Carlito's Care Home

Type of visit: Case Management - Deficiencies

On July 9, 2026, Licensing Program Analyst, Arvin Villanueva (LPA), conducted an unannounced case management visit at this facility. LPA met with administrator, Elvis Flores (AD), and explained the purpose of the visit. The purpose of the visit is to address facility action report (FAR) prepared by Alta Regional Center dated March 25, 2026. Present during this visit were four clients in care with two staff on duty. The licensee, Joanna Flores, arrived shortly after. Per FAR, ACRC representative conducted a review of the client’s medication records and corresponding medication supply. Documentation signed by the client’s physician indicated that Medication-1 (M1) 250 mg, previously ordered for administration every Monday, Wednesday, and Friday, was discontinued effective 02/12/2026. A review of the Medication Administration Record (MAR) confirmed that facility staff accurately reflected the discontinuation and did not administer the medication during the March 2026 medication cycle. Despite appropriate MAR documentation, inspection of the client’s March bubble pack revealed that M1 tablets remained present. According to the report, AD reported that a request had been made to the pharmacy to remove the discontinued medication from the bubble pack. The pharmacy declined, stating that bubble packs could not be altered after packaging. As a result, staff have been manually removing M1 tablets from the bubble pack, placing them into a separate Ziploc bag, and storing them apart from the client’s currently active medications. {1 of 2} Upon inspection of the Ziploc bag, the ACRC representative observed four (4) tablets present. Based on the March bubble pack cycle beginning Monday, March 2, a total of ten (10) tablets should have been available. Six (6) tablets were unaccounted for, and there were no corresponding MAR entries, destruction logs, or staff signatures documenting their removal, disposition, or handling. Based on the information above, this facility is hereby cited pursuant CCR Title 22, Division 6, Chapter 8. An exit interview was held with AD and Licensee. A copy of this report and appeal rights were provided. {2 of 2}the state’s words, verbatim · CDSS document, Jul 9, 2026

From the deficiency page — Deficiency type: Type A · Section cited: CCR 87465(h)(6) · Plan of correction due date: Jul 16, 2026

The licensee shall be responsible for assuring that a record of centrally stored prescription medications for each resident is maintained... This requirement is not met as evideced by: Based on observation, record reviews and interviews, the licensee did not comply with the regulation cited. There were missing medication tablets with no supporting documents. This poses an immediate health, safety, and/or personal rights risk to persons in care.the state’s words, verbatim · CDSS document, Jul 9, 2026

Plan of correction: Corrected prior to this visit. POC was submitted to Alta California Regional Center.

Type of visit: Required - 1 Year

On 4/2/2026, Licensing Program Analyst, Arvin Villanueva (LPA) arrived at this facility unannounced to conduct the annual inspection visit. LPA initially met with staff on duty, Sandy Pilapil, and stated the purpose of the visit. The licensee, Joanna Flores, and administrator, Elvis Flores, were notified and arrived later during the visit. Overview: Facility is a one-story house located in a residential neighborhood. Facility is licensed to serve up to 4 elderly residents, up to 4 may be non-ambulatory. Facility does not have a hospice waiver. Facility does not have clearance for bedridden residents. Physical Inspection: Areas inspected include, but not limited to, the kitchen, dining, resident units/bedrooms, resident bathrooms, common areas and outdoor areas. LPA inspected 4 of 4 bedrooms. 2 of the bedrooms have exits. Per fire clearance, the doors for these two rooms need to remain unlocked for emergency exits. 2 bathrooms were inspected. Hot water temperature ranged from was measured at 114 degrees Fahrenheit. Hallway temperature was between was maintained at 72 degrees Fahrenheit. Fire extinguishers were observed in the kitchen and was last inspected on 10/15/2025. Smoke and carbon monoxide detectors were observed throughout. During the testing of the detectors, the fire door automatically closed. LPA observed centrally stored medications, toxins, sharp objects and other dangerous items were kept locked and inaccessible to residents in care. In the kitchen area, LPA observed at least seven-day non-perishable and two-day perishable food supplies. Pantry was observed to be fully stocked with non-perishable food items. Kitchen refrigerator and freezer were maintained at regulatory temperature at 40 degrees Fahrenheit and 0 degrees Fahrenheit. The additional freezer in the dining area needs a thermometer. {1 of 2} The outdoor areas: LPA observed shade area and outdoor furniture for residents use. Ramps were observed to be in good repair at this time. Emergency walkways were observed to be unobstructed. Fence and gate were in good repair. Advisory was provided to not use the second latch of the gate. Advisory provided to licensee to ensure they know the location of each shut off valves and how to operate each one in case of emergency. Record Reviews: LPA reviewed 5 staff files, 4 resident files, and facility records. Review of resident files, including but not limited to, review of Admission Agreement, Physician Reports, Needs and Services Plan, Centrally Stored Medication Record and Ambulatory Status. LPA reviewed 2 of 4 resident medications. Facility manages 2 resident cash. Licensee counted 2 of 4 residents’ cash with LPA present. LPA reviewed current Surety Bond. Advisory was provided to reassess ambulatory status for 3 of 4 residents by their physicians. Review staff files included, but not limited, background clearance, First Aid/CPR certificate, Health Screen, Initial Training. Records of dementia training were not available for review during this visit. Per licensee, she conducted the training but has not completed the certificates for her staff. Per review of Guardian and LIS, one of the staff on duty (S2) was not associated to this facility. S2’s employment date was 1/27/2026. Advisory was provided to complete LIC508 for each staff. Review of fire drill/disaster drill records: facility conducts monthly drills and last drill was conducted on 1/15/26. Documents Requested: LPA obtained a copy of current Surety Bond LIC500, LIC308 during this visit. LPA requested a copy of updated Liability Insurance Certificate to be emailed at arvin.villanueva@dss.ca.gov Per the California Code of Regulations, Title 22, Division 6, Chapter 8, deficiencies were cited and immediate civil penalties were assess in the amount of $500. Advisories were provided. Exit interview was conducted. A copy of the report was provided upon exit. {2 of 2}the state’s words, verbatim · CDSS document, Apr 2, 2026

The state marks this report as 8 pages; the online copy we transcribed has 4. You can request the full file from the county licensing office.

