Del Monte Care

Allegation investigated: Staff is not ensuring that resident's privacy is protected

On 03/20/2026, Licensing Program Analyst (LPA) V. Gorban arrived commence complaint investigation to allegation stated above. LPA explained the purpose of the visit to house manager Victoria Montoya and was allowed entry. During the course of the investigation, LPA conducted a facility tour, conducted interviews, and reviewed records. Allegation: Staff is not ensuring that resident's privacy is protected. Based on interviews and records reviews no violation of title 22 observed that would jeopardize resident's privacy. Although the allegation may have happened or valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur, therefore above allegation is UNSUBSTANTIATED. No deficiencies issued. Exit interview conducted. Report signed on-site. A copy of this report provided to the facility representative. Unsubstantiatedthe state’s words, verbatim · CDSS document, Mar 20, 2026 · control 24-AS-20260311094340

Allegation investigated: Resident’s room is not kept in clean and sanitary condition. Staff did not ensure resident was provided with clean linen and or bedding Staff do not ensure resident has access to a telephone

On 03/20/2026, Licensing Program Analyst (LPA) V. Gorban arrived commence complaint investigation t oallegations stated above. LPA explained the purpose of the visit to house manager Victoria Montoya and was allowed entry. During the course of the investigation, LPA conducted a facility tour, conducted interviews, and reviewed records. The Department has investigated the allegations: Resident’s room is not kept in clean and sanitary condition and Staff did not ensure resident was provided with clean linen and or bedding. Based on observation during facility tour LPA toured random rooms and observed trash cans empty and rooms appear clean with clean linen on beds. Based on interviews and record reviews, beding linen available and replaced by staff either on residents shower days or sooner if requested. Facility staff provide light cleaning daily and twice a week provide deep cleaning to each residents rooms. Although the allegations may have happened or are valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur, therefore above allegations are UNSUBSTANTIATED. Report continues on attached LIC9099-C Unsubstantiated Allegation: Staff do not ensure resident has access to a telephone. Based on observations and interviews, the facility has a working telephone, accessible to residents to use when asked. The number provided in the advertisement is up to date. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur, therefore above allegation is UNSUBSTANTIATED. No deficiencies issued. Exit interview conducted. Report signed on-site. A copy of this report provided to the facility representative.the state’s words, verbatim · CDSS document, Mar 20, 2026 · control 24-AS-20260319101112

Type of visit: Required - 1 Year

On 09/22/2025, Licensing Program Analyst (LPA) V Gorban arrived at the facility unannounced to conduct Required Annual Inspection. LPA met with house manager Victoria Montoya, administrator Kay Cabuco, certification number 7025362740 and expiration date 02/15/2027 was notified of Licensing visit. LPA conducted tour inside and out of facility with house manager. The facility comprised of two addresses, one (1221 david ave, one building with six residents) occupied by dementia residents while the other (1229 david ave, seven buildings with thirty six residents) occupied by assisted living residents. Both addresses located next to each other and accessible by locking mechanism gate. The facility was observed to be at a comfortable temperature of 77 degrees, clean, in good repair, and no passageway obstructions or fire hazards observed. Fire extinguisher was observed with a service date of 03/10/2025. last disaster drill recorded in April 11th, 2025 Dining area and Kitchen were toured. An adequate supply of perishable and non-perishable food was observed to be properly stored in freezer, refrigerator, and pantry. Food is delivered once a week on Thursdays, Sysco. Refrigerator temperature was maintained at 40.0-degree F. and freezer was maintained at -9-degree F. LPA toured resident bedrooms. Residents' rooms were toured and observed with adequately furnished with bed, dresser, and adequate lighting. Hot water temperature tested at 112 degrees F. LPA observed securely fastened grab bar and non-skid mat in shower area. Medications were stored in a locked medication room in a medication cart. Medications records were reviewed. Facility uses Synkwise for medication documentation and tracking. First Aid Kit was stored in medication room and observed with all required items. Adequate PPE supplies was observed. LPA toured laundry room and observed chemicals were stored and locked for staff use only. LPA reviewed personnel and residents files. No deficiencies were observed during this visit. Exit interview conducted, report signed and copy provided for facility records.the state’s words, verbatim · CDSS document, Sep 22, 2025

