Casa Elite

Type of visit: Case Management - Health Checks

Licensing Program Analyst, David Roman (LPA D. Roman) conducted an unannounced case management visit to check on the health and safety of residents in care as well as to interview a staff/outside source for an unrelated case. LPA D. Roman gained access to the facility, identified himself, and met with Facility Manager, Beatriz Rivas to discuss the purpose of today's visit. LPA D. Roman's visit consisted of briefly speaking with residents concerning their health and safety, touring the interior and exterior of the facility, and obtaining additional information about the residents care. Overall, the facility did not have any immediate health and/or safety violations. The resident in question was out to dialysis services and is to return in the afternoon. LPA interviewed the House Manager, Beatriz regarding the residents health conditions. An exit interview was conducted with Facility Manager, Beatriz Rivas to which a copy of this report along with Licensee/Appeal Rights was provided to them whose signature below confirms receipt of this report and their rights.the state’s words, verbatim · CDSS document, Sep 2, 2026

Type of visit: Case Management - Other

Licensing Program Analyst, David Roman (LPA D. Roman) conducted an unannounced case management visit to check on the health and safety of residents in care as well as to interview a resident for an unrelated case. LPA D. Roman gained access to the facility, identified himself, and met with Facility Manager, Beatriz Rivas to discuss the purpose of today's visit. LPA D. Roman also met with Licensee, Irma Pineda via phone. LPA D. Roman's visit consisted of briefly speaking with residents concerning their health and safety, touring the interior and exterior of the facility, and obtaining additional information about the residents care. Overall, the facility did not have any immediate health and/or safety violations and after speaking with residents did not receive any complaints about their health. The resident that LPA was to interview is out to dialysis services and is to return in the afternoon around 4:00pm. LPA is to return to interview the resident. An exit interview was conducted with Facility Manager, Beatriz Rivas to which a copy of this report along with Licensee/Appeal Rights was provided to them whose signature below confirms receipt of this report and their rights.the state’s words, verbatim · CDSS document, Apr 10, 2026

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) David Roman conducted an unannounced Required Annual Inspection. The facility file was reviewed prior to the visit. LPA was welcomed by, identified himself to, and discussed the purpose of the visit with House Manager, Beatriz Rivas. According to the facility’s license, the facility has a maximum capacity of eight clients, of whom all may be non-ambulatory and three of which may be bedridden. A hospice waiver has been approved for one resident. At a later time, House Manager contacted the Administrator, Irma Pineda via video chat. LPA D. Roman introduced himself to the Administrator and informed them of the purpose for today's visit. LPA along with facility staff, toured the interior and exterior of the facility and inspected each room. The facility was sanitary, and in good repair. Pathways were free of obstruction and slip hazards. Resident bedrooms contained the required furnishings. Doors, windows, toilets, and showers were in working order. The facility had sufficient space and equipment to facilitate dining, laundry, visitation, meetings, and resident activities. Cooking/dining equipment and utensils were present. There were no toxic chemicals/poisons accessible to clients. Medications were labeled, as required, and stored in locked areas. Water temperature was measured at 105 degrees F. No pools or bodies of water on the premises. Per House Manager, Beatriz Rivas, no firearms or ammunition are kept at the facility. Smoke/carbon monoxide detectors, emergency lighting, and facility telephone were all working. Fire extinguishers were present. First aid kits were complete and readily accessible. Resident records reviewed needed required documentation. Staff records reviewed also needed required documentation. (Cont. on LIC809-C) LPA D. Roman informed House Manager, Beatriz Rivas of the information needed in the employee binders (First Aid Certificates, SOC341A forms, trainings etc.) as well as some information needed in the resident binders (admission agreements, identification & emergency contact info, etc). During today's visit it was observed that one resident's bed was in the common area. Administrator reported that the resident's bed is in the common area due to the severity of their health issues as staff are more accessible to their needs. LPA educated the Administrator on Title 22 regulations, specifically pertinent to personal rights, as well as fire clearance and facility sketch layouts. Administrator agreed to have the resident moved to a room ASAP. One deficiency was cited today for R1 bed in a common area, and technical violations were issued for plant and operations. An exit interview was conducted with House Manager, Beatriz Rivas, to whom a copy of this report the Licensee/Appeal Rights, and LIC 809-D were provided during the visit. LPA also contcated the Administrator, Irma Pineda via phone for the exit interview.the state’s words, verbatim · CDSS document, Mar 26, 2026

