Avalon Palm Care, Inc. DBA Avalon Palm

Type of visit: Case Management - Annual Continuation

Licensing Program Analyst (LPA) Jose De La Cruz conducted an unannounced Continuation Annual Inspection visit. The LPA introduced himself and disclosed the purpose of the visit to Caregiver Fanetia Avril. During the visit the LPA interviewed residents, review records and completed the inspection tool. An exit interview was conducted with Caregiver Fanetia Avril. A copy of this report and Licensee Rights (LIC 9058), were provided to Caregiver Fanetia Avril to whom a copy of this report, and the Licensee/Appeal Rights (LIC9058 03/22) were provided during today’s visit.the state’s words, verbatim · CDSS document, Dec 10, 2025

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Jose De La Cruz made an unannounced visit to conduct a Required Annual Inspection. The facility file was reviewed prior to the visit. LPA was welcomed by, identified themselves to, and discussed the purpose of the visit with Caregiver Maria Torga. The facility's license shows a maximum capacity of six (6) non-ambulatory residents, ages 60 and over, one of which might be bed ridden. Hospice waiver approved for four (4) hospice residents. LPA and Licensee toured the interior and exterior of the facility and inspected each room. The facility was clean, sanitary, and in good repair. Pathways were free of obstruction and slip hazards. Client bedrooms contained the required furnishings. Doors, windows, screens, toilets, and showers were in working order. Extra linens and hygiene supplies were present, as well as Personal Protective Equipment. The facility had sufficient space and equipment to facilitate dining, laundry, visitation, meetings, and client activities. The facility contained at least 2 days of perishable food, and at least 7 days non-perishable food, all safely stored. Cooking, dining equipment, and utensils were present. No toxic chemicals or poisons were accessible to clients. Medications were labeled, as required, and stored in locked areas. No pools or bodies of water exist on the premises. Per caretaker, no firearms or ammunition are kept at the facility. Carbon monoxide detectors, emergency lighting, and facility telephone were all in working order. Fire extinguisher was serviced within the last 12 months. First aid kit was complete and readily accessible. Required licensing postings were observed in visible areas of the facility. [CONTINUED ON LIC 809-C] [CONTINUED FROM LIC809] LPA interviewed staff and clients, and reviewed facility records. The files reviewed by LPA contained required documents. Confidential records were stored in locked areas. No deficiencies were cited per California Code of Regulations.. An exit interview was conducted with Caregiver Maria Torga, to whom a copy of this report, and the Licensee/Appeal Rights (LIC9058 03/22) were provided during today’s visit.the state’s words, verbatim · CDSS document, Dec 8, 2025

The state marks this report as 4 pages; the online copy we transcribed has 3. You can request the full file from the county licensing office.

Type of visit: Case Management - Annual Continuation

Licensing Program Analyst (LPA) Sabel Martinez conducted an unannounced Continuation Annual Inspection visit. The LPA introduced himself and disclosed the purpose of the visit to Administrator Magdarline Winblad. During the visit the LPA reviewed facility records, including the Infection Control Plan, Emergency Disaster Plan, Liability insurance, and resident and staff records. Facility postings were observed to be in a visible area of the facility. The facility had telephone service. The facility was clean, and in good repair. There were no deficiencies cited during the visit. An exit interview was conducted with House Manager Bryan Gonzalez. A copy of this report and Licensee Rights (LIC 9058), were sent to Administrator Magdarline Winblad via email. An email read receipt confirms the documents were received by the administrator.the state’s words, verbatim · CDSS document, Jan 7, 2025

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Sabel Martinez conducted an unannounced Required Annual Inspection visit. The LPA introduced himself to and disclosed the purpose of the visit to Caregiver Malia Samuela. Administrator Magdarline Winblad arrived during the visit. The facility was licensed for a capacity of six (6) non-ambulatory residents, of which one (1) may be bedridden in bedrooms one through five. The facility also had an approved hospice waiver for four (4) residents. The LPA, accompanied by staff, toured the interior and exterior of the facility, and inspected bedrooms. The facility was clean, sanitary, and in good repair. Pathways were free of obstruction and slip hazards. Bedrooms contained the required furnishings. Doors, windows, screens, toilets, and showers were in working order. The facility had sufficient space to facilitate dining, visitation, meetings, and activities. No pools, nor bodies of water were observed on the premises. Per staff, no firearms nor ammunition were kept at the facility. Due to time constraints, an additional visit on a subsequent day is necessary to complete the annual inspection. No deficiencies were cited during today's date. An exit interview was conducted with Caregiver Malia Samuela. A a copy of this report, and the Licensee/Appeal Rights (LIC9058), were emailed to the administrator. An email read receipt confirms the documents were received.the state’s words, verbatim · CDSS document, Dec 31, 2024

