Casa Blanca Homecare

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Michael Cava conducted an Annual Required visit and inspection of the facility. LPA met with the staff, Angelita Cayanan, and explained the reason for the visit. At approximately 11:45pm, LPA took a tour of the physical plant. The facility is a two story building, but only the first floor is licensed for operation. Only the licensee/owner occupies the second floor. No residents are allowed on the second floor. Required postings were observed in the entry area. The smoke alarms are hardwired and interconnected. The carbon monoxide detector is located in the dining room area. The fire extinguisher is located in the kitchen. Kitchen: The kitchen appliances and fixtures were functional. LPA found a sufficient amount of perishable and non-perishable food properly stored. Knives and cleaning supplies are being stored in locked drawers. Properly labeled medications were locked in one of the kitchen cabinets. Bedrooms: There are three (3) bedrooms designated for residents' use. Two (2) bedrooms are for private use, and one (1) is shared. Bedrooms were properly furnished with appropriate beddings and linens with sufficient lighting. Bathrooms: There is one (1) bathroom designated for the residents' use. The bathroom was observed to be properly supplied and had functional fixtures. Hot water temperature was measured at 111 degrees Fahrenheit. There were no cleaning supplies stored in the bathroom during the day's inspection. Common Areas: These included the living room and dining area, which is next to each other. The common areas were properly furnished with a dining room table, large enough to seat six (6). The den has a recliner, long table and fireplace, which is non-functional and screened properly. No tools present. The auditory alarms on all exit doors were on and functional at the time of the visit. Surrounding Grounds: Entry/exits were free of obstruction. There are furniture appropriate for outdoor use. The outdoor area was free of hazards. There is a swimming pool, which is properly fenced with a five foot gate enclosing it. There is a lock at the gate, making entry inaccessible for the residents to gain entry. Garage: The garage is attached to the home. There is an additional refrigerator for extra perishable food storage. PPE and cleaning supplies are also maintained in the garage. Entry to the garage from the inside of the home is locked at all times, and requires a combination to unlock and gain entry. Laundry: Washer/dryer for the laundry is in the garage. Resident Files: LPA conducted a file review to insure forms are compliant with regulation. Staff Files: LPA conducted a file review of staff records to insure forms and training are up to date and compliant with regulation. . Medications: Medications are stored and locked in a cabinet. Medications and medication records were reviewed for proper storage and documentation. Pursuant to Title 22 Division 6 of the CA Code of Regulations, there were no deficiencies observed during the visit. Exit Interview Conducted and a Copy of the Report Issued.the state’s words, verbatim · CDSS document, Dec 3, 2025

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Michael Cava conducted an Annual Required visit and inspection of the facility. LPA met with the administrator, Marilou Andreas and explained the reason for the visit. At approximately 12:30pm, with the assistance of the administrator, LPA took a tour of the physical plant. The facility is a two story building, but only the first floor is licensed for operation. Only the licensee/owner occupies the second floor. No residents are allowed on the second floor. Required postings were observed in the entry area. The smoke alarms are hardwired and interconnected. The carbon monoxide detector is located in the dining room area. The fire extinguisher is located in the kitchen. Kitchen: The kitchen appliances and fixtures were functional. LPA found a sufficient amount of perishable and non-perishable food at the facility; properly stored. Knives and cleaning supplies are being stored in locked drawers. Properly labeled medications were locked in one of the kitchen cabinets. Bedrooms: There are three (3) bedrooms designated for residents' use. Two (2) bedrooms are for private use, and one (1) is shared. Bedrooms were properly furnished with appropriate beddings and linens with sufficient lighting. Bathrooms: There is one (1) bathroom designated for the residents' use, which was observed to be properly supplied and had functional fixtures. Hot water temperature was measured at 114 degrees Fahrenheit. There were no cleaning supplies stored in the bathroom during the day's inspection. Common Areas: These included the living room and dining area, which is next to each other. The common areas were properly furnished with a dining room table, large enough to seat six (6). The den has a recliner, long table and fireplace, which is non-functional but screened properly. No tools present. The auditory alarms on all exit doors were on and functional at the time of the visit. Surrounding Grounds: Entry/exits were free of obstruction. There was furniture appropriate for outdoor use. The outdoor area was free of hazards. There is a swimming pool, which is properly fenced with a five foot gate enclosing it. There is a lock at the gate, making entry inaccessible for the residents to gain entry. Garage: The garage is attached to the home. There is also an additional refrigerator for extra perishable food storage. PPE and cleaning supplies are maintained in the garage. Entry to the garage from the inside of the home is locked at all times, and requires a combination to unlock and gain entry. Laundry: Washer/dryer for the laundry is in the garage. Resident Files: Facility currently has no residents at this time. Staff Files: LPA conducted a file review of staff records to insure forms and training are up to date and compliance with licensing forms. Medications: There is a kitchen cabinet designated to store and lock medications. Pursuant to Title 22 Division 6 of the CA Code of Regulations, there were no deficiencies observed during the visit. Exit Interview Conducted and a Copy of the Report Issued.the state’s words, verbatim · CDSS document, Nov 9, 2024