Type of visit: POC

LPA D. Roman conducted an unannounced visit to follow up on a Plan of Correction. LPA D. Roman identified, introduced himself, and discussed the purpose of the visit with House Manager, Beatriz Rivas. LPA D. Roman along with facility staff conducted a tour of the facility inside and outside. LPA D. Roman observed no resident beds in the common area. LPA D. Roman observed R1 to be sharing a bedroom in the second room to the right of the house entrance. LPA D. Roman also observed that R1's property, clothing, and medical equipment was moved into the bedroom. LPA D. Roman generated the cleared POC letter. LPA D. Roman reported that the POC is to be cleared. An exit interview was conducted with Facility Manager, Beatriz Rivas to whom a copy of this report and Licensee/appeal rights was provided along with the clearance of the POC.the state’s words, verbatim · CDSS document, Mar 26, 2026

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Liliana Silveira conducted an unannounced Required Annual Inspection. The facility file was reviewed prior to the visit. LPA was welcomed by, identified themselves to, and discussed the purpose of the visit with Licensee Irma Pineda. According to the facility’s license, the facility has a maximum capacity of 8 non-ambulatory elderly residents, three (3) of whom may be bedridden. There is a hospice waiver approved for eight (8) residents. LPA, accompanied by Irma, toured the interior and exterior of the facility, and inspected each room. The facility was clean, sanitary, and in good repair. Pathways were free of obstruction and slip hazards. Client bedrooms contained the required furnishings. Doors, windows and screens, toilets, and showers were in working order. Extra linens and hygiene supplies were present, as well as Personal Protective Equipment. The facility had sufficient space and equipment to facilitate dining, laundry, visitation, meetings, and client activities. The facility’s ambient internal temperature was 77 degrees F. Hot water temperature at taps accessible to clients were all compliant: Bathroom #1 sink was 116.5 F. Bathroom #2 had two sinks: #1 was 118.1 F and #2 was 118.2 F. Bathroom #3 sink was 115.8. No pools or bodies of water were observed on the premises. Per Licensee Irma Pineda, no firearms or ammunition are kept at the facility. Smoke alarms, carbon monoxide detectors, emergency lighting, and facility telephone were all working. Fire extinguisher(s) were serviced within the last 12 months. First aid kit(s) were complete and readily accessible. There were no sharp objects, toxic chemicals/poisons, fireplaces, or open-faced heaters accessible to clients. Medications were labeled, as required, and stored in locked areas. Required licensing postings were observed in visible areas of the facility. [CONTINUED ON LIC 809-C] [CONTINUED FROM LIC 809] LPA interviewed staff and residents. LPA reviewed staff and client records/files. The interviews did not raise any significant licensing concerns. The reviewed files contained required documents. Confidential records were stored in locked areas. Irma also presented proof of current/active business liability insurance and surety bond. There was at least 2 days of perishable food, and at least 7 days non-perishable food present, all safely stored in the kitchen. Cooking/dining equipment and utensils were present. No deficiencies were observed or cited during today's annual inspection. An exit interview was conducted with Irma, to whom a copy of this report and Licensee/Appeal Rights (LIC9058 03/22) were provided.the state’s words, verbatim · CDSS document, Oct 30, 2024

