California Guest Home

Type of visit: Required - 1 Year

On today's date Licensing Program Analyst (LPA) William Vanegas made an unannounced visit for the purposes of conducting an annual inspection. Upon arrival LPA was greeted and granted entry to the facility by facility staff. LPA explained the purpose for the visit and Administrator (AD) was notified via phone call, and arrived shortly after to assist with the annual inspection. LPA began a tour of the facility accompanied by AD and observed the following. AD has a valid administrator certificate effective from July 08, 2025 through July 07, 2027. The facility is a two storied home with six bedrooms four of which are for resident use and two of which are for staff use. The facility has three bathrooms two of which are resident bathrooms and one of which is a staff bathroom located on the second floor. Furthermore the facility has an attached two car garage. LPA observed the kitchen area to be clean and free of any mildew and debris. Kitchen area contains of an electric stove, microwave, dishwasher, and a refrigerator. All appeared to be in good repair and tested operational. LPA observed a two supply of perishable food and a seven day supply of non-perishable food and a sufficient amount of emergency water on hand. LPA observed all resident bedrooms to be clean and clear of any hazards or debris. LPA observed all resident bedrooms to have required furnishings including a reading lamp, a chest of drawers, a bed, clean linens in good repair; meaning no strains or tares, a chair, and enough storage space to store personal belongings. LPA observed all resident bathrooms to be clean and free of any mildew or debris. Water faucets and toilets tested operational. Bathrooms contained required furnishings including grab bars, shower chair, and slip resistant floor matts. Hot water temperature tested between 107.7 and 119.2 degrees Fahrenheit. CONTINUED ON LIC809-C LPA observed all fire extinguishers to be fully charged and up to date. LPA observed all smoke detectors and carbon monoxide detectors to be in good repair and tested operational. LPA observed first aid kit to have all required items including adhesive tape, scissors, tweezers, bandages, a thermometer, and a first aid manual. LPA toured the outside of the facility and observed the following: The backyard is large enough to participate in outdoor activities upon resident request. LPA observed the outside of the facility to be free of any hazards and debris. LPA observed an outdoor shaded sitting area. LPA observed side exits to be free of any debris. LPA observed side gates to be self latching and unlocked. LPA reviewed medications with AD and per LPA review all medications are being documented correctly and being administered per physicians orders. LPA reviewed six resident files and two staff files, all files (Staff and Resident) had all required documents. Annual staff training was up to date and documented. Based on observations made during today's inspection no deficiencies will be issued per title 22 chapter 8 division 6 of the California Code of Regulations. An exit interview was conducted with AD and a copy of this report was provided to the facility.the state’s words, verbatim · CDSS document, Apr 9, 2026

Type of visit: Required - 1 Year

On February 6th, 2025 Licensing Program Analyst (LPA) William Vanegas made an unannounced visit for the purposes of conducting an annual visit. Upon arrival LPA Vanegas was greeted and granted entry by Care Giver (CG) Marjori Facinal and LPA Vanegas explained the nature of the visit. LPA Vanegas set up equipment and began a tour of the facility and observed the following. This is a two storied home with six bedrooms two of which are staff rooms and four of which are resident rooms. There are three bathrooms two of which are resident bathrooms and one of which is a staff bathroom. There is also an attached two car garage. LPA Vanegas observed the kitchen area to be clean and free of mildew and debris. LPA Vanegas observed there to be an electric stove, microwave, refrigerator, and dishwasher all which tested to be operational and in good repair. LPA Vanegas observed a two day supply of perishable food and a seven day supply of non-perishable food. LPA Vanegas observed resident bathrooms to be clean and free of mildew and debris. Water faucet and toilets tested to be operational, and bathrooms contained all required items such as grab bars, slip resistant floor matts, and a shower chair. Water in bathrooms tested to be between 114.3 and 123.2 degrees. LPA Vanegas observed client rooms to have all required furnishings such as a bed, clean linens in good repair meaning no strains or tears, chest drawers, and a reading lamp. However one room did not have a screen on the window a deficiency was cited on today's date. LPA Vanegas observed outside of facility to be clean and have no obstructions along the emergency exit route. Back yard is clean and in good repair, and big enough to participate in outdoor activities upon resident request. There is an outdoor shaded sitting area, and side doors are unlocked and self latching. LPA Vanegas observed all medications, toxins, and sharps to be locked away and inaccessible to clients in care. LPA Vanegas observed fire extinguisher to be fully charged and up to date, and for all carbon monoxide detectors and smoke detectors to be operational and in good repair. CONTINUED ON LIC809C LPA Vanegas reviewed three staff files and six resident files all resident files contained all the required documents and all staff training was undocumented. A deficiency was cited on today's date. LPA Vanegas reviewed first aid kit and it contained all required items such as scissors, adhesive tape, tweezers, first aid manual, and a thermometer. LPA Vanegas reviewed medications and medication administration record (MAR) and per LPA Vanegas review all medications are being administered per physician's orders and they are being documented correctly. Based on today's observations deficiencies will be cited per title 22 chapter six of the California Code of Regulations. An exit interview was conducted and a copy of this report was left at the facility.the state’s words, verbatim · CDSS document, Feb 6, 2025

