Elsabels Place for Seniors

Type of visit: Case Management - Health Checks

Licensing Program Analyst (LPA) Natasha Persaud conducted an unannounced Case Management - Health Checkst. LPA introduced herself and was granted entry into the facility by Administrator, Rolando Corpuz. Staff, Maria Corpuz and Staff, Leonard Sio were also present. During today's visit, LPA toured the facility, observed residents in care. No health & safety issues were observed. No deficiencies were issued. An exit interview was conducted and a copy of this report along with Licensee Rights (LIC 9058 03/22) were provided to Administrator, Rolando Corpuz whose signature below confirms receipt of these rights.the state’s words, verbatim · CDSS document, Aug 6, 2026

Type of visit: Case Management - Legal/Non-compliance

Licensing Program Analyst (LPA) Natasha Persaud conducted an unannounced visit to conduct a Case Management - Legal/Non-compliance visit. LPA introduced herself and was granted entry into the facility by Administrator, Rolando Corpuz. Staff, Leonard Sio was also present and discussed the purpose of the visit. During today's visit, LPA toured the facility, observed residents in care. No health & safety issues were observed at this time and no citations were issued. The following topics were discussed and the licensee was knowledgeable with all topics: 87355 Criminal Record clearance; 87412 Personnel Records; and 1569.50 Conduct Inimical No deficiencies were issued. An exit interview was conducted and a copy of this report along with Licensee Rights (LIC 9058 03/22) were provided to Administrator, Rolando Corpuz whose signature below confirms receipt of these rights.the state’s words, verbatim · CDSS document, Jul 31, 2026

Type of visit: Case Management - Health Checks

Licensing Program Analyst (LPA) Natasha Persaud conducted an unannounced visit to conduct a Health & Safety Inspection. LPA introduced herself and was granted entry into the facility by Licensee, Rolando Corpuz. During today's visit, LPA conducted a health and safety visit. LPA toured the facility, observed, and interviewed residents in care. No health & safety issues were observed at this time and no citations were issued. An exit interview was conducted and a copy of this report along with Licensee Rights (LIC 9058 03/22) were provided to Licensee, Rolando Corpuz whose signature below confirms receipt of these rights.the state’s words, verbatim · CDSS document, May 7, 2026

Type of visit: Case Management - Health Checks

Licensing Program Analyst (LPA) Natasha Persaud conducted an unannounced visit to conduct a Health & Safety Inspection. LPA introduced herself and was granted entry into the facility by Staff, Leo Sio. LPA met with Licensee, Licensee, Maria Sio Corpuz. During today's visit, LPA conducted a health and safety visit. LPA toured the facility, observed, and interviewed residents in care. No health & safety issues were observed at this time and no citations were issued. An exit interview was conducted and a copy of this report along with Licensee Rights (LIC 9058 03/22) were provided to Licensee, Maria Sio Corpuz whose signature below confirms receipt of these rights.the state’s words, verbatim · CDSS document, Apr 14, 2026

Type of visit: Case Management - Health Checks

Licensing Program Analyst (LPA) Natasha Persaud conducted an unannounced visit to conduct a Health & Safety Inspection. LPA introduced herself and was granted entry into the facility by Licensee, Rolando Corpuz and discussed the purpose of the visit. During today's visit, LPA conducted a health and safety visit. LPA toured the facility and interviewed residents and staff. No health & safety issues were observed at this time and no citations were issued. An exit interview was conducted and a copy of this report along with Licensee Rights (LIC 9058 03/22) were provided to Licensee, Rolando Corpuz whose signature below confirms receipt of these rights.the state’s words, verbatim · CDSS document, Apr 2, 2026

Type of visit: Case Management - Health Checks

Licensing Program Analyst (LPA) Liliana Silveira conducted an unannounced visit to conduct a Health & Safety Inspection and to clear a Plan of Correction (POC). LPA introduced herself and was granted entry into the facility by Licensee Rolando Corpuz. LPA discussed the purpose of the visit with the Licensee. During today's visit, LPA conducted a health and safety visit. LPA toured the facility and interviewed residents and staff. LPA also cleared a POC for a citation issued on March 26, 2026 regarding personnel records. LPA verified that the personnel records were present at the facility. No health & safety issues were observed at this time and no citations were issued. This report was discussed with Rolando. A copy of this report, along with Licensee/Appeal Rights, (LIC 9058 03/22) were provided at the conclusion of the visit.the state’s words, verbatim · CDSS document, Mar 27, 2026

Type of visit: Post Licensing

Licensing Program Analyst (LPA) Liliana Silveira conducted an unannounced, Post-Licensing visit to observe the facility’s compliance with Title 22, Division 6 of the California Code of Regulations and California Health & Safety Code. LPA was greeted by, identified themselves to, and explained the purpose of the visit to Licensee Rolando Corpuz. During today’s visit, LPA, accompanied by Licensee Rolando Corpuz, toured the interior and exterior of the facility and inspected each room. There are currently five (5) residents living in the home. The facility was clean, sanitary, and in good repair. Resident bedrooms were fully furnished and the linens on the beds were clean. LPA interviewed two (2) residents who did not express concerns or issues with the care provided at the facility. LPA also interviewed a staff and the interview did not raise any concerns. There were 2 days worth of perishable foods and 7 days worth of non-perishable food items. Toilets, sinks, and showers were in working order. The facility’s ambient internal temperature was compliant and the facility has enough linens, hygiene supplies, cooking and dining supplies. All kitchen appliances were in working order. The facility has locked areas for storage of sharp objects, medication, toxic chemicals/poisons and confidential resident and staff records. Smoke alarms, carbon monoxide detectors, emergency lighting, and facility telephone were all operational. Required licensing postings were observed in visible areas of the facility. There were no health & safety issues observed and no citations were issued during this visit. An exit interview was conducted with Rolando, to whom a copy of this report and the Licensee/Appeal Rights (LIC9058 03/22) were provided during the visit.the state’s words, verbatim · CDSS document, Mar 27, 2026

