Belrose Care Home II

Type of visit: Required - 1 Year

On 2/9/2026 at 9:30 AM, Licensing Program Analyst (LPA) James Sampair arrived unannounced to conduct this Required Annual Inspection. Upon entry, the LPA stated the purpose of the visit to Caregiver Emily David. Licensee / Administrator Rosa Junsay at approximately 11:30 AM. The LPA toured the facility, including but not limited to, residents’ rooms, bathrooms, kitchen, common areas, and the backyard. The LPA observed adequate lighting for the comfort and safety of residents in all rooms. Inside and outside areas are free of obstruction and no bodies of water. The temperature in the living room was measured at 71.0 degrees Fahrenheit. The maximum hot water temperature was measured at 111.5 degrees Fahrenheit in the kitchen. The residents’ bathrooms are equipped with grab bars and slip-resistant mats. There is more than the minimum of a one week supply of nonperishable foods and 2 days of perishable foods. The LPA observed the required postings in the facility. Smoke detectors and carbon monoxide detectors were tested and found to be in operating condition. The fire extinguisher was fully charged and replaced on 2/9/2026. The Emergency Disaster Plan was reviewed within the past year; the most recent review was on 2/9/2026. Emergency, disaster, and fire drills were conducted on a quarterly basis. First aid kit was observed to be complete. Liability insurance expires on 2/17/2026. Continued on LIC 809-C . . . . . . Continued from LIC 809 The LPA reviewed 5 resident records and 5 staff records. No citations were issued during the inspection. Exit interview conducted and a copy of this report provided.the state’s words, verbatim · CDSS document, Feb 9, 2026

Allegation investigated: Staff did not provide proper hygiene care to resident

On 7/07/2025, at 4:15 PM, Licensing Program Analyst (LPA) James Sampair arrived unannounced to investigate the allegation above. Upon arrival, the LPA informed Caregivers Liwayway Noche and Arnel Bulaon of the purpose for this visit. The complaint alleges staff did not provide proper hygiene care to Resident R1. The LPA interviewed Witness W1 by phone. At the facility, the LPA interviewed Caregivers Noche and Bulaon, who described their hygiene care of R1. They also described the behaviors of R1 that have injured his skin during the day and at night that resulted in this complaint from the hospital staff. As the Home Health Nurse for R1, Witness W2 confirmed the Caregivers' statements, both in terms of the high level of care provided to R1 and R1's behaviors that injures his skin. The data collected and analyzed by the LPA shows that the staff were providing proper hygiene care to Resident R1, which does not confirm the allegation. Continued on LIC 9099-C . . . Unsubstantiated . . . Continued from LIC 9099 Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove it; therefore, the allegation is UNSUBSTANTIATED. Exit interview conducted and a copy of this report was provided.the state’s words, verbatim · CDSS document, Jul 7, 2025 · control 15-AS-20250703095027

Type of visit: Required - 1 Year

On February 28, 2025 at 08:00 AM, Licensing Program Analyst (LPA) James Sampair arrived unannounced to conduct this annual required inspection. The LPA informed Caregivers Liwayway Noche and Arnel Bulaon of the purpose for this visit. Licensee / Administrator Rosa Junsay arrived at approximately 10:00 AM. The LPA inspected the inside and outside of the facility. The inspection included the kitchen, dining area, living room, bedrooms, bathrooms, garage, and yard. An adequate amount of food supplies were observed, more than the required minimum of 2 days of perishable and 7 days of non-perishable food. The central storage for medications was locked. The cleaning supplies and dangerous objects were stored in locked cabinets. Facility has working smoke and carbon monoxide detectors. Facility conducts disaster/emergency and fire drills on a quarterly basis; records showed that the most recent drill was conducted on December 20, 2024. The fire extinguisher was fully charged and last serviced on January 9, 2025. The indoor temperature was 71.0 degrees Fahrenheit and the maximum hot water temperature was 113.5 degrees Fahrenheit, both within the acceptable range. The LPA reviewed 5 resident and 5 staff records. No citations were issued during this inspection. Exit interview conducted and a copy of this report provided.the state’s words, verbatim · CDSS document, Feb 28, 2025

Type of visit: Case Management - Health Checks

On 4/9/2024 at 12:45 PM, Licensing Program Analyst (LPA) J. Sampair arrived at facility unannounced to conduct this case management visit. Upon arrival, the LPA stated the purpose of the visit to Caregivers Liwayway Noche and Arnel Bulaon, which was to verify the health and safety of their new residents who were admitted on 4/6/2024 due to the fire at Casa Blanca Homes (071441125). At 12:50 PM, the LPA and Caregiver Bulaon met with Residents R1 and R2. The Caregiver stated that because of the water used by the fire department when putting out the fire, the belongings of R1 and R2 were wet when they arrived. They dried all of those belongings. The LPA observed that both R1 and R2 were safe and healthy. No citations issued during this visit. Exit interview conducted with Caregiver Bulaon. A copy of this report provided via email to the Licensee.the state’s words, verbatim · CDSS document, Apr 9, 2024

Type of visit: Required - 1 Year

On 1/31/2024 at 10:00 AM, Licensing Program Analyst (LPA) J. Sampair arrived unannounced to conduct the Required Annual Inspection of the facility. Upon arrival, LPA stated the purpose of the visit to Caregivers Liwayway Noche and Rossett Daniel. Licensee Rosa Junsay arrived at approximately 11:15 AM. The LPA inspected the facility inside and outside. All outdoor and indoor passageways were free of obstruction. Outside, there were no bodies of water. Inside, the temperature was measured at 74.7 degrees Fahrenheit. The LPA observed adequate lighting in all of the rooms for the comfort and safety of the residents. LPA observed 7 days of nonperishable and 2 days of perishable foods on hand. Sharps were stored inaccessible to residents. Smoke and carbon monoxide detectors were in operating condition. Fire extinguisher was observed to be fully charged and last serviced on 12/6/2023. The LPA reviewed the records of 4 residents and 5 staff members. The LPA interviewed 2 residents and 2 staff members. Required Annual Inspection complete and no citations issued during the visit. Exit interview conducted with Licensee. A copy of this report provided via email to the Licensee.the state’s words, verbatim · CDSS document, Jan 31, 2024