California Care RCFE Baxter

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Kelly Dulek arrived at the facility unannounced to conduct a required annual visit at 09:44AM. LPA was greeted by staff. Facility Designee Arnida Obtinalla was available shortly after the LPA's arrival. Entrance interview conducted. Beginning at 09:55AM, the LPA, along with Facility Designee toured the physical plant areas inside and outside to ensure there are no health and safety hazards and that facility is in compliance with Title 22 Regulations. The following was observed: BEDROOMS: There are five (5) bedrooms in the facility; four (4) bedrooms are designated for resident use, including two (2) shared rooms, and two (2) private rooms. There is one (1) staff room, which was observed to be locked. All four (4) resident rooms were observed to be furnished appropriately with clean linens, appropriate furnishings and sufficient lighting. BATHROOMS: There are two (2) bathrooms for resident use, one (1) of which is a shared resident restroom located in the hallway and one (1) is a private resident restroom. Restrooms were observed to be equipped with slip-resistant surfaces. Grab bars were observed in the bathrooms. The water temperature was measured in the shared resident bathroom to be 115.5 degrees Fahrenheit, which is within the required range. KITCHEN: The LPA observed the kitchen/dining area to be clean. Kitchen appliances were in operable condition. The facility has a sufficient supply of seven (7) days perishable and two (2) days non-perishable food and emergency water. The LPA observed one designated cabinet where knives and sharps are stored Report Continued on LIC 809-C locked and inaccessible to residents. Cleaning supplies are located in a locked cabinet under the sink. LAUNDRY & GARAGE: The laundry room is located adjacent to the dining room. Laundry supplies and chemicals are stored in a locked cabinet, inaccessible to residents in care. Garage was observed locked and contained an additional freezer and pantry, which contained adequate emergency supplies. COMMON AREAS: This includes the living room and dining room areas. LPA observed common area to be clean and properly furnished at the time of the visit. Fireplace was noted to be screened and inaccessible to residents. The LPA observed the fire extinguisher to be fully charged and serviced on 12/19/2025. Hardwired smoke detectors and carbon monoxide detectors were tested at 10:03AM and were functional at the time of the visit. All required postings were observed in the facility entryway. OUTDOOR SPACE: The backyard has a covered patio area with patio furniture including a table and chairs for resident use. Facility has two total gates, one (1) gate was observed to be self-latching and closing with clear passageways for emergency exit use. There were no bodies of water on the premises. An outdoor shed was observed to be locked. RECORD REVIEW: Began at 10:11AM. Five (5) staff files and four (4) resident files were reviewed for documents including, but not limited to: health screening, TB test, staff training records, fingerprint clearance, resident physician's report, needs and service appraisal, and personal rights. All staff and resident records observed contained all required documents. MEDICATION REVIEW: Began at 11:07AM. Medications for two (2) of four (4) residents were observed. Medications were observed to be stored in a locked cabinet in the kitchen island. Medication Administration Records (MAR) and Centrally Stored Medication and Destruction Records (CSMDR) were reviewed. All medications reviewed were properly documented and appear to be self-administered as prescribed. INFECTION CONTROL/EMERGENCY DISASTER PLANNING: 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 drills are conducted quarterly; last emergency disaster drill was conducted 06/12/2026. INTERVIEWS: LPA interviewed one (1) staff and two (2) residents. No concerns were noted. No citations issued. Exit interview conducted. A copy of the report was provided.the state’s words, verbatim · CDSS document, Jul 8, 2026

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: Required - 1 Year

Licensing Program Analyst (LPA) Emily Peraldi arrived at the facility unannounced to conduct a required annual visit. At 10:30 a.m., the LPA met with staff and explained the reason for it visit. At 10:34 a.m., the Administrator Designee Arnida Obtinalla met with the LPA. RECORD REVIEW: Between 10:40 a.m. and 12:20 p.m., the LPA conducted a file review for all residents and staff regularly scheduled and observed the following: Staff have current first aid and training documentation. Resident records were reviewed for, but not limited to care plans, medical records, admissions agreement, consent forms. All files were in order. Administrator’s Certificate is valid until 05/07/2026. INFECTION CONTROL/EMERGENCY DISASTER PLAN: During today’s visit, the LPA reviewed the facility’s infection control plan. The facility’s policies and procedures as it pertains to infection control are adequate. The LPA also reviewed the facility's emergency disaster plan, which was observed to be complete and updated. Emergency drills are conducted quarterly, with the last drill documented on 06/01/2025 and 06/02/2025. At 12:21 p.m., the LPA conducted a review of medication and medication documentation with the Administrator Designee for two (2) out of five (5) residents and observed that medications were properly documented. Starting at 1:01 p.m., the LPA, along with Administrator Designee toured the physical plant areas inside and outside to ensure there are no health and safety hazards. Continued on LIC-809-C. KITCHEN: The LPA observed the kitchen and dining area. Knives are stored in a locked kitchen cabinet. Kitchen appliances are in operable condition. The facility has a sufficient supply of perishable and non-perishable food. At 1:03 p.m., hot water measured at 107.9-degree Fahrenheit. Medications are located in a locked kitchen cabinet. Cleaning supplies are located in a locked cabinet under the kitchen sink. OUTDOOR SPACE: At 1:08 p.m., the LPA observed the back patio which has a covered outdoor area for resident use. There is a gate on the side of the house designated for an emergency exit. There are no bodies of water on the premises. COMMON AREAS: The LPA observed common area to be relatively clean and properly furnished. The LPA observed the fire extinguisher to be fully charged and last serviced on 12/04/2024. At 1:18 p.m., fire alarms/carbon monoxide detectors were tested and functioned properly. All exits have functioning auditory devices and were operational at the time of the visit. There is a working telephone on premises. The LPA observed a closet in the hallway with additional bedsheets. The garage is attached and remains inaccessible to residents. Additional cleaning solutions and food supplies are located inside the garage. Laundry units are located near the kitchen area. BEDROOMS: The facility is a single-story residential home with five (5) bedrooms and two (2) bathrooms. Four (4) bedrooms are for resident use and one (1) for staff use. The LPA observed resident bedrooms, which were furnished appropriately with clean linens, appropriate furnishings and sufficient lighting. Inside temperature was maintained at a comfortable level. RESTROOMS: Restrooms are relatively clean and sanitary and in operating condition with grab bars and non-skid mats. At 1:15 p.m., hot water measured at 107.0-degree Fahrenheit. The sinks had sufficient liquid soap, and paper towels. During the time of the visit, the LPA spoke with all five (5) residents. No concerns were noted. No deficiencies cited at this time. Exit interview conducted. A copy of the report was issued.the state’s words, verbatim · CDSS document, Jul 16, 2025