Type of visit: Case Management - Health Checks

Licensing Program Managers (LPM) Simon Jacob and Sabel Martinez conducted a Case Management visit. LPMs disclosed the purpose of the visit to Caregiver Richelle Padilla and were allowed to enter the facility. The facility was clean, sanitary, and in good repair. Pathways were free of obstruction. There was at least 2 days of perishable food, and at least 7 days non-perishable food present, all safely stored. There were no toxic chemicals/poisons accessible to clients. Medications were labeled, and stored in a locked area. No pools, nor bodies of water were observed on the premises. Per staff, no firearms, nor ammunition were kept at the facility. Records for staff were not readily available for review. It was also discovered Staff #1 (S1) did not have a background clearance, nor was associated to the facility. These deficiencies were cited in an LIC 809-D form and an immediate $500 civil penalty was assessed in an LIC 421BG form. A plan of correction was jointly formulated with Caregiver Padilla, to whom a copy of this report, LIC 809-D, and appeal rights were provided.the state’s words, verbatim · CDSS document, Mar 26, 2026

From the deficiency page — Deficiency type: Type A · Section cited: CCR 87355(e)(2) · Plan of correction due date: Mar 26, 2026

87355 All individuals subject to a criminal record review pursuant to Health and Safety Code Section 1569.17(b) shall... (2) Obtain a California clearance or a criminal record exemption as required by the Department or This requirement was not met as evidenced by: Based on record review, the licensee did not comply with the section cited above in 1 of 3 staff which posed an immediate health and safety risk to 5 residents in care.the state’s words, verbatim · CDSS document, Mar 26, 2026

Plan of correction: Staff agreed to complete the missing informaiton requested to process the fingerprint clearance, once finger print clearance is granted, staff agreed to associate S1 to the facility. Licensee will review backgriund clearance regulations.

From the deficiency page — Deficiency type: Type B · Section cited: CCR87412(f) · Plan of correction due date: Mar 26, 2026

87412 Personnel Records (f) All personnel records shall be available to the licensing agency to inspect, audit, and copy upon demand during normal business hours.... This requirement was not met as evidenced by: Based on records review, the licensee did not ensure records for staff were available to licensing to inspect during normal business hours, which posed a potential risk to 5 of 5 residents in care.the state’s words, verbatim · CDSS document, Mar 26, 2026

Plan of correction: Staff agreed to have records at the facility and available for licensing to inspect withing the next two weeks, by 4/9/2026

Type of visit: Prelicensing

Licensing Program Analyst (LPA), Natasha Persaud conducted a Prelicensing inspection. An initial application to operate a Residential Care Facility for the Elderly was received on 06/20/25. The facility was approved to care for five (5) Non-Ambulatory Elderly Residents and one (1) bedridden. LPA was greeted and allowed entry into the facility by Applicant, Rolando Corpuz. Structure- The facility is a single story structure with 4 bedrooms and 3 bathrooms. There is an outdoor covered area for resident use. There is a small fountain at the entry. The water is less than 2 inches deep. Bedrooms Residents- Resident rooms may be used for Non-Ambulatory; Bedridden resident in room #1. Bedrooms Staff- There is staff room. Bathrooms- All bathrooms have a working toilet, sink, grab bars and tub/showers with non-skid mats. Linens & Hygiene Supplies- Adequate supply. Emergency Phone Numbers, Exit Plan and Required Postings- Posted. Smoke Detectors and Carbon Monoxide Detectors- Interconnected and hardwired. Appliances- Stove burners, oven, microwave, washer, and dryer working. Toxins- Stored in a locked cabinet. Water Temperature- Measured at 117 degrees F. Medications- Centrally stored and locked in a cabinet. First-Aid Kit- Stored in a locked cabinet. Resident & Staff Files- Stored in a locked cabinet. Activities- Adequate supplies to include exercising, crosswords, and puzzles for resident's use. Fire clearance- Approved on 12/12/25. Component III- Conducted at the Pre-Licensing visit. Information provided about how to operate the facility within substantial compliance. All items reviewed during the visit are in compliance. Prelicensing is complete and this facility has no deficiencies. Facility appears to be ready for licensure pending final review. An exit interview was conducted and a copy of this report along with Licensee Rights (LIC 9058 03/22) were provided to Applicant, Rolando Corpuz whose signature below confirms receipt of these rights.the state’s words, verbatim · CDSS document, Mar 2, 2026

Type of visit: Office

Facility Type: RCFE Application Type: CHOW Capacity: 6 Census (if any clients in care): 5 COMP II Participants: Licensee/administrator Rolando Corpuz Interview Method: Telephone interview On 2/11/2026, 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, Feb 11, 2026