Caccam's Sorrel Residence

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Brian Balisi arrived at the facility unannounced to conduct a required annual visit. Upon arrival, the LPA met with staff and explained the reason for the visit. Administrator Venis Caccam was unable to be onsite for the visit at this time, but stated staff can sign in their place. LPA toured the physical plant areas inside and outside to ensure there are no health and safety hazards and the facility is in compliance with Title 22 Regulations. LPA inspected the kitchen/food service area at approx. 09:40 a.m. Knives, sharp objects are stored in a closed plastic container underneath the sink, inaccessible to residents in care. Kitchen appliances were observed to be in operable condition. The facility has a sufficient supply of perishable and non-perishable food properly stored at this time. Dining room furniture was observed to be in good condition. Medication cabinet located next to the dining room was observed to be locked. Board games and other activities were observed stored on a shelf next to the medication cabinet. At the time of the visit, the common area furniture's were observed to be in good condition. The facility maintained a comfortable temperature of 72 degrees Fahrenheit. Smoke detector(s) and carbon monoxide detector were operational at the time of the visit. LPA observed fire extinguishers to be fully charged and last serviced 04/17/2026. There is a staff room, which was observed to be empty and inaccessible to residents in care. LPA also observed a laundry area by the master bed room inaccessible to residents in care. LPA observed four (4) resident bedrooms, which were furnished appropriately with clean linens, appropriate furnishings and sufficient lighting. The resident restrooms were clean and sanitary and in operating condition with grab bars and non-skid surfaces. The bathrooms were sufficiently stocked with supplies and paper towels. The hot water temperature was measured in each restroom between 105 - 120 degrees Fahrenheit. LPA observed hallway cabinets to store extra sheets and linen for resident use. All exits have functioning auditory devices and were operational at the time of the visit. The LPA observed required postings by the entry way. There is an attached garage observed inaccessible to residents in care. LPA observed garage to store an additional fridge to store extra perishable food, extra incontinent supplies, PPE , canned goods, as well as additional furniture and medical equipment for facility use. LPA observed a sufficient amount of emergency food and emergency supplies stored in a shelf next to the freezer. In an emergency staff would gather the three containers and distribute as needed. LPA also observed a backup generator stored in the garage as well. The backyard has a covered outdoor area equipped with furniture including a table and chairs for resident use. The LPA observed one (1) self-latching gate with clear passageways clear of obstruction. There were no bodies of water observed during the visit. LPA observed emergency bags stored by the entrance way containing clothes, flashlights and other items to use in the event of an emergency. Records review, five (5) client records were reviewed for, but not limited to: appraisals, medical records, admissions agreement, consent forms. Four (4) Personnel records were reviewed for, but not limited to: personnel records, health assessments, criminal record clearances, first aid/CPR training, and the appropriate training. All files were observed to be in order at this time .Cash resources were reviewed for residents in care. All cash resources were documented appropriately and accurately and were accompanied by corresponding purchase receipts. No deficiencies were observed during cash resource review. Medication review, medications for all residents were observed. All medications were stored properly and were appropriately documented on their respective centrally stored medication and destruction record sheets. No deficiencies were observed during medication review. Infection control / Emergency Disaster plan: During today’s visit, the LPA reviewed the facility's infection control practices and the facility's emergency disaster plan. The facility’s policies and procedures as it pertains to infection control are adequate. Emergency disaster drills are conducted monthly; the facility’s last emergency disaster drill was conducted on 04/16/2026 The facility’s emergency disaster plan is up to date and is adequate at this time. Both the infection control plan and the emergency disaster plan are reviewed/updated annually by the facility’s administrator. Smoke detectors and carbon monoxide detectors were tested, all alarms were functional at the time of the visit. During today’s visit LPA obtained a copy of the facility’s LIC 500, Limited Liability and resident roster. Exit interview conducted and copy of the report was issued.the state’s words, verbatim · CDSS document, Apr 24, 2026

