Casa Blanca Senior Care

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Tena Herrera conducted the required annual inspection. LPA arrived unannounced and met with Assistant Administrator Daniela Duarte and explained the purpose for today’s visit. The facility is licensed to serve (6) non-ambulatory individuals ages 60 and over (1) of which may be bedridden in Room #1. There is a hospice waiver for (2). The facility is a single-story home located in Bellflower, Ca. A tour of the facility includes: living room, dining area, kitchen, 3 bedrooms, 1 1/2 bathrooms (1/2 bath is designated for staff), laundry area is in the outdoor patio, there is a front yard and back yard. There is a separate detached ADU in the back of the facility that is currently occupied by licensee, this ADU is not part of the licensed facility. LPA used the Compliance and Regulatory Enforcement (CARE) tools for the visit todays visit and observed the following: Infection Control: The facility maintains the required Infection Control Plan. Operational Requirements: The facility has an approved fire clearance, there is a plan of operation with required Infection Control Plan and facility maintains the required liability insurance. Physical Plant & Environment Safety: LPA toured facility, residents’ bedrooms were checked and closet/drawer space to accommodate each resident comfortably was available. The front yard is free of debris/hazards and the outdoor and passageways are free of obstruction. No bodies of water were observed at the facility. There are no security bars or weapons on the premises. Hygiene products are readily available for clients. All storage areas for cleaning solutions, toxins, knives, and hazardous items are kept in a locked and are inaccessible to residents. Smoke detectors and carbon monoxide detectors are operable and in compliance. There fire extinguisher was observed and is fully charged. (Continued on LIC809-C) Staffing & Personnel Records-Training: LPA attempted to review 3 staff files and the files were not readily available for review, citationissued. Administrator Daniela Duarte certificate expires on 8/22/27. Resident Records-Incident Reports: Resident files are kept in a secure location (within staff room/office) and have the following documents in their files - Pre-admission appraisal/Appraisal Needs & Services Plan, Admission Agreements, Identification & Emergency Information and current Physician's Report. Proof of yearly needs and service was not updated, however, staff utilize an app where this is documented, LPA advised it would be best practice to update in one form or general area as the app did not have information easily accessible for this type of visit. Residents Rights-Information: Residents are provided with telephone and internet at the facility. The facility has the following posters posted: Residents Rights, Complaint Poster, and Ombudsman. Planned Activities: There is an outdoor activity area available for the residents. Food Service: The kitchen was observed for the ability to prepare and serve food. LPA observed an appropriate food supply of two (2) days of perishables and one week (7 days) of non-perishables. Incidental Medical & Dental: Medication is properly labeled and are centrally stored in a cabinet and are in their original containers. LPA reviewed 4 residents’ medications and observed that R1 and R2 are missing 1 of their routine medications each, citation issued. Disaster Preparedness: The facility has an Emergency Disaster Plan with contact numbers and at least 2 relocation sites. Last fire/disaster/earthquake drill was conducted on 6/18/26, technical advisory given to remind staff these must be done quarterly as proof of quarterly drills were not provided during visit. Residents with Special Health Needs: There are no bedridden or residents with postural supports at this facility. Per California Code of Regulations, Title 22, and California Health and Safety Code, the deficiencies observed during the visit will be documented on the LIC809D page. Exit interview held and a copy of the report and appeal rights were provided.the state’s words, verbatim · CDSS document, Jul 28, 2026

Type of visit: Case Management - Annual Continuation

Licensing Program Analyst (LPA) Tena Herrera arrived unannounced and met with Assistant Administrator Daniela Duarte to continue and complete the facilities 2025 Annual inspection, the purpose for today’s visit was explained. LPA utilized the Compliance and Regulatory Enforcement (CARE) tools for the visit todays visit, focused on the remaining domains and observed the following: Personnel Records and Staffing: There appears to be sufficient staffing at all times in the facility. Staff have criminal record clearance, current First-Aid training along with training in postural supports, Alzheimer’s and Dementia, medication assistance, and other ongoing training are documented in personnel files. LPA reviewed 5 staff files, and observed staff #1 missing their health screening and TB negative result missing from file, additionally Staff #1 is not associated to the facility (is finger print cleared just not associated - citations will be issued and details can be found on the LIC809-D page). Administrator/Licensee Miriam Galicia certificate is expired, however, there was proof of pending renewal provided during visit. Resident Records/Incident Reports: Resident files are kept in a secure location and have the following documents in their files - Pre-admission appraisal, Admission Agreements, Identification & Emergency Information and current Physician's Report. LPA reviewed 2 Resident Files during todays visit. Residents with Special Health needs: There are no bedridden or residents on hospice services at this time. Operational Requirements: Facility does not have the required liability insurance on file (citation will be issued and details can be found on the LIC809-D page) Per California Code of Regulations, Title 22, and California Health and Safety Code, deficiencies observed during today’s visit are documented on the 809-D. Exit interview was held and a copy of the report and appeal rights were emailed to casablancaseniorcare@gmail.comthe state’s words, verbatim · CDSS document, Sep 26, 2025