Type of visit: Case Management - Other

On 04/09/2025, Licensing Program Analyst (LPA) V Gorban arrived unannounced to conduct a Case Management visit. LPA met with facility Resident Care Director (RCD) Victoria Montoya, and stated the purpose of the visit. During this visit LPA conducted health and safety facility tour with RCD and discussed the visit. LPA served Decision and Order excluding Staff 1 (S1) from being present inside the facility. LPA requested a current and updated Personnel Report (LIC 500). RCD stated that Guardian account will be updated to remove S1 from the facility staff roster. A notice of completion shall be submitted to Community Care Licensing (CCL). LPA informed RCD that S1 is not allowed to be employed and/or on any facility premises. The Decision and Order came into effect as of 04/03/2025 upon receipt of the letter. A copy of the letter was given to RCD during this visit. Exit interview conduced, report signed and copy of this report provided for facility records.the state’s words, verbatim · CDSS document, Apr 9, 2025

Allegation investigated: Facility staff yelled at resident Facility staff spoke inappropriately to resident Facility staff did not ensure resident had drinking water Facility staff did not ensure resident had a clean mattress Facility staff did not maintain passageway free of obstruction

On 12/18/2024, Licensing Program Analyst (LPA) V. Gorban visited the facility to deliver findings. During this visit LPA met with facility manager Victoria Montoya. Administrator (AD) Kay Cabuco was notified of Licensing visit. During this visit LPA toured the facility inside and out, performing safety checks and observed residents in care. Allegation: Facility staff yelled at resident. Based on observation one out of 5 residents interviewed appear to speak very loudly and requested LPA to speak clear and loud as well. Based observations and residents interviewed no reports of being yelled at. During files review no concerns from residents observed or reported. Allegation: Facility staff spoke inappropriately to resident. During the visits on 8/18,9/10 and 12/06 LPA observed residents and care. During this visit LPA observed interactions of staff with residents. During facility visit staff and residents interviewed, both parties responded no to staff speaking inappropriately. Report continues on attached LIC9099-C Unsubstantiated Allegation: Facility staff did not ensure resident had drinking water. During the visit LPA toured and observed building 3 observed water cups and large containers filled with water available to residents for consumption. During interviews no water concern from residents interviewed. Allegation: Facility staff did not ensure resident had a clean mattress. During the facility tour and observation, residents’ rooms, mattresses, and line appear to be washed and odor free. During interview with staff residents receive clean mattress and washed/ clean bedding twice a week and more if needed, clean bedding available upon request. Allegation: Facility staff did not maintain passageway free of obstruction. During the facility visit on multiple occasions 8/19, 9/10, and 12/18 LPA toured the campus conducting safety checks. During those visits no passageway obstruction was observed. Although the above allegations may have happened or are valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur, therefore the allegations are Unsubstantiated . No deficiencies were observed during this visit. Exit interview conducted, report signed and copy of this report provided for facility records.the state’s words, verbatim · CDSS document, Dec 18, 2024 · control 24-AS-20240815140436