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Brian Balisi arrived at the facility unannounced to conduct a required annual visit. Upon arrival, the LPA met with staff and explained the reason for the visit. Administrator Venis Caccam arrived shortly after. LPA toured the physical plant areas inside and outside to ensure there are no health and safety hazards and the facility is in compliance with Title 22 Regulations. LPA inspected the kitchen/food service area at approx. 09:40 a.m. Knives, sharp objects and some cleaning supplies are stored inaccessible in a cabinet underneath the sink. Kitchen appliances were observed to be in operable condition. The facility has a sufficient supply of perishable and non-perishable food properly stored at this time. Dining room furniture was observed to be in good condition. Medication cabinet located next to the dining room was observed to be locked. Board games and other activities were observed stored on a shelf next to the medication cabinet. At the time of the visit, the common area furniture's were observed to be in good condition. The facility maintained a comfortable temperature of 72 degrees Fahrenheit. Smoke detector(s) and carbon monoxide detector were operational at the time of the visit. LPA observed fire extinguishers to be fully charged and scheduled to be serviced tomorrow. There is a staff room, which was observed to be empty and inaccessible to residents in care. The LPA observed four (4) resident bedrooms, which were furnished appropriately with clean linens, appropriate furnishings and sufficient lighting. The resident restrooms were clean and sanitary and in operating condition with grab bars and non-skid surfaces. The bathrooms were sufficiently stocked with supplies and paper towels. The hot water temperature was measured in each restroom between 105 - 120 degrees Fahrenheit. LPA observed hallway cabinets to store extra sheets and linen for resident use. All exits have functioning auditory devices and were operational at the time of the visit. The LPA observed required postings throughout the common areas. There is an attached garage observed inaccessible to residents in care. LPA observed garage to store an additional fridge to store extra perishable food. LPA also observed a laundry area, a sufficient supply of clean linen and towels, laundry supplies securely stored, extra incontinent supplies, PPE , canned goods, emergency food supply as well as additional furniture and medical equipment for facility use. The backyard has a covered outdoor area equipped with furniture including a table and chairs for resident use. The LPA observed one (1) self-latching gate with clear passageways clear of obstruction. There were no bodies of water over 3ft noted at the time of the visit. Records review, five (5) resident records were reviewed for, but not limited to: appraisals, medical records, admissions agreement, consent forms. Four (4) Personnel records were reviewed for, but not limited to: personnel records, health assessments, criminal record clearances, first aid/CPR training, and the appropriate training. All files were observed to be in order at this time . Last emergency disaster drill was conducted on 4/7/2025. Medications review, medications are centrally stored in a locked cabinet adjacent to the kitchen. All medications including PRNs were labeled, stored, and locked inaccessible to residents in care. PRNs have physicians order on file. Medications are properly documented on the centrally stored medications and destruction record. Medications appeared to be given as prescribed at the time of the visit. Infection control: Upon entry, the facility has a central entry point for symptom screening, temperature checks, and sanitation station. At this time, the staff will continue to keep up signs that promotes good hand hygiene and symptoms of a communicable disease. The facility has an adequate supply of Personal Protection Equipment (PPE), and the facility is able to obtain additional supplies as needed. The facility’s cleaning protocol is sufficient. If needed, the facility has the capacity to designate a single isolation room if the facility has a confirmed case of an infectious disease. The facility’s policies and procedures as it pertains to infection control are adequate. The LPA obtained the following documents at the time of visit: LIC500 Personnel Report, LIC9020 Client Roster, a copy of the emergency disaster plan, and a copy of the facility’s liability insurance. Interviews were conducted during the visit. Exit interview conducted. A copy of the report was provided to the Administratorthe state’s words, verbatim · CDSS document, May 2, 2025

Allegation investigated: Staff Physically Abused Resident

Licensing Program Analyst (LPA) Brian Balisi conducted an unannounced subsequent complaint visit to investigate the allegations listed above. Upon arrival LPA met with staff and explained the reason for the visit. Administrator Venis Caccam was contacted and stated they could not be onsite for the visit , but stated staff Joy Duya can sign in their place. On 12/11/2024, the initial complaint visit was conducted by LPA between approximately 10:10 a.m. - 02:00 p.m. During the visit, LPA conducted physical plant, interviewed staff, residents as well as reviewed and obtained copies of pertinent documentation relevant to the investigation. A collateral visit was conducted at ARC VC - Cochran between approx. 02:05 p.m. - 03:00 p.m. to conduct interviews with three (3) clients. Today LPA conducted physical plant and interviewed staff. It was reported that "Staff physically abused resident" as it was alleged that Client #1 (C1) was hit and pinched while in care. Unsubstantiated Continued from 9099 Interviews conducted with four (4) out of five (5) clients in care including C1 revealed that each have never observed staff hit, pinch or harm any client in care. One (1) client was unavailable to interview. LPA's interview with three (3) staff and the Administrator Venis Caccam revealed all four (4) have never observed any staff hit, pinch or harm any client in care. In addition LPA's interview with the family / responsible party of C1, the Administrator and the complainant revealed that C1 has a history of fabricating situations that have not occurred in order to gain attention. The family / responsible party of C1 and the complainant also did not express any potential or immediate concerns for staff at this time. Based on the information obtained during the investigation, the Department does not have sufficient evidence to corroborate the allegation. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur, therefore the above allegation, “Staff physically abused resident” is deemed Unsubstantiated at this time. Exit interview conducted and copy of report issuedthe state’s words, verbatim · CDSS document, Jan 29, 2025 · control 29-AS-20241205155850

