CJCP RCFE

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Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Steve Chang conducted an unannounced annual inspection visit, and met with Administrator (ADM) Marites Gonzaga. LPA toured the facility inside and out with ADM. License, Administrator Certificate, and personal rights posters were observed in the facility. 5 residents and 2 staff were observed in the facility. 1 resident went to day program. LPA reviewed 3 resident file and 3 staff files. Living Family room, kitchen, dining area, 2 restrooms, garage, and laundry rooms were inspected. 2 single resident bedrooms, 2 shared resident bedrooms, and 1 staff room inspected. Two day perishable food supplies and seven day nonperishable food supplies were observed sufficient. knives closet and dish washing solution closet were observed locked. The temperature of the refrigerator was observed at 35 degree F and the temperature of the freezer was observed at 0 degree F. Medication closet, knives closet, and chemical closet were observed locked. Room temperature was at 70 degree F, and hot water temperature was at 113 degree F in facility. Fire extinguisher was serviced on 4/21/2026. The facility was equipped with fire alarm system, smoke and carbon monoxide detectors. Carbon monoxide detectors were tested by ADM, and were working. First aid box, night lights, and flash lights were observed in the facility. Front yard and backyard were inspected. There was no obstruction to block the walkways. The last time the facility conducted the emergency and fire drill was on 4/10/2026. No citation noted today. Exit interview was conducted with ADM. This report was provided to ADM for signature. A copy of the report was provided to ADM.the state’s words, verbatim · CDSS document, Jun 4, 2026

Type of visit: Required - 1 Year

On 6/30/2025, LPA Grace Donato made an unannounced annual visit to the facility. LPA met with Administrator Marites Gonzaga. LPA explained the purpose of the visit. LPA toured the facility inside and outside including all of resident rooms and kitchen area and backyard. Facility is single story home with 4 resident bedrooms, 2 of which is shared. While touring the facility it was observed that the room temperature was at 70 deg F. Hot water was also tested in the bathrooms and the temperature was 106 deg F. The facility is observed to be clean, odorless, and well maintained. Residents bedrooms were observed to be well organized and fully furnished with adequate lighting. Sharps and toxic materials were observed locked. Food supply was observed with an adequate two day perishable and seven day non-perishable food supply. Carbon monoxide/ smoke detectors, and fire extinguisher were present throughout the facility. Facility has an updated log for emergency drill is done every quarter. Five resident records and five staff records were reviewed. Centrally stored medication was locked and inaccessible by residents. All medication was labeled and sorted by resident name. All medication logs are complete and updated. LPA received a copy of Liability Insurance. No deficiencies cited today. Report is reviewed and copy is provided.the state’s words, verbatim · CDSS document, Jun 30, 2025

Allegation investigated: Administrator has made inappropriate gestures and speech towards resident Administrator transported resident to bank without resident's wheelchair, forcing the resident to ambulate with a walker.

On 05/09/25 Licensing Program Analyst (LPA) Marcela Yanez conducted an unannounced complaint investigation visit to deliver the findings of the investigation. LPA met with Administrator Marites Gonzaga. On 03/12/25 the department received a complaint alleging that the facility staff (S3), made inappropriate gestures to the resident and transported resident without the resident's wheelchair, forcing the resident to ambulate with a walker. Based on document review of 3 resident’s file, LPA observed that R1 is allowed to ambulate with a 4 point cane for short distances. Unsubstantiated LPA interviewed 2 staff (S1, S2) ADM was also interviewed and 3 residents (R1, R2 & R3). 3 Out of 3 residents stated the facility staff did not make inappropriate gestures or used offensive language. 2 Out of 2 staff, stated they did not witness or hear, Administrator make inappropriate gestures or used foul language toward resident. Based on interviews and record review, although the allegations may have happened or is valid, there is not a preponderance of evidence to prove that the allegation did or did not occur. Therefore, the above allegation is unsubstantiated. No deficiencies cited during today’s visit based on California Code of Regulations (CCR) Title 22. An exit interview was conducted with Administrator Marites Gonzaga And a copy of the report was provided.the state’s words, verbatim · CDSS document, May 9, 2025 · control 26-AS-20250312103645

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Manuel Monter conducted an unannounced annual inspection visit, and met with Administrator (ADM) Marites Gonzaga. During the visit, LPA observed 5 residents and 2 staff. LPA toured the facility inside out with ADM which included the Living room, kitchen, dining room, 2 restrooms and 4 residents bedrooms. The staff area of the facility was also inspected. The front yard and backyard were inspected. There was no obstruction to block the walkways. Two-day perishable food supplies and seven day nonperishable food supplies were observed. LPA observed the medication storage area, knives storage area, and cleaning product storage area as locked and inaccessible to residents in care. Room temperature was at 73 degrees F, and hot water temperature was measured at 112 degrees F in both resident bathrooms. Fire extinguisher was serviced in April 9, 2024. The facility was equipped with smoke and carbon monoxide detectors. Smoke detectors was tested by ADM, and were functional. LPA observed facility first aid kit and facility fire/earthquake drill log. The facility's last drill was on April 1st, 2024. LPA reviewed facility records for 3 staff and 3 residents. LPA reviewed 3 resident medications and centrally stored medication records. LPA conducted interviews with 1 staff and 2 residents. No deficiencies cited during today's visit. This report was reviewed with Administrator Marites Gonzaga and a copy of the signed report was provided.the state’s words, verbatim · CDSS document, Apr 17, 2024