Dean's Care Villa 110

Allegation investigated: Staff did not keep resident's room at a comfortable temperature Staff did not ensure resident's diaper was changed timely Staff did not ensure residents clothes were changed Due to staff negligence, resident sustained a pressure injury Staff did not ensure resident's oral hygiene needs were met Staff are intoxicated while working at the facility

On 02/20/26, Licensing Program Analyst (LPA) M. Yang arrived unannounced to conduct subsequent complaint inspection and deliver complaint findings. LPA met with staff Yolanda Harness. Licensee John Nobleza who stated unable to attend meeting and authorized caregiver to receive and sign report. During the course of the investigation, the Department conducted interviews, records were reviewed and toured the facility. The facility temperature is set and maintained within regulations. Residents are checked every 2 hours and brief are changed as needed. Staff assist residents with brushing their teeth every morning and every night. Based on interviews conducted and observation, staff alleged not keeping the resident’s room at comfortable temperature, staff not changing resident’s diaper timely, staff not changing resident’s cloths, staff negligence resident sustained pressure injury, staff not ensuring resident’s oral hygiene is met, and staff intoxicated while working at the facility, the preponderance of evidences standard has not been met, therefore, the above allegations are found to be UNSUBTANTIATED. Exit interview conducted. A copy of this report was provided to staff, whose signature on this form confirms receipt of this report. Unsubstantiatedthe state’s words, verbatim · CDSS document, Feb 20, 2026 · control 24-AS-20260126112950

Type of visit: Case Management - Deficiencies

On 02/02/26, Licensing Program Analyst (LPA) M. Yang arrived to conduct an unannounced complaint investigation and met with Licensee (L1) John Nobleza. During the course of the investigation, LPA toured the facility. At approximately 01:08PM, L1 and LPA observed in R1’s drawers in room 1 multiple medications belonging to Staff 1 (S1) unlock. At approximately 01:14PM, LPA and L1 observed R2 sleeping in bed when R2’s medications were observed unlocked in the resident’s drawers. At approximately 01:23PM, LPA and L1 observed S1’s medication unlocked in bathroom shelf and S1’s medication creams unlock in bathroom drawers. A deficiency is being cited on the attached 809D in accordance to California Code of Regulations, Title 22, Division 6. An exit interview was conducted. A copy of this report and appeal rights was provided to Licensee, whose signature on this form confirms receipt of this report.the state’s words, verbatim · CDSS document, Feb 2, 2026

From the deficiency page — Deficiency type: Type A · Section cited: CCR 87309(a) · Plan of correction due date: Feb 3, 2026

87465(h)(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 87309(a) Disinfectants, cleaning solutions, poisons, firearms and other items which could pose a danger if readily available to clients shall be stored where inaccessible to clients. This requirement is not met as evidenced by: Based on observation, the Licensee did not comply with the section cited above when LPA and Licensee observed staff’s medications in room 1 and in bathroom unlock. A bleach bottle was observed unlock in the laundry room accessible to residents in care this poses an immediate health, safety or personal rights risk to persons in care.the state’s words, verbatim · CDSS document, Feb 2, 2026

Plan of correction: Licensee immediately locked staff medications and bleach bottle. POC cleared during visit.

Type of visit: Case Management - Annual Continuation

On 11/8/2025 Licensing Program Analyst (LPA) B. Miranda arrived at the facility unannounced to conduct and complete the an annual inspection. LPA was greeted by staff and allowed entrance into the facility. Staff contacted Licensee who arrived shortly after. LPA met with Licensee John Nobleza and conducted tour. LPA observed the facility to be clean, odor free, and clutter free. The facility is currently licensed for 6 and has a current census of 6. LPA observed all emergency exits to be clear and free from obstruction. LPA observed fire extinguishers to be last serviced 7/19/2025 and with current charge. Facility has 7 bedrooms with 2&1/2 bathrooms. 5 of the 7 bedrooms are for resident and the other 2 rooms are for staff. The master bedroom is a shared room with 2 residents, all other residents have their own room. LPA observed resident bedrooms to be properly furnished with adequate lighting. LPA tested the water temperature in the half bathroom which read at 109 degrees Fahrenheit and in the kitchen which read at 109 degrees Fahrenheit. Smoke & carbon monoxide detectors were tested and are in working condition. LPA observed medications to be locked and inaccessible to residents in care. LPA observed a 7 day supply of non-perishable food items and 2 days worth of perishable food items. LPA reviewed infection control plan which is current and up to date. LPA observed a sample of staff files and resident files which are current and up to date. LPA reviewed medications and did not observe any errors at this time. LPA observed the following deficiencies which were cited under Title 22: Laundry room door was open with unlocked cabinet which made cleaning supplies and chemicals accessible to residents in care. LPA observed 3 residents with full bed rails, 2 of the 3 residents are on hospice. Licensee was not able to provide doctor's order for full bed rail. Exit interview was conducted and a copy of this report LIC809, LIC809D, and appeal rights were emailed to Licensee John Nobleza.the state’s words, verbatim · CDSS document, Nov 8, 2025

From the deficiency page — Deficiency type: Type A · Section cited: CCR 87309(a) · Plan of correction due date: Nov 10, 2025

87309 Storage Space and Access (Unlocked items) (a) Except as specified in subsection (b), the licensee shall ensure that disinfectants, cleaning solutions, poisonous substances, knives, matches, tools, sharp objects, and other similar items which could pose a danger to residents are in locked storage and are not left unattended if outside the locked storage. This requirement is not met as evidenced by: Based on observation & interview, the licensee did not comply with the regulation shown above which poses an immediate Health or Safety and, Personal Rights risk to persons in care. LPA observed the laundry room door to be open with an unlocked cabinet containing cleaning supplies and chemicals.the state’s words, verbatim · CDSS document, Nov 8, 2025

Plan of correction: Licensee locked the cabinet and laundry door. Licensee will meet with staff.