Type of visit: Required - 1 Year

Licensing Program Analysts (LPAs) Trevor Byrne and Kelly Dulek arrived at the facility unannounced to conduct a required annual visit at 08:58AM. LPAs were greeted by staff who contacted Facility Designee Arnida Obtinalla who arrived at the facility at approximately 09:00AM. Entrance interview conducted. Beginning at 09:00AM, the LPAs, along with Facility Designee toured the physical plant areas inside and outside to ensure there are no health and safety hazards and that facility is in compliance with Title 22 Regulations. The following was observed: KITCHEN: The LPAs observed the kitchen/dining area to be clean. Kitchen appliances were in operable condition. The facility has a sufficient supply of seven (7) days perishable and two (2) days non-perishable food and emergency water. The LPAs observed one designated cabinet where knives and sharps are stored locked and inaccessible to residents. Cleaning supplies are located in a locked cabinet under the kitchen sink. LAUNDRY & GARAGE: The laundry room is located adjacent to the kitchen. Laundry supplies and chemicals are stored in a locked cabinet, inaccessible to residents in care. Garage was observed locked and contained an additional freezer and pantry, which contained adequate emergency supplies. COMMON AREAS: This includes the living room and dining room areas. LPAs observed common area to be clean and properly furnished at the time of the visit. Fireplace was noted to be screened and inaccessible to residents. The LPAs observed the fire extinguisher to be fully charged and purchased on 05/29/2024. Hardwired smoke detectors and carbon monoxide detectors were tested at 09:31 AM and were functional at the time of the visit. Report Continued on LIC 809-C Continued from LIC 809 BEDROOMS: There are five (5) bedrooms in the facility; four (4) bedrooms are designated for resident use, including two (2) shared rooms, and two (2) private rooms, as well as one (1) staff room. The staff room is kept locked. All 4 (four) resident rooms were observed to be furnished appropriately with clean linens, appropriate furnishings and sufficient lighting. BATHROOMS: There are two (2) bathrooms for resident use, one (1) of which is a shared resident restroom located in the hallway and one (1) is a private resident restroom. Restrooms were observed to be equipped with nonskid surfaces and contain nonskid mats. Grab bars were observed in the bathrooms. The water temperature was measured in the shared resident bathroom to be 114.8 degrees at 09:18 AM. The water temperature in the private bathroom was measured to be 118.6 degrees at 09:29 AM. Both restrooms were measured to be within the required range. OUTDOOR SPACE: The backyard has a covered patio area with patio furniture including a table and chairs for resident use. Facility has two total gates, one (1) gate was observed to be self-latching and closing with clear passageways for emergency exit use. There were no bodies of water on the premises at the time of the visit. RECORD REVIEW: Began at 09:37AM. Staff and resident records were reviewed for documents including, but not limited to: health screening, TB test, staff training records, fingerprint clearance, resident physician's report, needs and service appraisal, and personal rights. MEDICATION REVIEW: Began at 10:15 AM. Medications for three (3) of five (5) residents were observed. One (1) resident (Resident 1 – R1) had PRN (as needed) medications prescribed. The doctor for R1 indicated that the resident can not communicate their need for the medication. Based on record review the facility lacked a record of the times the physician was contacted to administer these medications. Report Continued on LIC 809-C Continued from LIC 809-C INFECTION CONTROL/EMERGENCY DISASTER PLANNING: During today’s visit, the LPAs 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. Last emergency disaster drill was conducted 04/27/2024. INTERVIEWS: LPAs interviewed two (2) staff and three (3) residents. The following deficiency was observed (See LIC 809-D) and cited from the California Code of Regulations, Title 22 and/or California Health and Safety Code. Licensee was advised that failure to correct the deficiency may result in civil penalties. Exit interview conducted. A copy of the report and appeal rights were provided.the state’s words, verbatim · CDSS document, Jul 5, 2024