Allegation investigated: Staff did not ensure the facility was free from mold

Licensing Program Analyst (LPA), Sabel Martinez, conducted an unannounced follow up complaint investigation visit, and delivered complaint findings. The LPA introduced himself and disclosed the purpose of the visit to Administrator Carmen Campas. Throughout the investigation, the Department secured records and conducted interviews with external and internal sources, including staff and residents. It was alleged staff did not ensure the facility was free from mold. On 04/15/2024, it was reported to the Department a source had witnessed a mildew smell in a resident’s bedroom. Interviews with both internal and external sources did not reveal any concerns with mold, nor similar smells emanating from resident bedrooms. On several visits to the facility, the LPA tour the facility, including the room in question, and did not witness any mildew, nor odors emanating from the rooms. (See LIC 9099C for continuation of report.) Unsubstantiated An interview with the administrator revealed a previous resident occupying the room in question may have stored a large amount of a dietary supplement, which could have contributed to the alleged smell. Staff, along with the LPA observation, confirmed bedroom windows were frequently opened to avoid odors. Based on the evidence obtained, there was not enough evidence to prove the alleged violation occurred, therefore, the allegation was Unsubstantiated. An exit interview was conducted with Administrator Campas, to whom a copy of this report, and Licensee/Appeals Rights (LIC 9058), were provided.the state’s words, verbatim · CDSS document, May 10, 2024 · control 08-AS-20240415153129

Allegation investigated: Licensee did not allow resident to visit with family/friends

Licensing Program Analyst (LPA) Renita Hall, conducted an unannounced visit to deliver findings regarding the allegation mentioned above. LPA was allowed entry by Malia Samuela, Caregiver . LPA identified herself and disclosed the purpose of the visit and elements of the complaint to the Caregiver. On August 28, 2023, a complaint was received alleging that the licensee denied a resident's right to visit with their friend. The complainant alleged that the licensee did not allow Resident 1 (R1) to visit with their family and friends. The complainant claimed that the resident's visitation rights were being denied without any valid reason. Interviewed R1 to obtain their perspective on the visitation restrictions. Interviewed facility staff members who were involved in the decision-making process regarding visitation. Reviewed facility policies and procedures related to visitation rights. Examined any relevant documentation, such as visitation logs or incident reports. Continued on 9099C Unsubstantiated During the interview, the complainant stated that they had been denied to visit with R1 and were denied by the licensee. The complainant claimed that no valid reason was provided for the denial of visitation rights. The complainant also stated that they could visit outside of the residence on the porch. Staff members involved in the decision-making process regarding visitation were interviewed. They explained that the visitation restrictions were implemented due to continuous disruption to other residents in care and leaving the door to R1 bedroom open with the alarm disarmed which led to the resident leaving their room and being found in the patio and or backyard of the facility. The alarm is in place to alert staff to ensure the resident's safety. However, visitation was never denied to family or friends. Based on the investigation findings, it is concluded that the allegation of the licensee not allowing the resident to visit with their family and friends is unsubstantiated. An unsubstantiated finding means that although the allegations may have happened or are valid, there is not a preponderance of the evidence to prove that the alleged violations occurred. An exit interview was conducted with Malia Samuela, Caregiver . A copy of this report and Licensee's Rights (LIC 9058 03/22) were provided to the and her signature on this report confirms receipt of the Licensee Rights.the state’s words, verbatim · CDSS document, Apr 18, 2024 · control 08-AS-20230828153715

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Sabel Martinez conducted an unannounced Required Annual Inspection. The LPA introduced himself and disclosed the purpose of the visit to Caregiver Malia Samuela. Administrator Magdarline Winblad arrived during the visit and assisted the LPA. The facility file reflected the facility was licensed for four (4) non-ambulatory residents in rooms 1-4, one (1) bedridden in room # 5, and one ambulatory resident in room # 6. A review of documents and the Field Automation System (FAS), revealed the Department received an updated fire clearance, received a request for non- ambulatory increase, and the Department conducted a Case Management visit on 8/7/23. During today's visit, the LPA toured the interior and exterior of the facility, and inspected each room. The facility was clean, sanitary, and in good repair. Pathways were free of obstruction. Resident bedrooms contained the required furnishings There was at least 2 days of perishable food, and at least 7 days non-perishable food present, all safely stored. There were no toxic chemicals/poisons accessible to clients. Medications were labeled, and stored in a locked area. No pools, nor bodies of water were observed on the premises. Per staff, no firearms, nor ammunition were kept at the facility. Smoke detectors, fire extinguisher(s), a first aid kit, and required licensing postings were observed in visible area of the facility. The LPA interviewed staff and reviewed multiple staff and client records/files. The files which LPA reviewed contained required documents. No deficiencies were observed or cited during today's annual inspection. An exit interview was conducted with Administrator Winblad, to whom a copy of this report, and the Licensee/Appeal Rights (LIC9058), were provided.the state’s words, verbatim · CDSS document, Dec 26, 2023