Type of visit: Required - 1 Year

Licensing Program Analysts (LPAs) Iby Strong and Amy Rodgers conducted an unannounced Required Annual Inspection. The facility file was reviewed prior to the visit. LPAs were welcomed by, identified themselves to, and discussed the purpose of the visit with Administrator Irma Pineda. According to the facility’s license, the facility has a maximum capacity of eight (8) clients, of whom may be non-ambulatory. LPA Rodgers, toured the interior and exterior of the facility, and inspected each room. The facility was clean, sanitary, and in good repair. Pathways were free of obstruction and slip hazards. Resident bedrooms contained the required furnishings. Doors, windows, toilets, and showers were in working order. Extra linens and hygiene supplies were present. The facility had sufficient space and equipment to facilitate dining, laundry, visitation, meetings, and resident activities. There was at least 2 days of perishable food, and at least 7 days non-perishable food present, all safely stored. Cooking/dining equipment and utensils were present. There were no toxic chemicals/poisons accessible to residents. Medications were labeled, as required, and stored in locked areas. No pools or bodies of water on the premises. Per Irma, no firearms or ammunition are kept at the facility. Carbon monoxide detectors, emergency lighting, and facility telephone were all working. Fire extinguisher(s) were present. First aid kit(s) were complete and readily accessible. Required licensing postings were observed in visible areas of the facility. LPA interviewed staff and reviewed staff record. LPA interview did not raise any licensing concerns. The files reviewed did not contain first aid training for two current staff. Confidential records were stored in locked areas. A deficiency is cited per California Code of Regulations, Title 22 (refer to the attached LIC 9099-D). An exit interview was conducted with Administrator, to whom a copy of this report, LIC 9099-C, LIC 9099-D, and the Licensee/Appeal Rights (LIC 9058 03/22) were provided to.the state’s words, verbatim · CDSS document, Nov 6, 2023

Type of visit: Case Management - Other

Licensing Program Analyst (LPA), Sabel Martinez, conducted an unannounced Case management visit. The LPA identified himself, and explained the purpose of the visit to Caregiver Veronica Naranjo. During today's visit, the LPA secured report signatures and delivered an amended report. An exit interview was conducted with Naranjo, to whom a copy of this report and the licensee appeal rights (LIC9058) were provided.the state’s words, verbatim · CDSS document, Oct 26, 2023

Type of visit: Case Management - Deficiencies

Licensing Program Analyst (LPA) Sabel Martinez conducted an unannounced Case Management visit to cite deficiencies discovered during a complaint investigation. The LPA introduced himself and disclosed the purpose of the visit to Caregiver Veronica Naranjo. Interviews, along with observations by the LPA, revealed the facility had used cannabis oil, and dried cannabis leaves to make teas for residents in care. The Cannabis oil was stored in the kitchen area in an unlocked location. Additionally, the Cannabis oil did not have the required labels. Prescribed Cannabis Gummies were also witnessed to be stored in the kitchen area in an unlocked location. These deficiencies were cited in an LIC 809D, and a Plan of Correction was jointly formulated with Administrator Pineda, over a telephone call. An exit interview was conducted with Naranjo, to whom a copy of this report, LIC 809D, and Licensee/Appeal Rights (LIC 9058), were providedthe state’s words, verbatim · CDSS document, Oct 26, 2023

From the deficiency page — Deficiency type: Type B · Section cited: CCR 87465(h)(2) · Plan of correction due date: Oct 26, 2023

87465 Incidental Medical and Dental Care (h) The following requirements shall apply to medications which are centrally stored: (2) Centrally stored medicines shall be kept in a safe and locked place that is not accessible to persons other than employees responsible for the supervision of the centrally stored medication. This requirement was not mer as evidenced by: Based on interviews and observation, the Licensee did not ensure centrally stored medication was locked in a place no accesible to residents in care, which posed a potential health, safety, and personal rights risk to 6 of 6 residents in care.the state’s words, verbatim · CDSS document, Oct 26, 2023

Plan of correction: Administrator agreed to provide centrally store medication training to all staff and submit proof of training, by 11/17/23.

From the deficiency page — Deficiency type: Type B · Section cited: CCR87475(h)(4) · Plan of correction due date: Oct 26, 2023

87465 Incidental Medical and Dental Care (h) The following requirements shall apply to medications which are centrally stored: (4) All centrally stored medications shall be labeled and maintained in compliance with state and federal laws. No persons other than the dispensing pharmacist shall alter a prescription label. This requirement was not met as evidenced by: Based on interviews and observations, the Licensee did not ensure centrally stored medication was labeled and maintained in complaince, which posed a potential health, safety, and personal rights risk to 6 of 6 residents in care.the state’s words, verbatim · CDSS document, Oct 26, 2023

Plan of correction: Administrator agreed to provide centrally store medication training to all staff and submit proof of training, by 11/17/23.