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Tena Herrera conducted the required annual inspection. LPA arrived unannounced and met with Assistant Administrator Daniela Duarte and explained the purpose for today’s visit. The facility is licensed to serve (6) non-ambulatory individuals ages 60 and over (1) of which may be bedridden in Room #1. There is a hospice waiver for (2). The facility currently has (1) resident that is receiving hospice services. This is a single-story home located in a residential area in Bellflower, Ca. A tour of the facility includes: living room, dining area, kitchen, 3 bedrooms, 1 1/2 bathrooms (1/2 bath is designated for staff), laundry area is in the outdoor patio, there is a front yard and back yard. There is a separate detached ADU in the back of the facility that is currently occupied by licensee, this ADU is not part of the licensed facility. LPA utilized the Compliance and Regulatory Enforcement (CARE) tools for the visit todays visit and observed the following: Infection Control: The facility maintains the required Infection Control Plan. Residents Rights-Information: Residents are provided with telephone and internet at the facility. The facility has the following posters posted: Residents Rights, Complaint Poster, and Ombudsman. Planned Activities: Facility provides scheduled activities and have a variety of activities to choose from within the facility. There is an outdoor activity area available for the residents. Disaster Preparedness: The facility has an Emergency Disaster Plan with contact numbers, however, Assistant Administrator Daniela confirmed they have not been conducting the required quarterly drills, details of this citation will be documented on the LIC809-D page. Continued on LIC809-C page. Physical Plant & Environment Safety: LPA toured facility, residents’ bedrooms were checked and closet/drawer space to accommodate each resident comfortably was available. The front yard is free of debris/hazards and the outdoor and passageways are free of obstruction. No bodies of water were observed at the facility. There are no security bars or weapons on the premises. Hygiene products are readily available for clients. The hot water temperature was tested throughout the facility and measured outside the required range of 105-120 degrees F, measuered at 140.0 degrees F during todays visit, citation will be issued and documented on the LIC809D page). All storage areas for cleaning solutions, toxins, knives, and hazardous items are kept in a locked and are inaccessible to residents. Smoke detectors and carbon monoxide detectors are operable and in compliance. There fire extinguisher was observed and is fully charged. During visit LPA observed 2 trails of ants, one trail in kitchen near fruit cart/med cabinet, one trail under dining table and one trail in Room #1. Food Service: The kitchen was observed for the ability to prepare and serve food. LPA observed an appropriate food supply of two (2) days of perishables and one week (7 days) of non-perishables. Incidental Medical & Dental: Medication are labeled and centrally stored in a cabinet and are in their original containers. LPA reviewed 3 residents’ medications and observed that staff have been placing medication in a weekly pill container which is not permitted per title 22 regulations, citation will be issued and details will be found on LIC809D page. LPA will return at a later time to complete inspection and review Personnel Records, Resident Files and Documentation for Residents with Special Health needs, and Proof of Liability Insurance. Per California Code of Regulations, Title 22, and California Health and Safety Code, the deficiencies observed during todays visit will be documented on the LIC809D page.. Exit interview held and a copy of the report and appeal rights were emailed to casablancaseniorcare@gmail.com.the state’s words, verbatim · CDSS document, Sep 12, 2025

Type of visit: Prelicensing

Licensing Program Analyst (LPA) Tena Herrera conducted an announced pre-licensed visit and met with Licensee Miriam Galicia and Administrators Karina Sanchez, Andrea Duarte, and Daniela Duarte for the purpose of conducting a Pre-Licensing Inspection / Component III visit. The facility has an approved fire clearance to be licensed to serve a capacity of six (6) non-ambulatory residents ages 60 and over, of which one (1) may be bedridden in room #1 (room closest to dining area). There is a Hospice Waiver Granted for two (two). This is a single-story home located in a residential area in Bellflower, Ca. A tour of the facility includes: living room, dining area, kitchen, 3 bedrooms, 1 1/2 bathrooms (1/2 bath is designated for staff), laundry area is in the outdoor patio, there is a front yard and back yard. There is a separate detached ADU in the back of the facility that is currently occupied by licensee, this ADU is not part of the licensed facility, LPA will inform CAB specialist of ADU and CAB will reach out to Licensee for any additional information that may be needed, as ADU was not listed on Facility Sketch not Fire Clearance. ADU has same address as facility. The physical plant was toured inside and out alongside Administrators. The following was observed/inspected: · There is a locked storage area that is centrally located for medication located in the dining area. · Cleaning supplies are kept separate from food and located in a locked cabinet in the patio. · Facility walls, ceilings, floors, window screens and areas around the facility are clean and in good repair. · Fire extinguisher and smoke detectors operate properly. · Doors and passageways are free of obstruction. (Continued on 809-C) · There are no pools/bodies of water at the facility and facility does not have firearms on premises. · There is an emergency exiting plan with emergency phone numbers posted. · There is a current disaster and mass casualty plan maintained at the facility. · There is a plan for staffing arrangements and a designated cabinet where personnel files will be stored. · Operating telephone and desktop computer on the premises and will be available to residents. · Residents Records have a designated area within a locked cabinet for safe keeping. · There is a linen closet with extra linens and towels. · Facility has a laundry area in the patio area. · First-aid supplies are maintained and readily available. · Refrigerator and freezer were observed and are maintained at the correct temperatures. · Food storage and preparation are clean and appropriate for food preparation. · Hot water temperature was tested and is within the required range of 105-120 degrees F. Component III was completed during todays visit and reviewed by Licensee and Administrators. An exit interview was conducted, and a copy of this report has been furnished to Licensee . Accordingly, LPA will submit a copy of this facility evaluation report to the Central Applications Bureau (CAB) for review. If the applicant has questions regarding the status of the application, they have been instructed to communicate with the CAB Analyst assigned to their application.the state’s words, verbatim · CDSS document, Sep 10, 2024