Edna's Residential Care I

Allegation investigated: Licensee is not ensuring that facility maintains a comfortable temperature for residents is care

Licensing Program Analyst (LPA) Valeria Conway arrived at 7:07 A.M. to conducted an unannounced subsequent complaint visit regarding the above noted allegation and to deliver findings. When the LPA arrived, there were two (2) staff members and four (4) residents present. The LPA was greeted by Caregiver, Nikki Villanueva. LPA informed the reason for the visit. Caregiver contacted the Administrator by phone, Edna Dangiapo. At 7:30 A.M. Administrator arrived at the facility. Entrance Interview conducted. During initial visit, the LPA conducted a physical plant tour and conducted interviews with the back-up administrator, administrator and Resident #1 (R1). During today's visit, a brief physical plant tour was conducted, and room temperatures were checked in randomly selected resident rooms and common areas. The following was observed. Continued on LIC 9099-C Unsubstantiated Continued from LIC 9099 Regarding allegation “Licensee is not ensuring that facility maintains a comfortable temperature for residents is care.” It was alleged that the Licensee/Administrator does not turn on the central heater system at night, resulting in residents sleeping in cold conditions. Interviews were conducted with the Administrator, back-up administrator, and staff, all of whom denied any issues related to room temperatures. LPA attempted to interview all residents in care. Two (2) residents were unable to effectively communicate due to loss of level of cognitive abilities, one (1) resident declined to be interviewed, and one resident reported that their room, located in the back of the house, can become cold during the night. During unannounced visits, LPA conducted a physical plant tour of the facility. The tour revealed that the central heating system was not functioning properly in the back portion of the house. However, space heaters were provided in each bedroom located in that area. Throughout the investigation, the LPA measured room temperatures in four (4) randomly selected resident rooms and two common areas; one room measured 67 degrees Fahrenheit, while the remaining recorded temperatures ranged from 68 - 70 degrees Fahrenheit. Based on the above information gathered, including interviews, observations and temperature measurements, although the allegations may be valid, there is insufficient evidence to support the allegation or that a violation occurred; therefore, the allegations “Licensee is not ensuring that facility maintains a comfortable temperature for residents is care.” is deemed unsubstantiated at this time. Exit interview conducted and a copy of this report was provided.the state’s words, verbatim · CDSS document, Jan 21, 2026 · control 29-AS-20251219104145

Type of visit: Case Management - Deficiencies

Licensing Program Analyst (LPA) Valeria Conway conducted a Case Management - Deficiencies visit in conjunction with a complaint visit (Complaint control # 29-AS-20251219104145.) LPA met with Administrator, Edna Dangiapo. The purpose of this report is to issue citations for deficiencies observed during the investigation. During the course of the investigation, it was discovered that the central heating system was not functioning properly in the back portion of the house. Although the administrator stated that the heating system was working properly, interviews with staff and Resident #1 indicated that the system has been experiencing ongoing issues. Upon LPA’s request for the administrator to activate the heating system, LPA observed that the air supply duct at the far end of the house was not producing airflow or heat. This affected three (3) resident bedrooms and one (1) common area located in that section of the facility. While the administrator reported that a contractor had recently serviced the system, both staff and the administrator were unable to demonstrate how to set the heating system to automatically turn on and they are unaware on how to work the system. An interview conducted during today’s visit with an HVAC contractor revealed that the thermostats are not accurate and advised the administrator to set the temperature several degrees higher in order for the system to activate. Regarding the air supply duct not producing airflow in the back portion of the house, the contractor stated that a return visit will be necessary to further inspect and assess the issue. Pursuant to Title 22, California Code of Regulations and/or CA Health and Safety Code, the following deficiencies were cited (refer to LIC 809.) Administrator was informed that failure to correct the deficiencies may result in civil penalties. Exit interview conducted, appeal rights discussed, and a copy of this report and appeal rights were provided.the state’s words, verbatim · CDSS document, Jan 21, 2026

From the deficiency page — Deficiency type: Type B · Section cited: CCR 87303(a)&(b) · Plan of correction due date: Feb 4, 2026

87303(a)&(b) (a) The facility shall be clean, safe, sanitary and in good repair at all times... and (b)A comfortable temperature for residents shall be maintained at all times.This requirement is not met as evidenced by: The licensee did not comply with the section cited above by having part of the heating system not in good repair which poses/posed a potential health, safety or personal rights risk to persons in care.the state’s words, verbatim · CDSS document, Jan 21, 2026

Plan of correction: Administrator/licensee agrees to have the air supply duct at the far end of the house fixed before POC due date.