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Martha Arroyo arrived at the facility unannounced for a required one-year annual inspection today. The last annual conducted at this facility was on 05/12/2023. When the LPA arrived, there were three (3) staff and one (1) resident present. LPA was greeted at the door by Administrator, Venis Caccam and the reason for the visit was explained. Entrance interview. At 10:28 a.m., the LPA along with the Administrator toured the physical plant areas inside and outside to ensure there are no health and safety hazards and facility is in compliance with Title 22 Regulations. KITCHEN: The LPA inspected the kitchen/food service area at 10:46 a.m. Kitchen appliances appeared clean and were in operable condition at the time of the visit. The facility has a sufficient supply of perishable and non-perishable food. Food labels were inspected and checked for dates and expiration dates and expiration dates were clearly marked. The knives and sharps are stored locked under the kitchen sink inaccessible to residents in care. At 10:48 a.m., the hot water temperature was measured in the kitchen sink, and it measured 106.7 degrees Fahrenheit. COMMON AREAS: At the time of the visit, the living room and dining room furniture was observed to be in good condition. The facility maintained a comfortable temperature. At 10:30 a.m., the smoke detector(s) and carbon monoxide detector were tested and operational at the time of the visit. The fire extinguisher was observed to be in compliance with a charge date of 04/26/2024. LPA observed required postings throughout the common space. There is a working telephone on premises. Continued on LIC 809C... Continued from LIC 809... Working auditory alarms were observed at the time of the visit. Different activities for resident use were observed by the dining room. The washer and dryer were observed inside a hallway closet which was locked and inaccessible at the time of the visit. GARAGE: The garage is attached and inaccessible to residents in care at the time of the visit. There are two (2) additional refrigerators with perishable foods in good condition. The facility has a sufficient amount of emergency food and water. LPA observed a sufficient supply of Personal Protection Equipment (PPE). Detergents and cleaning solutions were observed inside two (2) locked cabinets at the time of the visit. BACKYARD: The backyard has a covered outdoor area equipped with furniture for resident use. Emergency exits and passageways were observed free of obstruction. There was one (1) gate that self-latches. No bodies of water were noted at the time of the visit. BEDROOMS: There are four (4) resident bedrooms and one (1) staff bedroom. One (1) bedroom is for double occupancy, and three (3) bedrooms are single occupancy. LPA observed the resident bedrooms to be furnished appropriately with clean linens, appropriate furnishings, and sufficient lighting. There is a cabinet by the hallway with additional clean linens and towels for resident use. RESTROOMS: There are two (2) full restrooms and one (1) half restroom for resident use. Restrooms were clean and sanitary and in operating condition with grab bars and non-skid surfaces. The bathrooms were sufficiently stocked with supplies and paper towels; towels and washcloths are not shared. The hot water temperature was measured in all three bathrooms, and they measured between 105- and 107-degrees Fahrenheit between 10.33 a.m. and 10:41 a.m. RECORDS: Records review began at 11:05 a.m.; five (5) resident records were reviewed for, but not limited to: signed admission agreements, current medical assessments with TB results, Consent for Treatment form, and current needs and services plan. All records were complete. Continued on LIC 809C... Continued from LIC 809C... Three (3) personnel records including the Administrator’s file were reviewed for, but not limited to: personnel records, health assessments, criminal record clearances, first aid/CPR training, and the appropriate training. All files were complete. Administrator’s certificate is active and expires on 01/26/2026. The facility is vendored by Tri-Counties Regional Center (TCRC) as a level 3 home. The last disaster drill was conducted on 04/13/2024. MEDICATIONS: Medications review began at approximately 1:20 p.m.; medications are centrally stored in a locked cabinet adjacent to the kitchen. All medications including PRNs were labeled, stored, and locked inaccessible to residents in care. PRNs have physicians order on file. Medications are properly documented on the centrally stored medications and destruction record. Medications appeared to be given as prescribed at the time of the visit. Exit interview. No citations issued. Report was reviewed and a copy was provided.the state’s words, verbatim · CDSS document, May 7, 2024