Carriage House

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Alviso conducted a Required - 1 Year inspection and met with live-in caregiver Melanie Taningco. A second caregiver, Brian, was also observed to be working during the inspection. Administrator Josephine Blancaflor was contacted, and arrived within the hour to meet with the LPA. There were six (6) residents in care during the LPA's inspection. Facility has an approved dementia plan of operation. There is an approved hospice waiver for two (2) residents. Facility has a required infection control plan. Facility has a required emergency disaster plan. Fire clearance is approved for six (6) non-ambulatory, which includes one(1) bedridden approval (room #1 only). Fire extinguishers (2) were serviced and tagged as required. Facility has a hard wired smoke alarm system, which also has carbon monoxide check. The alarm system was put into test mode to check that it was working properly during the inspection. All exits were free and clear of obstructions. The backyard self latching fire exit gate opened freely, as required. Emergency disaster drills are being conducted quarterly as required; Last drill was conducted with facility staff on 9/3/25. The LPA reviewed six (6) resident files, resident medication records, and medication storage, including refrigerated medications. All files had required documentation. The LPA reviewed five (5) staff files. All staff had criminal record clearance as required. All staff had required first aid certification, and CPR certification, as required. All staff annual training was reviewed during the inspection. Continued on LIC809C... LPA toured the facility with caregiver Brian and the Administrator. Hot water was 107.4 degrees Fahrenheit, which is within regulation. Facility was clean and orderly. Food supply was sufficient with both perishable and non-perishable foods. Resident rooms, bathrooms, hallways, and common areas had sufficient lighting for residents in care. The facility was at a comfortable temperature during the inspection. There was a sufficient supply of hygiene products, linens, cleaners/disinfectants, personal protective equipment (PPE), and paper products. All bathrooms had grab bars, and shower had non-slip mat for residents' use. All disinfectants/cleaners were locked and inaccessible to residents in care. All medications were locked and inaccessible to residents in care. LPA observed all utilities to be working appropriately, and available for use as required for facility operations. LPA observed the following deficiency: Per LPA's record reviews, R5 is diabetic, and needs insulin injections, per medical assessment dated 8/12/25. R5 has a one touch blood- glucose meter on that reads blood glucose levels. Per interview with staff S1, R5 does own insulin injection. Per medical assessment, R5 is not able to provide own injections or handle own medications; There is no Dr's Order that R5 is able to provide own injections or self inject the insulin KwikPen as needed. This deficiency will be cited, 87629(a) Injections - The licensee shall be permitted to accept or retain a resident who requires intramuscular, subcutaneous, or intradermal injections if the injections are administered by the resident or by an appropriately skilled professional, see LIC809D. Deficiencies cited from the California Code of Regulations, Title 22, Division 6 of California Regulation. Failure to correct the deficiency and/or repeat deficiencies within a 12 month period may result in civil penalties. Appeal rights provided to the Administrator. Exit interview conducted with Licensee/Administrator Josephine Blancaflor.the state’s words, verbatim · CDSS document, Oct 14, 2025

Type of visit: Case Management - Annual Continuation

Licensing Program Analyst (LPA) Alviso conducted continued annual inspection and met with live-in caregiver Melanie Taningco. LPA observed a second caregiver, Jennie, working in the facility upon arrival. Administrator Josephine Blancaflor was contacted, and arrived within the hour to meet with the LPA. There were six (6) residents in care during the LPA's inspection. Facility has an approved dementia plan of operation. There is an approved hospice waiver for two (2) residents. Fire clearance is approved for six (6) non-ambulatory, which includes one(1) bedridden approval (room #1 only). Facility has a required infection control plan. Facility has a required emergency disaster plan. LPA reviewed facility records. Emergency Disaster drill are conducted as required, quarterly drills with one being an evacuation drill. Last drills conducted with facility staff were held on 9/30 and 6/29, 2024. LPA observed all utilities were working appropriately and available for use as required for facility operations. Fire extinguishers (2) were serviced and tagged as required. All exits were clear and unobstructed. Facility was clean and orderly. Food supply was sufficient with both perishable and non-perishable foods; LPA observed lots of fruit on the kitchen counter which is used for residents meals and snacks. Resident rooms, bathrooms, hallways, and common areas had sufficient lighting for residents in care. All disinfectants and cleaners were locked and inaccessible to residents in care. All medications were locked and inaccessible to residents in care. The facility was at a comfortable temperature. There was a sufficient supply of hygiene products, linens, cleaners/disinfectants, personal protective equipment (PPE), and paper products. LPA reviewed six (6) resident files, including a review of resident medications/logs. Continued on LIC809C... LPA reviewed four (4) staff files, including staff required training. LPA is requesting the following documents be updated and submitted by 1/4/2025: LIC308 - Designation of Administrator Responsibility LIC500 - Personnel Report LIC610E-Emergency Disaster Plan (ensure to review and update as needed/required) Infection Control Plan (ensure to review and update as needed/required) Copy of LIC400 Handling of Client Cash Resources (include copy of surety bond if handling cash) Copy of Current Liability Insurance Resident Roster Copy of current Administrator Certificate LPA observed the following deficiencies which will be cited today: LPA observed the backyard fire exit gate to be broken, a bit slanted down, large and heavy, and not able to open freely as needed during an emergency. LPA obtained photos. The Administrator stated they have an estimate to have the gate and it's side fencing redone and balanced as needed, so the fire exit gate works appropriately. This deficiency will be cited, 87203 Fire Safety- All facilities shall be maintained in conformity with the regulations adopted by the State Fire Marshal for the protection of life and property against fire and panic, see LIC809D. Deficiencies cited from the California Code of Regulations, Title 22, Division 6 of California Regulation. Failure to correct the deficiency and/or repeat deficiencies within a 12 month period may result in civil penalties. Appeal rights provided to the Administrator. Exit interview conducted with Licensee/Administrator Josephine Blancaflor.the state’s words, verbatim · CDSS document, Dec 4, 2024