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Valeria Conway arrived at the facility unannounced to conduct a required annual visit at 10:00 A.M. When the LPA arrived, there were two (2) staff members and four (4) residents present. The LPA was greeted by Caregiver, Nikki Villanueva. LPA informed the reason for the visit. Caregiver contacted the Administrator by phone, Edna Dangiapo. At 10:35 A.M. Administrator arrived at the facility. Entrance Interview conducted. Beginning at 10:45 A.M., the LPA, along with Administrator toured the physical plant areas inside and outside to ensure there are no health and safety hazards and facility is in compliance with Title 22 Regulations. The following was observed: Smoke detector was tested at 11:20 A.M. and carbon monoxide detector was tested at 11:22 A.M. and both were functional at the time of the visit. Fire extinguisher was observed to be fully charged and last serviced on 08/12/2025. LPA observed a fire sprinkler system on site. The last documented annual inspection was conducted in 2023; however, Fire inspector R. Martinez explained that, because the facility is equipped with a residential sprinkler system, annual maintenance is not required. COMMON SPACES: In the common areas, walls and flooring were checked for cleanliness and good condition. At the time of the visit, living room and dining room furniture was observed to be in good condition. The LPA observed the required postings in the common area. The facility serves residents with dementia, the auditory alarms on the exit doors were tested and functioned properly at the time of visit. The facility maintained a temperature of 72 degrees. Facility provides sufficient space to accommodate both indoor and outdoor activities. LPA observed a working phone available for residents use whenever needed. Continued on LIC 809-C Continued from LIC 809 BEDROOMS: There are 6 (six) total bedrooms; one (1) of which is a shared resident room, four (4) are private resident rooms and one (1) is designated as a staff room. The LPA observed the resident bedrooms, which were furnished appropriately with clean linens, appropriate furnishings and sufficient lighting. Staff room was observed to be locked. RESTROOMS: The LPA observed two (2) restrooms in the facility, both of which are common restrooms for shared resident use. Resident restrooms were observed to be clean and sanitary and in operating condition with grab bars and slip-resistant mats and surfaces. Hot water temperature was measured and was within the required range. KITCHEN: Kitchen appliances appeared to be in operable condition. The facility has a sufficient supply of perishable and non-perishable food. LPA conducted a review of expiration dates on product labels. Medication and files were observed to be locked inside kitchen cabinets next to the fridge at the time of the visit. At 10:29 A.M. hot water measured 112.9 degrees Fahrenheit. GARAGE/LAUNDRY ROOM: Adjacent to the kitchen is the facility's garage which remains unlocked. Inside the garage, the LPA observed a washer and dryer, cleaning supplies, personal grooming items, mobility devices, as well as knives and sharps. All potentially hazardous items were observed to be secured in a locked cabinet. Additionally, the facility stores its emergency food and emergency water supplies inside the garage. OUTDOOR SPACE: The backyard has a covered outdoor area equipped with furniture for residents’ use. No bodies of water were observed at the time of the visit. Facility has two side gates; both were observed to be self-latching and closing with clear passageways for emergency exit use. RECORD REVIEW: Between 11:46 A.M and 1:55 P.M., LPAs reviewed six (6) staff files and four (4) resident files. Files were reviewed for, but not limited to: Physician's Reports, Personal Rights, Admission Agreements, staff training records, health screenings, TB tests, and background clearance. All files reviewed were observed to be in compliance with regulation. Continued on LIC 809-C Continued from LIC 809-C MEDICATION REVIEW: At 2:00 P.M. medications for four (4) residents were observed. All residents' medications were observed to be maintained and administered in compliance with regulation. During today's visit, LPA gathered the following Personnel report (LIC 500), Resident Roster, a copy of the facility's liability insurance. Emergency disaster drills are conducted quarterly, with the last drill documented on 11/01/2025. No citations issued. Exit interview conducted a copy of this report was provided.the state’s words, verbatim · CDSS document, Dec 4, 2025

