Douglas Residential Care

Type of visit: Required - 1 Year

On 09/15/2025 at 11:35 am, Licensing Program Analyst (LPA) Zina Brown conducted an unannounced visit to the above facility. The purpose of today’s visit was to conduct the one-year inspection. LPA met with Charesa Reyes, Administrator and the purpose of the visit was discussed. Facility is licensed to serve 6 non- ambulatory residents an approved hospice waiver for 1 resident. Three (3) of the residents are diagnosed with dementia, three (3) hospice resident. The facility has a current administrator certificate (#7029005740) for Charesa Reyes (Administrator) valid from 11/21/2024 - 11/20/2026. The facility fees are current (payment made on 09/15/2025). LPA provided pin #198081 with the option for the facility to make an payment online. The facility has liability insurance with Primary Care Insurance, A Risk Retention Group, Inc (NAIC#16959) with an effective date as of (08/02/2025 - 08/26/2025) with each occurrence at $1,000,000 and general aggregate at $3,000,000 (policy #PCI43093369-01) The facility does not handle any of the residents’ money. The home is a two story home consisting of: (3) shared resident bedrooms, (2) shared bathroom, with a upstairs living quarters for the staff (with a bathroom and bedroom, a living room, kitchen with dining area, laundry room, an outdoor shaded patio area and a detached garage with an additional refrigerator. Between the hours of 11:41am - 12:55pm , LPA conducted a records review of (6) residents records, (3) staff records and (6) Client Medication Administration Records and the facility disaster plan. All client & staff records were complete. The facility disaster plan was current (last conducted on 09/01/2025) and in compliance with Title 22 at the time of visit. LPA did not observed any discrepancies at the time of visit. Between the hours of 1:00 pm - 1:25pm, LPA Zina Brown toured the inside and outside of the facility. All client room were checked. Resident bedrooms had the required furniture had the required furniture, bed linens and closet/drawer space to accommodate each resident comfortably. Resident bathrooms were checked. Toilets and water faucets worked properly, grab bars were secure, shower was free of mold/mildew and a non-skid mat was in place, water temperature measured at 112.6°F (bathroom #1), 112.1°F(bathroom #2) and 113.5°F (kitchen). Resident bath towels, toiletries and personal hygiene supplies were adequately stocked. Common areas were clean and clear of hazards; doorways were free of obstructions. Kitchen was checked and observed to be within Title 22 regulations. Perishable and non-perishable food supply was checked. All cleaning solutions, hazardous Items, and medications were securely locked and inaccessible to residents. Smoke detectors were working properly, and fire extinguisher was fully charged. Carbon monoxide detector was operational. First Aid kit was available. Outside grounds were toured and no bodies of water were observed. Walkways around the home were clear of hazards. There are no security bars or weapons on the premises. During today’s visit LPA did not observe any deficiencies. An exit interview was conducted with Charese Reyes, Administrator and a copy of this report was provided.the state’s words, verbatim · CDSS document, Sep 15, 2025

Type of visit: Case Management - Annual Continuation

On 09/19/2024 at 9:00am , LPA Zina Brown conducted an unannounced continuation annual visit using the CARE Inspection Tool. LPA met Eduardo Pinawin (caregiver) with the purpose of today’s visit was explained. LPA reviewed (6) Client Medication Administration Records and did not observe any discrepancies at the time of visit. According to the California Code of Regulations (Title 22, Division 6, Chapter 8), LPA did not observe deficiencies therefore no citations were issued at this time. An exit interview was conducted, and a copy of the Facility Evaluation Report was provided to Eduardo Pinawin (Caregiver).the state’s words, verbatim · CDSS document, Sep 19, 2024

