Chalet Terrace Senior Living

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Alberto Lopez conducted an unannounced annual required 1-year visit. . LPA was met by Evangelina Reyes, Co-Administrator and Administrator Amanda Palomino arrived a short time later and also assisted with the visit. LPA explained the purpose of the visit. The facility is licensed to serve six (6) residents over the age of 60, of which six (6) may be non-ambulatory and has a hospice waiver approved for four (4). One (1) out of the six (6) residents in care is currently on hospice care. LPA OBSERVATIONS: 1. Infection Control: The facility staff are using appropriate hand hygiene and wearing gloves while assisting the clients. Staff are cleaning and disinfecting each shift for high touched surface area. Facility has sufficient PPE supplies and but does have an Infection Control Plan. Physical Plant: The facility is a single-story dwelling located in a residential neighborhood and consists of three (3) resident bedrooms, one (1) staff bedroom, two (2) shared bathrooms, kitchen, dining room, living room, detached garage, front yard, and backyard. LPA Lopez observed auditory device on entry of door to be operational, sliding door and exits. LPA Lopez observed knives and sharps located in kitchen cabinet, to be inaccessible to residents in care. Kitchen appliances were observed to be clean and in working order. LPA observed staff preparing lunch for residents during visit. Monitor was observed to be mounted near sink area and accessible to residents, staff, and visitors. Water temperature in two (2) resident bathrooms was within 107.1 -107.4 degrees F. which is within range. Bathrooms were observed to be very clean and well stocked. LPA observed signs promoting proper hand-washing etiquette. (See 809-C for continuation). (continued from 809) LPA observed all three (3) resident bedrooms to contain required furnishings, lighting, and linens, towels, and hygiene products. LPA observed detergents and disinfectants to be inaccessible to residents in care. LPA Lopez observed two (2) emergency food buckets in laundry cabinet. Dining room was observed to be clean and contained one table with plenty of seating. Yard was observed to be well maintained and no hazards were observed. Plenty of shade and seating were observed. 3. Operational Requirements: The facility maintains a fire clearance approved by the fire department. The facility has shaded area with table and chairs for residents to utilize for outdoor area. The last fire/disaster drill was conducted on 09/01/2025. LPA reviewed and verified facility liability insurance which expires on 03/16/2026 4. Staffing: The facility has sufficient staff, and the night supervision staff did receive planned emergency training. 5. Personnel Record-Training: All the staff files are maintained at the facility. Staff employed are over the age of 18 and are fingerprint cleared and associated to the facility. The administrator Amanda Palomino certificate expires on 06/15/2026. All the direct care staff received Medication Management Training. All first aid training certificates for staff are current. 6. Resident Records-Incident Reports: Resident files are maintained at the facility and have the following documents in their files - Admission Agreements, Identification & Emergency Information, current Physician's Report, Pre-admission appraisal/Appraisal Needs & Services Plan. 7. Resident Rights-Information: The Complaint, ombudsman and residents personal rights are posted by the main entry. Visiting hours were posted at facility. 8. Planned Activities: Facility has sufficient space to accommodate indoor and outdoor activities. There are sufficient supplies and equipment to meet resident's physical capability. LPA observed staff assisting in activities for residents during visit. (continued on 809C) (continued from 809C) 9. Food Service: The kitchen was inspected and has sufficient supply of 2-day perishable & 7-day non-perishable food. Kitchen, food preparation area, and storage areas were observed to be clean and sanitary. The food is properly stored in the refrigerator (clean, labeled and well maintained). Pesticides and cleaning supplies are kept away from the food preparation areas. Kitchen is kept clean and free from rodents. 10. Incidental Medical & Dental: The medications are centrally stored in original containers. During the visit today, LPA reviewed four (4) residents' medication files, and all medications are administered according to Doctor’s orders. 11. Disaster Preparedness: The facility has an Emergency Disaster and Mass Casualty Plan containing emergency evacuation, storage and preservation of medications, The facility conducts emergency drill on a quarterly basis for all staff and residents. 12. Residents with Special Health Needs: No residents have prohibited health conditions. No deficiencies observed during today’s visit. Exit interview conducted and copy of report and appeal rights were provided.the state’s words, verbatim · CDSS document, Feb 24, 2026