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Valeria Conway arrived at the facility unannounced to conduct a required annual visit at 9:20 A.M. When the LPA arrived, there were three (3) staff members and six (6) residents present. The LPA was greeted by Caregiver, Nikki Villanueva. LPA informed the reason for the visit. Caregiver contacted the Administrator by phone, Edna Dangiapo. At 9:55 A.M. Administrator arrived at the facility. Entrance Interview conducted. Beginning at 9:57 A.M., the LPA, along with Administrator toured the physical plant areas inside and outside to ensure there are no health and safety hazards and facility is in compliance with Title 22 Regulations. The following was observed: Smoke detector was tested at 10:35 A.M. and carbon monoxide detector was tested at 10:10 A.M. and both were functional at the time of the visit. Fire extinguisher was observed to be fully charged and last serviced on 07/08/2024. COMMON SPACES: In the common areas, walls and flooring were checked for cleanliness and good condition. At the time of the visit, living room and dining room furniture was observed to be in good condition. The LPA observed the required postings in the common area. The facility serves residents with dementia, the auditory alarms on the exit doors were tested and functioned properly at the time of visit. The facility maintained a comfortable temperature of 73 degrees. Facility provides sufficient space to accommodate both indoor and outdoor activities. LPA observed a working phone available for residents use whenever needed. Continued on LIC 809-C Continued from LIC 809 BEDROOMS: There are 6 (six) total bedrooms; 1 (one) of which is a shared resident room, 4 (four) are private resident rooms and 1 (one) is designated as a staff room. The LPA observed the resident bedrooms, which were furnished appropriately with clean linens, appropriate furnishings and sufficient lighting. Staff room was observed to be locked. RESTROOMS: The LPA observed 2 (two) restrooms in the facility, both of which are common restrooms for shared resident use. Resident restrooms were observed to be clean and sanitary and in operating condition with grab bars and non-skid surfaces. Hot water temperature was measured and was within the required range. KITCHEN: Kitchen appliances appeared to be in operable condition. The facility has a sufficient supply of perishable and non-perishable food. LPA conducted a review of expiration dates on product labels. Medication and resident files were observed to be locked inside kitchen cabinets next to the fridge at the time of the visit. At 10:15 A.M. hot water measured at 119.4 degrees Fahrenheit. GARAGE/LAUNDRY ROOM: Adjacent to the kitchen is a garage. LPA observed a washer and dryer. Garage remains unlocked, but contains a locked cabinet that contains cleaning supplies, personal grooming items, as well as knives and sharps. Garage also contains extra food, emergency food and water as well as storage. OUTDOOR SPACE: The backyard has a covered outdoor area equipped with furniture for resident use. No bodies of water were observed at the time of the visit. All exits and passageways were observed to be free of hazards. Facility has two side gates; both were observed to be self-latching and closing with clear passageways for emergency exit use. Continued on LIC 809-C Continued from LIC 809-C RECORD REVIEW: Between 11:00 A.M. and 12:12 P.M. Staff and resident records were reviewed for documents including, but not limited to: health screening, TB test, staff training records, fingerprint clearance, resident physician's report, needs and service appraisal, and personal rights. Six (6) resident records reviewed were complete and contained all required documents. LPA observed that the Administrator has been using the Resident Appraisal (LIC603A) form in place of the required Appraisal/Needs and Service Plan (LIC625). Licensee stated that the LIC603A has been utilized for several years and was unaware of the requirement for a LIC625 form. The LPA emailed the Administrator a copy of the LIC625 and explained that LIC 625 shall be completed annually or whenever there is a change in the resident’s condition. Four (4) staff files including the Administrators were reviewed. All files were complete and contained all required documents. At 9:20 A.M. LPA knocked on the door to conduct today’s annual visit. Staff #1 (S1) opened the door and notified Staff #2 (S2) that LPA was present. After LPA began the visit, S1 was no longer in the area. When the Administrator arrived, LPA inquired about S1. The Administrator stated that S1 is S2’s spouse. Additionally, Administrator informed LPA that S1 is not currently an employee of the facility, however, S1 has been helping around the facility informally to determine if S1 is a good fit for a potential caregiver role. LPA asked the Administrator if S1 has fingerprint clearance. The Administrator responded that S1 does not currently have fingerprint clearance, as they are not yet an employee. A review of the facility records and interviews confirmed that S1 does not have an employee file. Additionally, a check of the Guardian system revealed that S1 is not associated to the facility and does not have a fingerprint clearance on file. LPA reminded Administrator that per regulation any person who provides client assistance shall be deemed to meet the criminal record clearance requirements. Furthermore, LPA reiterated Administrator that all staff members shall complete fingerprinting, undergo a background check, and be officially associated with the facility before assisting residents. S1 left the facility during today’s visit. MEDICATION REVIEW: At 12:50 P.M. medications for 6 (six) residents were observed. All residents' medications were observed to be maintained and administered in compliance with regulation. Continued on LIC 809-C Continued from LIC 809-C INTERVIEWS: Throughout the visit, LPA interviewed 2 (two) staff and 2 (two) residents/family members. During today's visit, LPA gathered the following Personnel report (LIC 500), Resident Roster, a copy of the facility's liability insurance. Emergency disaster drills are conducted quarterly, with the last drill documented on 11/01/2024. Pursuant to Title 22, California Code of Regulations and/or CA Health and Safety Code, the following deficiencies were cited (refer to LIC 809-D.) Administrator was informed that failure to correct the deficiencies may result in civil penalties. Exit interview conducted, appeal rights discussed, and a copy of this report and appeal rights were provided.the state’s words, verbatim · CDSS document, Nov 14, 2024