The state marks this report as 3 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 09/18/2024 at 09:47am, Licensing Program Analyst (LPA) Zina Brown conducted an unannounced visit to the above facility. The purpose of today’s visit was to conduct the one- year inspection. LPA met with Charesa Reyes , Administrator and the purpose of the visit was discussed. Facility is licensed to serve 6 non- ambulatory residents an approved hospice waiver for 1 resident. Three (3) of the residents are diagnosed with dementia, three (3) hospice resident, and (1) home health (1). The facility does not handle any of the residents’ money. The home is a two story home consisting of: (3) shared resident bedrooms, (2) shared bathroom, with a upstairs one (1) bathroom, and one (1) staff bedroom, a living room, kitchen with dining area, laundry room, an outdoor shaded patio area and a detached garage with an additional refrigerator. At 10:00am LPA Zina Brown toured the inside and outside of the facility. All client room were checked. Resident bedrooms had the required furniture had the required furniture, bed linens and closet/drawer space to accommodate each resident comfortably. Resident bathrooms were checked. Toilets and water faucets worked properly, grab bars were secure, shower was free of mold/mildew and a non-skid mat was in place, water temperature measured at 118.3F (bathroom #1), 118.5 F(bathroom #2) and 114.4 F (kitchen). Resident bath towels, toiletries and personal hygiene supplies were adequately stocked. Common areas were clean and clear of hazards; doorways were free of obstructions. Kitchen was checked and observed to be within Title 22 regulations. Perishable and non-perishable food supply was checked. All cleaning solutions, hazardous items, and medications were securely locked and inaccessible to residents, fire extinguisher was fully charged. Carbon monoxide and smoke detector was operational. First Aid kit was available. Outside grounds were toured and no bodies of water were observed. Walkways around the home were clear of hazards. There are no security bars or weapons on the premises. Report continues on LIC 809-C On 09/18/2024 LPA conducted residence record review of 6 six residence. 3 out 6 residence physican report states the residence are bedridden. Based on LPA observation during inspection and additional records review, residence are listed as non-ambulatory. On 09/18/2024, the administrator informed the LPA that the facility does not have liability insurance. Deficiencies cited under California Code of Regulations (Title 22, Division 6, Chapter 8); LPA observed the following deficiencies. Due to time constraints, LPA was unable to complete the inspection, LPA will return at a later date. Additional citations maybe issued. An exit interview was conducted, and a copy of Report and Appeal Rights provided.the state’s words, verbatim · CDSS document, Sep 18, 2024

Type of visit: Required - 1 Year

On 10/7/2023, Licensing Program Analyst (LPA) Alfonso Iniguez conducted an unannounced annual required visit using the CARE Inspection Tool. LPA met with Charesa Reyes /Administrator. LPA explained the purpose of today’s visit. The facility is licensed to serve (6) residents ages 60 and above of which (6) may be non-ambulatory. Facility has an approved hospice waiver for (1) residents. The one-story residential home consists of (3) resident bedrooms, (2) resident bathrooms, living room, dining room, kitchen, staff room, office area, attached garage with washer and dryer/ storage area, backyard with table and chairs. LPA Iniguez toured the physical plant with administrator. No bodies of water were observed. There were no obstructions on the premises. Beds and bedding supplies were in good condition, adequate lighting was provided, and storage for the resident’s personal belongings was observed. Bathrooms were found to be within Title 22 regulations and were operational. LPA inspected rooms: #1, #2, and #3, smoke and carbon monoxide combo are all operable conditions. The water temperature properly measured between 105°-120°F: Kitchen 108.6°F, Bathroom #1:106.9°F. Evaluation Report Continues LIC 809-C LPA Iniguez observed the facility to be sanitary and appropriately furnished at the time of the visit. Storage areas for personal hygiene, cleaning supplies, toxins, and sharps objects were stored and not accessible to residents. The kitchen was inspected and there is sufficient perishable and non-perishable food available maintained properly. All fire extinguishers were charged and were operable. A review of (4) residents' service files, (4) staff personnel files and (4) Medication Administration Records (MAR) were maintained in order. First AID kit was checked. Last facility disaster drill was on:10/1/2023. A copy of the liability insurance was provided to LPA during visit. LPA observed the facility's infection control practices. According to the California Code of Regulations (Title 22, Division 6, Chapter 8), LPA did not observe deficiencies therefore no citations were issued at this time. An exit interview was conducted, and a copy of the Facility Evaluation Report was provided to Charesa Reyes /Administrator.the state’s words, verbatim · CDSS document, Oct 7, 2023