Type of visit: Required - 1 Year

On 09/10/2024, Licensing Program Analyst (LPA) V Gorban arrived at the facility unannounced to conduct Required Annual Inspection. LPA met with Administrator (AD) Kay Cabuco, certification number 7025362740 and expiration date 02/15/2025. LPA conducted tour inside and out of facility with AD. Residents observed at the facility during quite time resting after lunch. The facility was observed to be at a comfortable temperature of 74 degrees, clean, in good repair, and no passageway obstructions or fire hazards observed. Fire extinguisher was observed with a service date of 03/11/2024 Dining area and Kitchen were toured. An adequate supply of perishable and non-perishable food was observed to be properly stored in freezer, refrigerator, and pantry. Food is delivered once a week on Thursdays. Refrigerator temperature was maintained at 43.0-degree F. and freezer was maintained at -6-degree F. LPA toured resident bedrooms. Residents' rooms were toured and observed with adequately furnished with bed, dresser, and adequate lighting. Hot water temperature tested at 112 degrees F. LPA observed securely fastened grab bar and non-skid mat in shower area. Medications were stored in a locked medication room in a medication cart. Medications records were reviewed. First Aid Kit was stored in medication room and observed with all required items. Adequate PPE supplies was observed. LPA toured laundry room and observed chemicals were stored and locked for staff use only. Report continues on attached LIC809-C. Facility courtyard was toured and observed to be free from debris. There was outdoor seating available for the residents. A sample of residents’ file was reviewed to have updated emergency contact, Admission agreement, Needs and Services Plan and Pre-Appraisal Plan. A sample of staff files were reviewed. Staff files were observed to have current First Aid/CPR, Health screening, and Personnel record. Staff are fingerprinted clear and associated to the facility. Community Care Licensing (CCL) is always striving to have facility files that reflect the most accurate & up to date information for your facility. In an effort to maintain your facility file, please submit the most current & complete forms &/or information as identified below: Residential Care Facility for the Elderly (RCFE): · LIC 308 Designation of Facility Responsibility · LIC 309 Administrative Organization · LIC 500 Personnel Report · LIC 610E Emergency Disaster Plan For Residential Care Facilities For The Elderly · LIC 9020 Register of Facility Clients/Residents Please submit the above forms/information to Fresno CCL by: 09/12/2024 As an operator of a Community Care Licensed facility it is your responsibility to be aware of and in compliance with all regulations, including Chaptered Legislation. Go to www.ccld.ca.gov to stay updated and informed. No deficiencies issued during this inspection. An exit interview was conducted with the ED. A copy of this report was given to the ED, whose signature on this form confirm receipt of these reports.the state’s words, verbatim · CDSS document, Sep 10, 2024

Type of visit: Prelicensing

On 10/30/2023, Licensing Program Analyst(LPA) D. Ayers arrived at the facility to conduct an announced Pre-Licensing Inspection. LPA met with Licensee/Administrator Kay Cabuco. LPA met with Licensee and toured the facility inside and outside. Pathways and doors were clear and free from obstruction. Smoke-detectors and carbon-monoxide detectors were present and operational. Facility fire extinguishers were present and recently serviced. Facility was clean and odor free. Common areas were clean, adequately furnished, and adequately lit. Resident bedrooms were clean and had required minimum furnishings. Resident bathrooms were clean, had required secure grab bars and non-skid mats, and water temperature was within required temperature range. Sharp items were secured in a locked drawer in the kitchen. Medications were secured in a locked medication room. The fences had self-latching mechanisms and there were no outdoor hazards. There is adequate outdoor covered seating for residents. LPA reviewed facility plan of operations and emergency disaster plan. Pre-Licensing is complete and this facility has no deficiencies. Licensee completed Component III. Exit interview was conducted with the Licensees. A copy of the report was provided.the state’s words, verbatim · CDSS document, Oct 30, 2023

Type of visit: Office

Facility Type: RCFE Application Type: CHOW Capacity: 65 Census (if any clients in care): 23 COMP II Participants: Kay Cabuco (Administrator/Corporate Board Member) & Matthew Delbruegge (Corporate Board Member) Interview Method: Virtual interview via Microsoft Teams On October 17, 2023, applicant/administrator participated in COMP II. Identification of the applicant and administrator was verified through interview questions based on photo ID and other identifying personal information. During COMP II, applicant and administrator confirmed that they have read and understand community care facility licensing laws included in the Health and Safety Codes and the California Code of Regulations Title 22. Signed LIC 809 with copy of photo ID have been obtained. During COMP II, CAB analyst confirmed Applicant/Administrator’s understanding of following areas: 1. Facility operation: License type, client/resident populations, and program 2. Admission Policies 3. Staffing requirements & Training 4. Restrictive/Prohibited Health Conditions 5. General provisions 6. Emergency Preparedness 7. Complaints & Reporting 8. Pre-licensing readinessthe state’s words, verbatim · CDSS document, Oct 17, 2023