From the deficiency page — Deficiency type: Type A · Section cited: CCR87608(5)(B) · Plan of correction due date: Nov 10, 2025

87608 Postural Supports (Hospice- Full Bed Rails) (5) Under no circumstances shall postural supports include tying, depriving, or limiting the use of a resident's hands or feet. (B) Bed rails that extend the entire length of the bed are prohibited except for residents who are currently receiving hospice care and have a hospice care plan that specifies the need for full bed rails. This requirement is not met as evidenced by: Based on observation, interview, and record review, the licensee did not comply with the regulation shown above which poses an immediate Health and Safety or Personal Rights risk to persons in care. LPA observed R1, R2, and R3 to have full bedrails. R1 & R3 are on hospice with no doctor orders for bedrails.the state’s words, verbatim · CDSS document, Nov 8, 2025

Plan of correction: Licensee will remove bed rails or get doctor's orders for full bedrails.

Type of visit: Required - 1 Year

On 11/4/2025 Licensing Program Analyst (LPA) B. Miranda arrived at the facility unannounced to conduct an annual inspection. LPA met with Staff Yolanda Harness who stated the power has been out since 11:00 am. Administrator John Nobleza was contacted via phone. John stated he was only made aware of the electricity being out about 30 minutes ago. LPA will not be able to conduct the annual inspection at this time due to the electricity being out. Administrator was informed an incident report needs to be completed and sent to Licensing regarding this incident. LPA also explained there needs to be a plan in case the electricity will remain out once it starts to get dark. Administrator John stated he understood. Exit interview was conducted and copy of this report LIC809 was provided to staff Yolanda.the state’s words, verbatim · CDSS document, Nov 4, 2025

Type of visit: Required - 1 Year

On 10/15/2024, Licensing Program Analyst (LPA) Walton arrived unannounced to conduct an annual inspection. LPA introduced self, stated the purpose of the visit and was granted entry to the facility. LPA met with Licensee, John Nobleza. LPA reviewed facility records and observed the following: Resident records were found to be complete. Personnel records were found to be complete. Emergency Disaster plan and Infection control plan reviewed. Last fire drill was conducted on 06/25/2024. Fire extinguisher was last serviced on 07/26/2024. LPA conducted a tour of the facility with Licensee. Common areas were observed to have required furnishings and adequate lighting. LPA toured resident bedrooms. LPA observed resident bedrooms to have required furnishings. Resident bathrooms toured and observed to be operational. Bathrooms were properly equipped with securely fastened grab bars in toilet and tub/shower areas, non-skid mats were observed. Hot water measured at 106.8 degrees F. Smoke detector and carbon monoxide detector were tested and observed to be operational. LPA toured the facility kitchen. Kitchen appeared clean and safe for food preparation. LPA observed an adequate food supply. Exterior tour conducted. All exits were open and free from obstructions. Side gate was observed to be self-latching. No deficiencies issued during today's inspection. Exit interview conducted. A copy of this report was discussed and provided to Licensee, John Nobleza, whose signature on this form confirms receipt of this document. LPA is requesting the following documents be submitted to the Fresno CCL office by 10/29/2024: Current copy of Administrator Certificate, Designation of Facility Responsibility (LIC308), Administrator Organization (LIC 309), Affidavit regarding Client/Resident Cash Resources (LIC 400), Liability Insurance, Emergency and Disaster Plan (LIC 610E) Personnel Report (LIC500), Register of Facility Clients/Residents for (LIC9020A), Surety Bondthe state’s words, verbatim · CDSS document, Oct 15, 2024

The state marks this report as 4 pages; the online copy we transcribed has 1. You can request the full file from the county licensing office.

Type of visit: Required - 1 Year

On 11/15/2023, Licensing Program Analyst (LPA) Walton arrived unannounced to conduct an annual inspection. LPA introduced self, stated the purpose of the visit and requested to meet with the Administrator. LPA was granted entry to the facility and facility staff contacted the Administrator. LPA met with Administrator, John Nobleza. There are 6 residents present during today's inspection. LPA reviewed resident records and personnel records. Medication records reviewed. Medications observed to have original labels and be administered as prescribed. Last fire drill was conducted on 09/22/2023. Fire extinguisher last serviced 07/17/2023. LPA conducted a tour inside and outside of facility. Facility observed to be clean, odor free and at a comfortable temperature. Common areas were furnished well with adequate seating and lighting available. Resident rooms appeared clean and had required furnishings. LPA observed an adequate supply of linen. Resident bathrooms were properly equipped with securely fastened grab bars in toilet and tub/shower areas, non-skid mats were observed. Hot water measured at 118.6 degrees Fin the bathroom near bedroom 3 and 116.2 degrees F in the bathroom in the shared bedroom. Kitchen toured, appeared clean, observed a 7-day supply of non-perishable and 2-day supply of perishable food. Exterior tour conducted, all exits open and free of obstructions. Side gate was observed to be self-latching. LPA is requesting the following documents be submitted to the Fresno CCL office by 11/29/2023: Current copy of Administrator Certificate, Designation of Facility Responsibility (LIC308), Administrator Organization (LIC 309), Affidavit regarding Client/Resident Cash Resources (LIC 400), Liability Insurance, Emergency and Disaster Plan (LIC 610E) Personnel Report (LIC500), Register of Facility Clients/Residents for (LIC9020A), Surety Bond. No deficiencies issued. Exit interview conducted. A copy of this report was discussed and provided to Administrator, John Nobleza, whose signature on this form confirms receipt of this document.the state’s words, verbatim · CDSS document, Nov 15, 2023