Type of visit: Post Licensing

On 12/3/2025 at 12:30 PM, Licensing Program Analyst (LPA) Shakaricka Hughes arrived at the facility to conduct an unannounced post licensing inspection. LPA Hughes met with licensee Joanna Flores and explained the purpose of the visit. The current census is 1 with 3 facility staff. This facility is a single story building licensed to serve (4) non-ambulatory residents. LPA inspected the physical plant including but not limited to the common area, kitchen, dining area, resident bedrooms, resident bathrooms, laundry room and outside courtyards of the facility to ensure compliance with Title 22 regulations. LPA observed the facility to be free of odor, clean and in good repair. LPA observed bedrooms to be properly furnished with appropriate bedding and lighting. There are no bodies of water present. LPA toured the kitchen and observed sufficient seven-day non-perishable and two-day perishable food supplies. Hot water temperature was measured at 119.6 degrees Fahrenheit in resident bathroom sink, which is within the required regulation of 105 to 120 degrees Fahrenheit. Grab bars and non-slip mat were observed to be stable and in good repair at this time. Smoke and carbon monoxide detectors are in compliance with fire safety. The fire extinguisher is located in the common area and was last serviced on 10/15/2025. LPA observed the facility has a public telephone in the common area and the facility has the required posters posted. Facility thermostat was observed at 68 degrees Fahrenheit. LPA observed toxins located in the kitchen area kept locked and inaccessible to residents. LPA observed sharp knives kept locked in the kitchen and inaccessible to residents. Continuation 809-C LPA checked medication storage and found medication to be locked away and inaccessible to residents. LPA reviewed 1 out of 1 residents medications and the medication administration record (MAR) was complete. The first aid kit was checked and contained the required components. LPA requested resident and staff files for review. LPA reviewed 1 out of 1 resident files and they were complete. LPA reviewed 3 staff files, and it was complete. LPA reviewed staff criminal record clearances, and a review of staff records indicates that all facility staff or other individuals who require caregiver background checks are fingerprint cleared. The following documents will be email to LPA by 12/5/2025 end of day: (1) LIC 308 Designation of Administrative Responsibility (2) Copy of Administrator Certificate (3) LIC 610 Current Emergency Disaster Plan (4) Proof of Current Liability Insurance (5) LIC 500 Current Personnel Report As a result of this post licensing visit, the facility is in compliance with Title 22 Regulations, and a copy of the LIC 809 report was provided to the facility.the state’s words, verbatim · CDSS document, Dec 3, 2025

Type of visit: Prelicensing

On 3/26/25 at 1:00pm Licensing Program Analyst (LPA) Kevin Gould arrived at Carlito's Care Home LLC for the purpose of conducting an unannounced Pre-Licensing inspection. LPA met with applicants, Elvis Flores and Joanna Flores and together conducted a tour of the home to ensure it meets all requirements to be licensed. The facility is requesting a licensed capacity of four (4) non-ambulatory residents. The home is equipped with four (4) bedrooms all identified as single resident rooms. All resident bedrooms are approved for non-ambulatory residents per city fire clearance. LPA and applicants evaluated the physical plant to ensure the health and safety of future residents in care. Areas inspected are including but not limited to the kitchen, resident bedrooms; resident bathrooms, living and dining room and outdoor areas. LPA observed the facility to be free of odor, clean and in good repair. LPA observed that all rooms are equipped with the required furniture and sufficient lighting throughout the facility. LPA measured the water temperature, temperature measured at 108 degrees F which meets the 105-120 degree Fahrenheit regulation. LPA observed sufficient seven day non-perishable and two day perishable food supplies. Fire extinguishers and smoke detectors are current and in compliance with fire safety. LPA notes the facility had the required carbon monoxide detectors. First aid kit was checked and is complete. LPA observed centrally stored medications secure from residents. LPA and applicants conducted the Component III orientation and LPA answered all applicant questions before concluding the inspection/orientation. The applicants have met all requirements to be licensed by the department. LPA will contact CAB to approve license.the state’s words, verbatim · CDSS document, Mar 26, 2025

Type of visit: Office

Facility Type: Residential Care Facility for the Elderly Application Type: Initial Capacity: 4 Census (if any clients in care): 0 COMP II Participants: ELVIS FLORES, JOANNA FLORES Interview Method: Telephone interview On March 06, 2025, applicant/administrator participated in COMP II. Identification of the applicant and administrator was verified through interview questions based on photo ID and other identifying personal information. During COMP II, applicant and administrator confirmed the understanding of the California Code Title 22 Regulations. Signed LIC 809 with copy of photo ID have been obtained. During COMP II, CAB analyst confirmed Applicant/Administrator’s understanding of following areas: 1. Facility operation: License type, client/resident populations, and program 2. Admission Policies 3. Staffing requirements & Training 4. Restricted/Prohibited Health Conditions 5. General provisions 6. Emergency Preparedness 7. Complaints & Reporting 8. Pre-licensing readinessthe state’s words, verbatim · CDSS document, Mar 6, 2025