Cavilla Care Home

Type of visit: Required - 1 Year

At 10:00 am on 03/10/2026, Licensing Program Analyst (LPA) Rankin arrived at the facility unannounced to conduct the annual facility inspection. LPA met with Licensee's Joyce Cabandong. A tour of the inside and outside of the facility was conducted. The following was inspected and noted during the annual visit: Physical Plant & Environment Safety: The facility is a 6 bedroom and 3 bathroom home. One room is for staff. The facility occupies 4 residents and employs 3 staff of which one is the Administrator and facility has 2 on-call staff. The facility is clean, safe and sanitary. LPA noted that all resident bedrooms had required furnishings and bedding. The facility has smoke and carbon monoxide detectors which were tested and working at time of visit. The lighting and lamps are sufficient for the use of the facility and for resident comfort and safety. The showers have non-skid flooring. Toilet, hand washing and bathing facilities are operational and secured grab bars are present. The pathways are clear of any obstructions. Disinfectants, cleaning solutions and poisons are inaccessible to residents. The facility has sufficient space inside and outside for activities and visiting. The facility has a backyard for client use with furniture and plenty of shade. The backyard has a locked shed to store extra furniture and items. Operational Requirements: The Facility is operating in compliance with the granted fire clearance based on the facility sketch. The facility has current liability insurance and expires on 03/07/2027. The facility is approved for a capacity of 6 non-Ambulatory and approved for hospice waiver of 1. Continued 809-C Staffing, Personnel Records & Training: Staff records are kept confidential. LPA reviewed staff files. Files reviewed had current 1st Aid/CPR, Personnel Records/Application, Health screening with TB results, Criminal Record statements, and Fingerprint clearance/Associations/exemptions. Administrators certificate is expires 4/8/27. Resident Records & Incident Reports: The facility keeps separate files on each resident confidential. Four files were reviewed for but not limited to signed Admission Agreements, Medical Assessments, ID and Emergency contact forms. Records complete. Incidental Medical & Dental: The facility has a medication cabinet in the kitchen that is kept locked. Facility provides or assist in providing transportation to medical and dental appointments when needed. The medications records were reviewed, and all residents had a Centrally Stored Medication Destruction Record (CSMDR) and Medication Administration Records (MAR) . Administrator maintains a record of PRNs provided. LPA reviewed a sampling of residents’ medications, no medications labels were altered, no expired medications, and medications were stored in original containers. Food Service: The facility handles and prepares food safely. The facility has 2-day perishables and 7 day non-perishables to meet the food service requirement. All food is covered, stored and marked appropriately. Fresh fruit and vegetables was noted by LPA. Food, snacks and drinks are available when the residents want them. Cleaning solutions and equipment are stored separately from food supplies. Kitchen areas are kept clean and free from litter, rodents, and insects. Disaster Preparedness: The current emergency disaster forms were posted. The facility conducts quarterly disaster drills; last drill occurred in January of 2026. The fire extinguishers were charged and last inspected on 3/2/26. Emergency exits and telephone numbers were posted. A set of keys is available for staff on all shifts to access full facility in an emergency. Residents with Special Health Needs: The facility does accept dementia residents in care. All items that could pose a danger, sharps, cleaners were locked or in accessible to residents in care. The facility does not have delayed egress. The backyard has a double gate that needs to be repaired, and the facility is actively working on it. Exit interview conducted and copy of report printed for Administrator.the state’s words, verbatim · CDSS document, Mar 10, 2026

The state marks this report as 6 pages; the online copy we transcribed has 3. You can request the full file from the county licensing office.