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Alviso conducted Required-1 Year inspection and met with live-in caregiver Melanie Taningco. LPA observed a second caregiver working in the facility upon arrival. Administrator Josephine Blancaflor was contacted, and arrived within the hour to meet with the LPA. There were five (5) residents in care during the LPA's inspection. Facility has an approved dementia plan of operation.There is an approved hospice waiver for two (2) residents. Fire clearance is approved for six (6) non-ambulatory, which includes one(1) bedridden approval (room #1 only). Facility has a required infection control plan. Facility has a required emergency disaster plan. LPA toured the facility. Hot water was 114.6 degrees Fahrenheit, which is within regulation. Fire extinguishers (2) were serviced and tagged as required. All exits were clear and unobstructed. Facility was clean and orderly. Food supply was sufficient with both perishable and non-perishable foods; LPA observed lots of fruit on the kitchen counter which is used for residents meals and snacks. LPA observed dinner being prepared, lasagne, salad, cut up watermelon. Resident rooms, bathrooms, hallways, and common areas had sufficient lighting for residents in care. Facility has replaced the slider doors, and are having the slider doorway bottoms worked on to have no safety hazards when coming in or out of the slider doors. All disinfectants/cleaners were locked and inaccessible to residents in care. All medications were locked and inaccessible to residents in care. The facility was at a comfortable temperature. There was a sufficient supply of hygiene products, linens, cleaners/disinfectants, personal protective equipment (PPE), and paper products. The annual will be continued at a later date.the state’s words, verbatim · CDSS document, Nov 6, 2024

Type of visit: Case Management - Annual Continuation

Licensing Program Analyst(LPA) Alviso conducted Required-1 Year inspection and met with live-in caregivers Melanie and Russel Taningco. Administrator Josephine Blancaflor was contacted by staff to notify them of LPA's arrival to the facility. There are six (6) residents in care. Facility has an approved dementia plan of operation. There is an approved hospice waiver for two (2) residents. Fire clearance is approved for six (6) non-ambulatory, which includes one(1) bedridden approval (room #1 only). Facility has an approved dementia plan of operation. Hospice waiver approved for one (1) resident. Facility has a required infection control plan. Facility has a required emergency and disaster plan. The LPA reviewed six (6) resident files. All files were complete. The LPA reviewed three (3) staff files. All staff have criminal record clearance as required. All staff have training. There was a sufficient supply of food, hygiene products, cleaners, and paper products. All auditory alarms were working as required. Based on LPA's review of facility records, and staff interviews, there have been no emergency drills conducted as required, quarterly drills; One of the quarterly drills must be a facility evacuation drill. The last drill per record review was in 2019. This deficiency will be cited. H&S Code 1569.695(c)- A facility shall conduct a drill at least quarterly for each shift. The type of emergency covered in a drill shall vary from quarter to quarter, taking into account different emergency scenarios. Documentation of the drills shall include the date, the type of emergency covered by the drill, and the names of staff participating in the drill, see LIC809D. Deficiencies cited from the California Code of Regulations, Title 22, Division 6 of California Regulation and Health and Safety Code. Failure to correct the deficiency and/or repeat deficiencies within a 12 month period may result in civil penalties. Appeal rights provided to staff Melanie Taningco for the Administrator. Exit interview conducted with staff Melanie Taningco.the state’s words, verbatim · CDSS document, Dec 12, 2023

Type of visit: Required - 1 Year

Licensing Program Analyst(LPA) Alviso conducted Required-1 Year inspection and met with live-in caregivers Melanie and Russel Taningco. Administrator Josephine Blancaflor arrived to the facility within the hour to meet with the LPA. There are six (6) residents in care during the LPA's inspection. Facility has an approved dementia plan of operation. There is an approved hospice waiver for two (2) residents. Fire clearance is approved for six (6) non-ambulatory, which includes one(1) bedridden approval (room #1 only). Facility has a required infection control plan. The LPA toured the facility with the caregivers. All exits were clear and unobstructed. All smoke alarms were working properly during the inspection; The facility has a carbon monoxide detector that was working properly during the inspection. Two fire extinguishers were serviced and tagged as required. Toxins/cleaners were locked up making them inaccessible to residents in care. Medications were locked up making them inaccessible to residents in care. The hot water was checked at 118.7 degrees Fahrenheit. The LPA will complete the annual inspection at a later date.the state’s words, verbatim · CDSS document, Dec 5, 2023