. The last fire drill was conducted on 10/30/2024. Due to insufficient time LPA will continue this annual inspection at a later time. Exit interview is conducted and a copy of this report is provided.the state’s words, verbatim · CDSS document, Dec 11, 2024

Allegation investigated: Staff does not ensure facility is free of mal odors Staff speak inappropriately to resident in care

On 9/9/24 Licensing Program Analyst (LPA) K. Nguyen arrived unannounced to conduct a complaint investigation for the above allegation starting at 10:50am. LPA met with Administrator (ADM), Nicole Morals and explain the purpose of the visit. Allegation: Staff does not ensure facility is free of mal odors: Unsubstantiated During visit LPA interviewed 4 residents and attempted to interview 2 other residents, and three care staff. LPA took a tour of the facility including but not limited to living room, kitchen, bathroom, and dining area. LPA tour R1, R2, R3, R4, R5, and R6 room. LPA observed all 6 residents’ room do not have an odor smell. LPA observed the facility do not have an odor smell. Report continued on LIC 9099C... Unsubstantiated Allegation: Staff speak inappropriately to resident in care: Unsubstantiated LPA interviewed 4 out of 6 residents all stated that staff are nice and treat them with respect. When interviewed 4 residents they stated that they have not heard nor witness any staffs yelled or disrespect any residents. LPA interviewed R4 family member that comes daily if R4 family member have heard or witness any staff yelled/speak rudely to any residents R4 family member stated “no, all staff here are nice”. LPA interviewed 3 staff all stated that they do not yell at any residents nor witness any of the staff yelled or being disrespectful to any of the residents. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur, therefore the allegation is UNSUBSTANTIATED. Exit interview conducted and a copy of this report provided via email.the state’s words, verbatim · CDSS document, Sep 9, 2024 · control 15-AS-20240830154823

Type of visit: Case Management - Other

LPA conducted an unannounced case management regrading the the update physician report for R1. LPA meet with Administrator (ADM), Nicole Morales and explained the purpose of the visit. ADM explained to LPA there are some complication of R1 primary doctor, which R1 case manger is aware and is trying to schedule for R1 to see another doctor. ADM will notify LPA sometime next week of the process of getting R1 physician report. LPA explained to ADM when calling 911 for R1 regrading R1 condition. When calling 911 for R1 all staff must know the term (bariatric) in order for the emergency crew to be prepared. ADM agreed and understood. ADM confirmed with Joe fire department of the POC of the back gate from 9/9/24 to 9/18/24. No deficiency issue on today date. Exit interview is conducted a report is provided.the state’s words, verbatim · CDSS document, Sep 9, 2024

Type of visit: Case Management - Other

On 8/19/24 at 9:15am LPA K. Nguyen arrived unannounced to conduct a case management in regrades of a resident health and safety by the fire department. LPA spoke with Administrator (AD), Josephine Santos regrading the purpose of the visit. AD was not able to be present due to being out of state. AD asked LPA to discuss the issue with Co-Administrator Nicole Morales who is covering for AD while AD not available. LPA meet with fire code compliance officer, Joe Villarreal during facility visit. There are recommendation that Joe advice's the facility need to do in order to be compliance with the fire clearance. Facility needs to complete and turn in by in order for the facility to be compliance with fire code: -Living room door need to be fix by 8/19/24. -Fire extinguisher with a current tag by 8/23/24. -All Room need to be labeling including residents, staff, and bathroom by 8/23/24 - Back gates need to be at least 39 inches wild for wheelchair accessible by 9/9/24 Report continue on LIC 809c... LPA require documents including but not limited to: -R1 update Physician report by 9/3/24 -R1 update needs and services plan in detail 8/23/24 -Facility needs to show proof AD that R1 can exit the back gate in case of emergency (wheelchair or walker) -Administrator needs to review reporting requirements in title 22 and submit to CCLD a self certified statement stating that AD understand the regulation by 9/9/24. Exit interview is conducted and a copy of this report is provided.the state’s words, verbatim · CDSS document, Aug 19, 2024

Type of visit: Required - 1 Year

On this day at around 9:40 am, Licensing Program Analyst (LPA) Luisa Fontanilla arrived unannounced to conduct an annual required inspection and met with Administrator Nicole Morales (Administrator certificate #6063810740 exp 8/25/24). LPA explained to Nicole the purpose of the visit. During the visit, LPA inspected the facility inside and out including but not limited to resident bedrooms, bathrooms, kitchen, dining area, garage and backyard. There was sufficient supply of perishable and non perishable foods. The facility room temperature was observed set at 72 Fahrenheit. Hot water temperature measured at 107 Fahrenheit. There was sufficient supply of linen, warm blankets, sheets and towels available for use of the residents. A fire extinguisher that appeared full and was last serviced on 3/15/2023 was observed. The facility has a first aid kit that appeared complete. The last fire drill was conducted on 12/27/2023. At 10:35am, LPA reviewed 5 resident files and 4 staff files. At 1:50 pm, LPA interviewed 2 residents and 2 staff. The following deficiencies were observed: 5 bottles of medicine unlocked on the table ripped screen door, unused bed/wheelchair, recycles and other things in the backyard No approved exception for R2 no proof of staff training for R2 Deficiencies are cited per Title 22 California Code of Regulations (refer to Lic 809D). Exit interview was conducted and Appeal Rights was provided.the state’s words, verbatim · CDSS document, Jan 27, 2024