Type of visit: Required - 1 Year

At 9:05 am on 04/9/2025, Licensing Program Analyst (LPA) Rankin arrived at the facility unannounced to conduct the annual facility inspection. LPA met with Licensee's Joyce and Joseph Cabandong announced who they are and the reason for the visit. A tour of the inside and outside of the facility was conducted with Administrator. The following was inspected and noted during the annual visit: Physical Plant & Environment Safety: The facility is a 6 bedroom and 3 bathroom home. The facility is occupying 4 residents and employs 3 staff of which one is the Administrator. The facility is clean, safe and sanitary. LPA was authorized to enter and inspect facility. LPA's noted that all resident bedrooms had required furnishings and bedding by regulations. The facility has smoke and carbon monoxide detectors. Carbon Monoxide was tested and working properly. The lighting and lamps are sufficient for the use of the facility and for resident comfort. The showers have non-skid mats/flooring. Toilet, hand washing and bathing facilities are operational and secured grab bars are present. The pathways are clear of any obstructions. Facility is well lit inside and outside for safety. Disinfectant, cleaning solutions and poisons are inaccessible to residents. The facility has sufficient space inside and outside for activities and visiting. The facility has a backyard for client use with furniture and plenty of shade. The facility has telephone and internet service for resident use. Operational Requirements: The facility has a current plan of operation on file. The Facility is operating in compliance with the granted fire clearance based on the facility sketch. The facility has current liability insurance and expires on 03/20/2026. The facility is approved for a capacity of 6 non-Ambulatory and approved for hospice waiver of 1. Continued 809-C Staffing, Personnel Records & Training: Staff records are kept confidential. LPA reviewed staff files and administrator training's. Completion of administrator application is being scheduled and will be submitted to LPA. Citation for expired certificate was given. Administrators certificate was submitted for renewal, but LPA noted missing courses. Files reviewed had current 1st Aid/CPR, Personnel Records/Application, Health screening with TB results and annual training certificates. Annual training required by staff is scheduled to be completed by the end of April. Resident Records & Incident Reports: The facility keeps separate files on each resident confidential. Four files were reviewed for signed Admission Agreements, Medical Assessments, LIC. 602A Physicians Report, ID and Emergency contact forms, Appraisal Needs and Services plans (ANS), TB results, Personal Rights, and Safeguard for personal property and valuables. The facility does not handle cash resources. Incidental Medical & Dental: The facility has a medication cabinet in the kitchen that is kept locked. Facility provides or assist in providing transportation to medical and dental appointments when needed. The medications records were reviewed, and all residents had a Centrally Stored Medication Destruction Record (CSMDR). Administrator maintains a record of PRNs provided; LPA gave additional guidance for an update to their PRN log. LPA reviewed all residents’ medications, no medications labels were altered, no expired medications, and medications were stored in original containers. Food Service: The facility handles and prepares food safely. The facility has 2-day perishables and 7 day non-perishables to meet the food service requirement. All food is covered, stored and marked appropriately. Fresh fruit and vegetables was noted by LPA. Food, snacks and drinks are available when the residents want them. Cleaning solutions and equipment are stored separately from food supplies. Kitchen areas are kept clean and free from litter, rodents, and insects. Disaster Preparedness: The current emergency disaster forms were posted. The facility conducts disaster drills, administrator will be adding quarterly drills to their schedule. The fire extinguishers were charged. Emergency exits and telephone numbers were posted. Continued to 809-C Residents with Special Health Needs: The facility does accept dementia residents in care. All items that could pose a danger, sharps, cleaners were locked or in accessible to residents in care. The facility does not have delayed egress. The facility does have 1 hospice resident in care. Hospice services records are kept on file. The administrator noted the facility gate will be repaired and updated with self-latching and self-closing equipment. Gate showed repair from last years visit, but new concrete was poured at residence next door which adjusted the ground. The backyard is completely fenced. Exit interview conducted, citation issued, and copy of Appeal Rights and annual report printed for Administrator.the state’s words, verbatim · CDSS document, Apr 9, 2025

The state marks this report as 13 pages; the online copy we transcribed has 5. You can request the full file from the county licensing office.

Type of visit: Required - 1 Year

At 8:00 am on 04/16/2024, Licensing Program Analyst (LPA's) Rankin and Jeffries arrived to the facility unannounced to conduct the annual facility inspection. LPA's met with Licensee's Joyce and Joseph Cabandong announced who they are and the reason for the visit. Licensee and LPA's conducted a full facility physical inspection. LPA's noted that this is a 6 bedroom , 3 bathroom, den, two living room area's, dining room and kitchen. Medications are locked in two cabinets in the kitchen area and staff and residents records are kept in a locked cabinet in the den. LPA's tested smoke detectors and carbon monoxide detectors to all be in working condition. LPA's observed the garage door to be locked however one of the locks required adjustment. LPA's noted that all resident bedrooms had required furnishings and bedding by regulations. LPA's noted that the facilitates water temperature was with in regulations temperature. LPA observed at least two days of perishable and at least 7 days of non-perishable foods on hand for 6 residents and staff. LPA's conducted a staff and resident file review. LPA's conducted a sample medication audit. LPA's noted that Centrally Stored Medication Record (CSMR) was missing and two needed updating, this was addressed in the care tools modules. LPA's noted that the facility was clean and in good repair. LPA noted that all passageways and doors were clear of obstacle and debris. LPA's noted that both fire extinguishers observed were pressurized and in the green reading. Licensee and LPA's conducted a full review of the annual care tools modules. LPA's note two citations during the care tools module. Administrators certificate was expired. LPA's address expired certificate with Licensee as requiring additional hours for completion and current administrators certificate. The second violation as noted above, CSMR was missing and not updated, this resulted in a citation and required mitigation with in 24 hours. LPA noted that no other citations were issued as a result of this annual facility inspection. Exit interview, report read, appeal rights provided, and report provided.the state’s words, verbatim · CDSS document, Apr 16, 2024

The state marks this report as 4 pages; the online copy we transcribed has 3. You can request the full file from the county licensing office.