Emerald Isle Assisted Living #2

Type of visit: Required - 1 Year

On 01/08/2026, Licensing Program Analyst (LPA)Villegas conducted an unannounced annual required visit using the CARE Inspection Tool. LPA met with Ceceni Walker as the purpose of the visit was explained. The facility is licensed to serve (6) residents ages 60 and above ambulatory/non-ambulatory, there is an approved hospice waiver for (2). Facility fees are current, liability insurance active (CFP3312403-01). The facility is a single-story structure located in a residential neighborhood that consists of (4) resident bedrooms, (1) staff bedroom, (2) full bathrooms, kitchen, dining area, living room, and a shaded patio area located in backyard. The facility entrance and exits are wheelchair accessible. The facility has (1) garage that is utilized for supplies. There were no bodies of water or obstructions on the premises. All resident bedrooms were inspected, 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. Smoke detectors and carbon monoxide detectors were in operable conditions. The last drill was conducted in December 2025. The water temperature properly measured between 105°-120°F.. The kitchen was inspected and there is sufficient perishable and non-perishable food available maintained properly. Toxins and sharps were locked and inaccessible to residents in care. All fire extinguishers were charged and were operable, The first AID kit was checked. A review of (4) residents files, (4) Medication Administration Records, and (3) staff personnel files was conducted. Exit interview conducted, and a copy of this report was provided.the state’s words, verbatim · CDSS document, Jan 8, 2026

Type of visit: Required - 1 Year

On 01/24/2025 at 09:00 AM, Community Care Licensing Division (CCLD) conducted an unannounced annual inspection visit at the Emerald Isle Assisted Living 2 Facility. CCLD staff was allowed entry into the facility by Administrator Laura Martz. Administrator Martz asked infection control questions and took CCLD staff temperature prior to entrance into the facility. Facility is to operate a Residential Care Facility for 6 Elderly residents 60 years or older. Currently, there are six (6) residents residing in the facility, 60 and older. CCLD staff explained to Administrator Martz, the purpose of the one-year Annual Inspection visit, and escorted CCLD staff on a tour of the entire inside and outside facility grounds. As part of the inspection, CCLD staff reviewed: Six (6) residents service records, six (6) residents medication records (MAR), three (3) staff records, and inspected the inside facility and outside grounds. The facilities’ last fire drill was conducted on 12/10/2024. The one-story residential home consists of four (4) resident bedrooms, two (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. No weapons are stored in the premises. Kitchen was inspected and observed to be clean and operational. A two-day supply perishable and seven-day supply of non-perishable foods are present in the facility. Emergency Water Storage is in the garage and kitchen area. CCLD staff observed that all facility rooms are clean and in good repair. A comfortable temperature was observed, and the facility has central air and heating. CCLD staff observed the following during inspection of resident’s rooms: mattresses are in good condition, adequate lighting present, plenty of dresser/closet space is present, and all bed linens present. All bedrooms contain furniture, lighting fixtures and personal storage space as required, all beds have the required amount of linen and mattress covers, CCLD staff observed fully stocked closet with bedding, towels, and toiletries supplies. Bathroom fixtures are clean, in good repair, and working properly and contain the required nonskid mats and grab bars. CCLD staff observed bathrooms were found to be within Title 22 regulation. Bathroom #1 hot water temperature properly measured at 113 degrees Fahrenheit; bathroom #2 hot water temperature properly measured at 111 degrees Fahrenheit. Kitchen hot water temperature properly measured at 115 degrees Fahrenheit. Facility (2) Carbon Monoxide and (10) Smoke Detectors hard wired operated and connected were tested and are working properly. The facility one (1) Fire Extinguishers was checked and found to be fully charged and accessible. All exit doors in the facility have alarm systems. The facility has a working landline telephone. All toxins and knifes are locked/secured and inaccessible to residents. Medications are centrally stored and in a locked storage cabinet. Facility 2 first aid kit is fully stocked with manuals was checked and in order. All Exits/ Walkways around the home were free of debris and hazards. Outside patio accessible to residents. Six (6) resident files were reviewed and found to be complete. CCLD staff reviewed six (6) resident medications (MAR) and they were all found to be administered according to doctor's orders. Three (3) staff files were checked and have the required documents. CCLD staff noted the Administrator Laura Martz Certification # 6061671740 expiration date of 6/5/2025 was valid at time of inspection. The facility does not handle residents money/cash resources and no surety bond is needed. Commercial General Liability Policy #PCI2130019501 policy period from 05/08/2024 to 05/08/2025 underwritten by Primary Insurance Company, coverage 1,000,000/3,000,000 is valid at time of inspection. Administrator Valencia to email CCLD staff a full copy of the commercial insurance policy including all endorsements no later than 02/10/2025. All the required documents are posted in the facility in a clearly visible area. During the visit, CCLD staff observed the facility infection control practices. CCLD staff observed screening protocols for visitors, staff, and residents, sanitizing stations (Located in common areas and restrooms). CCLD staff observed staff and residents were NOT wearing face coverings. CCLD staff observed the facility has a 30-day supply of Personal Protective Equipment (PPE). CCLD staff advised the Administrator Martz to continuously monitor the Centers for Disease Control (CDC) website and Community Care Licensing Provider Informational Notices (PIN) for any updates relating to COVID-19 guidance. According to the California Code of Regulations (Title 22, Division 6, Chapter 8), CCLD staff did observe deficiencies therefore citations were issued at this time. Annual Licensing Fee is CURRENT. An exit interview was conducted, and a copy of the Facility Evaluation Report was provided to Administrator Laura Martz.the state’s words, verbatim · CDSS document, Jan 24, 2025

Type of visit: Annual/Random

On 1/17/2024, Licensing Program Analyst (LPA) Alfonso Iniguez conducted an unannounced annual required visit using the CARE Inspection Tool. LPA met with Ceceni Rose Pare/Administrator. LPA explained the purpose of today’s visit. The facility is licensed to serve (6) residents ages 60 and above ambulatory/non-ambulatory. Dementia waiver on file. Approved hospice waiver for (2). The facility is a single-story structure located in a residential neighborhood. It consists of (5) resident bedrooms, (1) staff room, (2) full bathrooms, kitchen, dining area, living room, and patio area with shade located in backyard. The facility entrance and exits are wheelchair accessible. The facility has (1) garage that is utilized for supplies. LPA Iniguez toured the physical plant with administrator. There were no bodies of water or obstructions on the premises. A total of (5) rooms were inspected. 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 the carbon monoxide detectors combo were in operable conditions. The water temperature properly measured between 105°-120°F: Kitchen 109.7°F, Bathroom #1:112.7°F, Bathroom #2:109°F. Evaluation Report Continues LIC 809-C LPA Iniguez observed the facility to be clean, sanitary, and appropriately furnished at the time of the visit. Storage areas for personal hygiene, 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 (3) residents' service files, (2) staff personnel files and (3) Medication Administration Records (MAR) LPA did not find discrepancies. The first AID kit was checked. Last facility disaster drill was: 12/11/23. LPA observed the facility's infection control practices. A copy of the liability insurance will be emailed to LPA. Deficiency cited under California Code of Regulations, Title 22, Division 6, Chapter 8. An exit interview was conducted, and a copy of the Facility Evaluation Report was provided to Ceceni Rose Pare /Administrator.the state’s words, verbatim · CDSS document, Jan 17, 2024