Del's Haven II

Type of visit: Required - 1 Year

On this day, Licensing Program Analyst (LPA) Kevin Saborit-Guasch made an unannounced visit to the facility to conduct the required annual inspection. LPA was greeted and granted entry by facility caregiving staff after introducing himself and stating the purpose of the visit. Administrator Delia Pardo was also present to assist while administrator Dianna Manalo was notified by telephone and arrived later to assist. There are currently six residents in care, four of which are receiving hospice care at this time. Residents are observed relaxing in the facility's common areas or in their respective bedrooms. LPA accompanied by facility staff toured the physical plant. The facility is a one-story house with four private and one shared bedrooms. There are two bathrooms used by residents. One resident is bedridden and occupies a room cleared for a bedridden resident. All occupied bedrooms appear clean and sanitary. One resident uses half-length rails for postural support and two residents have full rails. Adequate physician orders reviewed. All resident bedrooms have the required furnishings. Bathrooms appear clean and sanitary and are all equipped with grab bars and slip mats. Hot water temperature measured at 106F and 107F at two separate sinks used for personal grooming. LPA observed the kitchen has a minimum two (2) day perishable and seven (7) day non-perishable food supply. Sharp items, cleaning supplies and the medication central storage are verified to be secure. Two wall-mounted fire extinguishers are present and verified to be charged with up-to-date maintenance tags. Carbon monoxide and smoke detectors were found to be present and operational. Emergency food is present in the pantry and emergency water supplies are stored in the garage. CONTINUED ON FORM LIC809-C CONTINUED FROM FORM LIC809 LPA and facility staff toured the outside of the facility. LPA observed a shaded outdoor seating area with outdoor furniture for resident use on the deck behind the property. The identified route of egress is free of clutter and obstructions. There are self-latching gates on both sides of the premises. The facility does not utilize either locked perimeters or delayed egress. There are no bodies of water on the premises. LPA reviewed six resident records. One admission agreement reviewed is missing the facility representative signature. Consultation provided. LPA reviewed resident medication records and prescription orders with no discrepancies observed. LPA reviewed staff records for three staff members during the visit. Proof of current CPR training reviewed. Disaster drills are conducted quarterly. All staff members scheduled are verified to be background cleared and associated to the licensed location. The administrator certificate is current for Mrs. Pardo and Mrs. Manalo. Based on the observation conducted during the present visit, no deficiencies are being cited per Title 22 of the California Code of Regulations. An exit interview was conducted and a copy of this report along were provided to a facility representative.the state’s words, verbatim · CDSS document, Nov 17, 2025

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.

Type of visit: Required - 1 Year

Licensing Program Analysts(LPAs) Joseph Alejandre, Nancy Guillen and Brandon Lopez made an unannounced visit to conduct the required annual inspection. LPAs were greeted and granted entry. LPAs met with Administrator Dianna Manalo. LPAs and the Administrator toured the facility. Facility is a single story home with 5 bedrooms, 2 bathrooms, family room with a TV, dining room, and a kitchen. Facility has a capacity of 6 non-ambulatory residents of which 1 may be bedridden and a hospice waiver for 4. LPAs observed a 2 day perishable and 7 day non-perishable food supply on hand in the kitchen. LPAs observed the knives are kept under the sink which is locked. LPAs observed expired shelf stable food in the kitchen cupboard. Staff discarded all the expired food. LPAs observed 2 insects in the kitchen. LPAs observed the refrigerator lining on the inside of the refrigerator is cracked. LPAs observed medications are kept locked in the hall closet. LPAs inspected both bathrooms. Both bathrooms are clean and operational. Hot water measured 106.5 to 106.8 degrees Fahrenheit. LPAs and the Administrator inspected the resident rooms. LPAS observed that in bedroom 1 and bedroom 5 both residents had bed rails. LPAs verified that the residents in bedroom 1 and 5 had orders for bed rails. All bedrooms had the required furniture and linens. LPAs and Administrator toured the garage. The garage is kept locked and used for storage. The garage stores extra food, supplies, and furniture. LPAs and Administrator toured the backyard. The backyard is a deck. No bodies of water observed in the backyard. There is a shaded seating area with a table and chairs for residents to sit outside. The exit gate on the South side of the house is operational. LPAs observed the pathway to the North side of the house had a table, tools, wooden box, and propane tanks. The North side exit gate is operational. Smoke detectors/carbon monoxide detectors tested operational. There is no record of an emergency disaster drill being conducted. LPAs reviewed 6 resident records. No discrepancies observed. LPAs reviewed resident medications. Resident 2 (R2) was missing PRN medication Acetaminophen 325 mg. No other discrepancies observed. LPAs reviewed 2 staff files. Both staff members are background cleared and associated to the facility. Both staff members had the required training. LPAs inspected the First Aid Kit. The first aid kit is missing a complete First Aid Manual, all other elements were present. Deficiencies are being cited per Title 22 Division 6 of the California Code of Regulations. A copy of the report along with the Appeal of Rights was provided. An exit interview was conducted with the Administrator.the state’s words, verbatim · CDSS document, Oct 23, 2024

The state marks this report as 9 pages; the online copy we transcribed has 5. You can request the full file from the county licensing office.