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Kelly Dulek arrived at the facility unannounced to conduct a required annual visit at 12:46PM. LPA met with Licensee/Administrator Edna Dangiapo. Entrance interview conducted. Beginning at 12:48PM, the LPA, along with Licensee/Administrator toured the physical plant areas inside and outside to ensure there are no health and safety hazards and facility is in compliance with Title 22 Regulations. The following was observed: Smoke detector was tested at 02:45PM and carbon monoxide detector was tested at 02:45PM and both were functional at the time of the visit. Fire extinguisher was observed to be fully charged and last serviced on 03/16/2023. BEDROOMS: There are 6 (six) total bedrooms; 1 (one) of which is a shared resident room, 4 (four) are private resident rooms and 1 (one) is designated as a staff room. The LPA observed the resident bedrooms, which were furnished appropriately with clean linens, appropriate furnishings and sufficient lighting. Staff room was observed to be locked. RESTROOMS: The LPA observed 2 (two) restrooms in the facility, both of which are common restrooms for shared resident use. Resident restrooms were observed to be clean and sanitary and in operating condition with grab bars and non-skid surfaces. Water temperature was measured and was within the required range. KITCHEN: Kitchen appliances appeared to be in operable condition. The facility has a sufficient supply of perishable and non-perishable food. Adjacent to the kitchen is a garage. Garage remains unlocked, but contains a locked cabinet that contains cleaning supplies, personal grooming items, as well as knives and sharps. Garage also contains extra food, emergency food and water as well as storage. Report Continued on LIC 809-C COMMON SPACES: In the common areas, walls and flooring were checked for cleanliness and good condition. At the time of the visit, living room and dining room furniture was observed to be in good condition. The LPA observed the required postings in the common area. OUTDOOR SPACE: The backyard has a covered outdoor area equipped with furniture for resident use. No bodies of water were observed. All exits and passageways were observed to be free of hazards. RECORD REVIEW: Staff and resident records were reviewed for documents including, but not limited to: health screening, TB test, staff training records, fingerprint clearance, resident physician's report, needs and service appraisal, and personal rights. 5 (five) resident records reviewed were complete and contained all required documents. 3 (three) staff files reviewed were complete and contained all required documents. INFECTION CONTROL/EMERGENCY DISASTER PLAN: During today’s visit, the LPA reviewed the facility’s infection control plan. The facility’s policies and procedures as it pertains to infection control are adequate. LPA also reviewed the facility's emergency disaster plan, which was observed to be complete and updated annually, as required. Emergency drills are conducted quarterly, with the last drill documented on 11/01/2023. MEDICATION REVIEW: Medications for 2 (two) residents were observed. Both 2 (two) of 2 (two) residents' medications were observed to be maintained and administered in compliance with regulation. INTERVIEWS: Throughout the visit, LPA interviewed 2 (two) staff and 2 (two) residents/family members. During today's visit, LPA gathered the following items: LIC 500 A copy of the facility's liability insurance No deficiencies cited. Exit interview conducted. A copy of the report was provided.the state’s words, verbatim · CDSS document, Dec 15, 2023