Type of visit: Required - 1 Year

Licensing Program Analysts (LPAs) Claudia Gutierrez and Michael Tea conducted an unannounced visit to California Guest Home. The purpose of today’s visit was to conduct the Annual Required inspection. LPAs were allowed entry into the home and met with Staff Marjorie Facinal. Facility is licensed for 6 non-ambulatory residents. Facility has an approved hospice waiver for 6 residents and the home currently has five residents and three residents are currently on hospice. Priscilla Celis has an Administrator Certificate expiring on July 7, 2025. LPAs Gutierrez and Tea along with Staff Arphie Tanedo and Administrator Priscilla Celis toured the facility at 8:14 AM. LPAs toured the physical plant, checked food service, and the first aid kit. The home consists of four resident bedrooms, one shared hall bathroom and another one in a shared resident room, a living room, dining room, and kitchen on the first floor and two staff bedrooms and a bathroom on the second floor for staff. There are no residents residing on the second floor. Resident bedrooms had the required furniture, bed linens and closet/drawer space to accommodate each resident. Toilets and water faucets were operational, grab bars were secure and shower was free of mold/mildew. Water temperature measured at 119.3 degrees F in all facility bathrooms. LPAs observed an extra supply of resident bath towels, toiletries and personal hygiene supplies during today's visit. Common areas were clear of hazards, doorways were free of obstructions. First aid kit had all the required elements. LPAs observed a locked storage area for cleaning supplies under the bathroom sink. Facility has a two day supply of perishable and a seven day supply of non-perishable food as required by regulation. LPAs observed sharps locked in a kitchen drawer. Smoke detectors and Carbon Monoxide detectors tested operational during today's visit. Fire extinguisher was observed to be fully charged with service tag dated September 6, 2023. Kitchen appliances were observed to be operational. LPAs toured the backyard and observed the backyard fence to be leaning towards the neighbors' house causing a tear in the middle leaving a gap in the fence and between the two properties. (Cont. LIC809-C) LPAs also observed a torn patio umbrella and discarded chairs, mattresses, bed rails, and wheelchairs leaning or stacked on top of each other on the side patio. The hallway bathroom air fan vent is loose and hanging from the ceiling, cob webs and dust were observed above the shower area in the bathroom of the shared room; a Deficiency was cited on today's date. LPAs observed emergency food and water supply in the garage. Emergency disaster plan was posted and visible. At 8:45 AM, LPAs reviewed five resident files and four staff files. Resident files contained required documents including admission agreements, current physician reports, resident appraisals and physician orders for bed rails as indicated. Staff files reviewed contained required documentation of annual training, health screen/TB, and criminal record clearance. At 8:24 AM, LPAs reviewed medication storage and administration. Centrally stored medications were observed to be stored in a locked cabinet, however, unsecured medication was observed on the kitchen table and in a resident's bathroom: a deficiency was cited on today's date. Deficiencies are being cited per Title 22 Division 6 of the California Code of Regulations. An exit interview was conducted with AD Priscilla Celis and a copy of this report, LIC809-D, and Appeal Rights was provided at the end of the inspection.the state’s words, verbatim · CDSS document, May 23, 2024