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Alberto Lopez conducted an unannounced Annual Required 1-year Visit on 04/01/2025. LPA was met by Staff Karla Pablo Damian and explained the purpose of the visit. Administrator Amanda Palomino arrived later to assist with the visit. Vannesa Hinojosa was also present and assisted with the visit. The facility is licensed to serve six (6) residents over the age of 60, of which six (6) may be non-ambulatory and has a hospice waiver approved for four (4). Two (2) out of the six (6) residents in care are currently on hospice care. LPA OBSERVATIONS: The facility is a single-story dwelling located on in a residential neighborhood and consists of three (3) resident bedrooms, one (1) staff bedroom, two (2) shared bathrooms, kitchen, dining room, living room, detached garage, front yard, and backyard. LPA Lopez observed auditory device on entry of door to be operational, sliding door and exits. Physical Plant: Front Yard: Is well maintained and no hazards were observed during visit. Kitchen: LPA Lopez observed sufficient 2 days of perishables and 7-day supply on non-perishables. LPA Lopez observed knives and sharps located in kitchen cabinet, to be inaccessible to residents in care. LPA observed several bottles of cleaning solutions and disinfectants located in kitchen cabinet, to be inaccessible to six (6) out of six (6) residents in care. Kitchen appliances were observed to be clean and in working order. LPA observed staff preparing lunch for residents during visit. Monitor was observed to be mounted near sink area and accessible to residents, staff, and visitors. LPA Ramirez has addressed this issue on previous visit. . Dining Room/Living room/: Dining room was observed to be clean and contained one table with plenty of seating. LPA Lopez observed five (5) out of the six (6) residents seated in this area during the visit. (See 809-C for continuation). (continue on 809) Laundry room: LPA observed detergents and disinfectants to be inaccessible to residents in care. LPA Lopez observed two (2) emergency food buckets in laundry cabinet. Linen Closet: Contained plenty linens, towels, hygiene products and PPE supply. Resident Rooms 1-3: All resident rooms are shared, and LPA observed a camera mounted in the corner of resident room #3. LPA Ramirez has previously addressed this issue. LPA observed all three (3) resident bedrooms to contain required furnishings, lighting, and linens. Bathrooms 1-2: Water temperature in two (2) resident bathrooms were within 105.0 – 120.0 degrees F. Bathrooms were observed to be clean and well stocked. LPA observed signage promoting proper hand washing etiquette. Backyard: Well, maintained and no hazards were observed. Plenty of shade and seating was observed. Emergency Drills/Emergency Disaster Plan: Last documented drills were conducted on 03/01/2025. Emergency disaster plan (LIC610) was observed, reviewed and needs updating Carbon Monoxide Detectors/Fire Alarm/Fire Extinguisher: LPA observed carbon monoxide in hallways and smoke detectors were observed to be operable. LPA observed fire extinguisher near kitchen to be fully charged. Personnel Records: Personnel records are maintained at facility. LPA reviewed staff files for three (3) staff. LPA observed Administrator’s certificate for Amanda Palomino with an expiration date of 06/15/2026.. Resident Records: Five (5) resident records were reviewed. Medication for four (4) residents were reviewed and medication was administered according to doctor’s orders. Liability Insurance & Infection Control Plan: LPA requested and obtained a copy of liability insurance and infection control plan. Exit interview was conducted. No deficiencies were observed. Technical Advisories provided. A copy of this report was provided.the state’s words, verbatim · CDSS document, Apr 1, 2025

The state marks this report as 5 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

Licensing Program Analyst (LPA) Kimberly Ramirez conducted an unannounced Annual Required 1-year Visit on 02/10/2024. LPA was met by Caregiver Liseth Ramos and explained the purpose of the visit. Administrator Amanda Palomino arrived 1 /12 later to assist with tour. The facility is licensed to serve six (6) residents over the age of 60, of which six (6) may be non-ambulatory and has a hospice waiver approved for four (4). Two (2) out of the six (6) residents in care are currently on hospice care. LPA OBSERVATIONS: The facility is a single-story dwelling located on in a residential neighborhood and consists of three (3) resident bedrooms, one (1) staff bedroom, two (2) shared bathrooms, kitchen, dining room, living room, detached garage, front yard, and backyard. LPA Ramirez observed auditory device on entry of door to be operational, sliding door and exits. Front Yard: Is well maintained and no hazards were observed during visit. Kitchen: LPA Ramirez observed sufficient 2 days of perishables and 7-day supply on non-perishables. LPA Ramirez observed knives and sharps located in kitchen cabinet, to be inaccessible to six (6) out of six (6) residents in care. LPA Ramirez observed several bottles of cleaning solutions and disinfectants located in kitchen cabinet, to be inaccessible to six (6) out of six (6) residents in care. Kitchen appliances were observed to be clean and in working order. LPA Ramirez observed staff preparing lunch for residents during visit. LPA Ramirez observed a 22 – 32 inch monitor that was displaying live video feed of common areas and shared resident rooms. Monitor was observed to be mounted near sink area and accessible to residents, staff, and visitors. LPA Ramirez will issue Technical Violation. Dining Room/Living room/: Dining room was observed to be clean and contained one table with plenty of seating. Living room was observed to have plenty of seating and lighting. LPA Ramirez observed near by thermostat to read 72 degree F. LPA Ramirez observed five (5) out of the six (6) residents seated in this area during the visit. See 809-C for continuation. Laundry room: LPA Ramirez observed detergents and disinfectants to be inaccessible to six (6) out of six (6) residents in care. LPA Ramirez observed two (2) emergency food bucket in laundry cabinet. Linen Closet: Contained plenty linens, towels, hygiene products and PPE supply. Resident Rooms 1-3: All resident rooms are shared and LPA Ramirez observed a camera mounted in the corner of resident room. LPA Ramirez observed all three (3) resident bedrooms to contain required furnishings, lighting, and linens. Bathrooms 1-2: Water temperature in two (2) resident bathrooms were within 105- 120 degrees F. Bathrooms were observed to be clean and well stocked. LPA Ramirez observed signage promoting proper handwashing etiquette. Backyard: Well maintained and no hazards were observed. Plenty of shade and seating was observed. Garage: LPA Ramirez observed extra PPE supply in this area and emergency water supply. Emergency Drills/Emergency Disaster Plan: Last documented drills were conducted on 12/01/23 and 09/01/23. Emergency disaster plan was observed and reviewed. Carbon Monoxide Detectors/Fire Alarm/Fire Extinguisher: LPA observed carbon monoxide in hallways and smoke detectors were observed to be operable. LPA Ramirez observed fire extinguisher near kitchen to be fully charged. Personnel Records: Personnel records are maintained at facility. LPA Ramirez reviewed staff files for four (3) staff. LPA Ramirez observed Administrator’s certificate for Amanda Palomino with an expiration date of 06/15/2024. Resident Records: Six (6) resident records were reviewed. Liability Insurance & Infection Control Plan: LPA Ramirez requested and obtained a copy of liability insurance and infection control plan. Exit interview was conducted. No deficiencies were observed. A copy of this report was provided.the state’s words, verbatim · CDSS document, Feb 10, 2024

The state marks this report as 3 pages; the online copy we transcribed has 2. You can request the full file from the county licensing office.