Allegation investigated: Due to neglect, resident has multiple unstageable pressure injuries

This is an amended report to the complaint investigation report issued by Licensing Program Analyst (LPA) Martha Guzman Chavez on February 3, 2022. The initial findings to the above allegation was substantiated at that time. The Licensee had since submitted a first and second level appeal, which was reviewed by the Department. Based on this review, the Licensee provided a chronological timeline of events of Resident 1’s (R1) condition, which was being treated by home health, and by facility staff with instruction from home health, for maintenance, moisturizing, prevention, and ongoing care of R1. Furthermore, information submitted by the Licensee reveal that on May 11, 2020, R1 was transferred to the hospital per physician’s instructions, due to R1 experiencing pain and discoloration. At admission to the hospital, on May 11, 2020, medical records indicate that R1 was noted to have a mild skin breakdown, and a diagnosis of a “mild stage II decubitus ulcer”. On May 12, 2020, while still at the hospital, a wound care clinician examined R1’s wound to progress and become an Unstageable pressure injury. Unsubstantiated Based on the Department's review of this appeal and supporting documents, it was determined that there is a lack of sufficient evidence to support the citation issued by LPA Guzman Chavez issued under section 87615(a)(1) Prohibited Health Condition. Therefore, the appeal is granted, and the citation with the related $500 civil penalty is dismissed. The allegation finding is changed from Substantiated to Unsubstantiated. The Licensee is advised and a copy of this report given.the state’s words, verbatim · CDSS document, Nov 16, 2023 · control 31-AS-20200515121104

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Michael Cava conducted an Annual Required visit and inspection of the facility. LPA met with the administrator, Marilou Andreas and explained the reason for the visit. At 10:15am, with the assistance of the administrator, LPA took a tour of the physical plant. The facility is a two story building, but only the first floor is licensed for operation. Only the licensee/owner occupies the second floor. No residents are allowed on the second floor. Required postings were observed in the entry area. The smoke alarms are hardwired and interconnected. The carbon monoxide detector is located in the dining room area. The fire extinguisher is located in the kitchen. It was purchased on 11/30/22. Kitchen: The kitchen appliances and fixtures were functional. LPA found a sufficient amount of perishable and non-perishable food at the facility; properly stored. Knives and cleaning supplies are being stored in locked drawers. Properly labeled medications were locked in one of the kitchen cabinets. Bedrooms: There are three (3) bedrooms designated for residents' use. Two (2) bedrooms are for private use, and one (1) is shared. Bedrooms in use by residents were properly furnished with appropriate beddings and linens with sufficient lighting. Bathrooms: There is one (1) bathroom designated for the residents' use, which was observed to be properly supplied and had functional fixtures. Hot water temperature was measured at 110.5 degrees Fahrenheit. There were no cleaning supplies stored in the bathroom during the day's inspection. Common Areas: These included the living room and dining area, which is next to each other. The common areas were properly furnished with a dining room table, large enough to seat six (6). The auditory alarms on all exit doors were on and functional at the time of the visit. Surrounding Grounds: Entry/exits were free of obstruction. There was furniture appropriate for outdoor use. The outdoor area was free of hazards. There is a swimming pool, which is properly fenced with a five foot gate enclosing it. There is a lock at the gate, making entry inaccessible for the residents to gain entry without supervision. The garage is designated for extra storage and the laundry area. There is also an additional refrigerator for extra perishable food storage. PPE and cleaning supplies are maintained in the garage. Entry to the garage from the inside of the home is locked at all times, and requires a combination to unlock and gain entry. Resident Files: LPA conducted a file review of resident records to insure compliance of licensing forms. Staff Files: LPA also conducted a file review of staff records to insure forms and training are up to date and compliance with licensing forms. Medications: Medication and Medication Records were review for proper documentation. Pursuant to Title 22 Division 6 of the CA Code of Regulations, there were no deficiencies observed during the visit. Exit Interview Conducted and a Copy of the Report Issued.the state’s words, verbatim · CDSS document, Nov 16, 2023