Evercare Homes

Type of visit: Case Management - Deficiencies

Licensing Program Analysts (LPA) Sarah Hurt conducted an unannounced visit today to conduct a Case Management inspection. LPA met with Administrator Diana Diaz, and explained the purpose of today's visit. During the visit, LPA reviewed resident records and identified concerns related to residents’ Needs and Services Plans, hospice documentation, and documentation pertaining to PRN medications. During record review, LPA observed that resident Needs and Services Plans were not current and/or did not reflect residents’ current care and supervision needs. A Needs and Services Plan reviewed by LPA was dated 09/16/2025 and had not been updated within the annual period. Additionally, records reviewed did not reflect current needs and interventions identified during the investigation. Specifically, R1’s plan did not address reported ongoing bathing refusals and behavioral concerns identified by facility representatives. Another resident’s plan did not reflect current needs related to recurrent falls, increased supervision, attempts to ambulate/get out of bed, and interventions implemented by the facility in response to those needs. LPA reviewed the record of a resident currently receiving hospice services. The hospice care plan available for review had an expiration date of 07/13/2026. LPA requested a current hospice care plan; and Administrator was able to provide by end of visit. LPA was unable to locate documentation identifying the resident’ 2's ability to determine the need for PRN medication and/or the required physician instructions regarding assistance with PRN medications. LPA requested the applicable PRN documentation from facility admin; however, the facility was unable to provide the required documentation for review during the visit. Technical violations are being issued during today's visit. See 809D and LIC9102TV for additional information. Exit interview conducted with Administrator Diana Diaz and a copy of this report provided.the state’s words, verbatim · CDSS document, Sep 26, 2026

Type of visit: Required - 1 Year

Licensing Program Analysts (LPA) Sarah Hurt conducted an unannounced visit today for the facility’s annual inspection. LPA met with Administrator Diana Diaz, Continual Administrator's Certification expires 03/10/2028. There are currently 4 residents who reside at this home and there is 1 resident on hospice at this time. LPA inspected the interior and the exterior of the facility including the common living spaces, resident bedrooms and bathrooms, medication storage, kitchen, garage and outdoor areas. Bedrooms were clean and in good repair. There is a locked storage for medications. Food supply is adequate for 2-day perishable and 7-day nonperishable. Fire extinguisher is within the safety regulation period. Smoke alarms were tested and are operational. The home has a carbon monoxide detector and performs disaster drills as required. Water temperature was tested at 109 degrees. First Aid kit is on site and complete. Toxins and cleaning supplies are locked and inaccessible. LPA reviewed facility Infection Control Plan, Emergency Disaster Plan, a sample of staff and resident files. LPA observed hygiene items accessible to Resident 1 despite Physicians report documenting at risk if allowed access. LPA observed staff 1's Health Screening not signed by Physician. LPA observed Admission agreements with no label or title. LPA observed several windows with no window screen. LPA observed the facilities Infection Control plan is not documented as reviewed annually. The Infection Control Plan does not include how the Infection control lead will be trained. No deficiencies observed or cited during today's inspection per California Code of Regulations, Title 22. LPA requested the following documents: LIC 500 Personnel Report, LIC 308 Designation of Administrative Responsibility, LIC 610-E the Emergency Disaster Plan and copy of current Administrator’s Certificate to update the facility file. Listed documents shall be sent to Licensing. Exit interview conducted with Administrator, Diana Diaz, and copy of report left at facilitythe state’s words, verbatim · CDSS document, Jun 27, 2026

Type of visit: Prelicensing

Licensing Program Analyst (LPA) Shawna Doucette arrived to the facility announced to conduct the Pre licensing visit. LPA Shawna Doucette met with Licensee/Administrator Elizabeth Ramos who granted LPA's entry into the facility. LPA toured facility. Common rooms have adequate furnishings and lighting. All of the resident bedrooms have all the required furnishings and adequate lighting. Hot water temperature in bathrooms measured at 115.8 degrees F. LPA observed a supply of extra bed linens and personal hygiene and grooming products. Kitchen observed to have dishes, plates, utensils. Cleaning supplies are stored in a locking cabinet in the kitchen and in a locked hallway closet. Medications are locked in a medication cabinet in the office. First aid kit contains all the required items. A fire extinguisher is present and has a service date of 01/25/2025. Smoke detectors and carbon monoxide were operating. Outside of the facility toured. Exits open free of obstruction. The residence has door alarms upon entering and exiting the facility. No outside hazards were observed. No pools or bodies of water. All required postings are posted. Facility phone number will be (661) 282-8475. Component III was conducted during pre-licensing visit with Applicants. I have found that applicant has met all pre licensing requirements. LPA will submit documentation to CAB in Sacramento for final review prior to license being issued.the state’s words, verbatim · CDSS document, May 27, 2025

Type of visit: Office

Component II completion: Successful Facility Type: RCFE Application Type: INITL Capacity: 6 Census : 0 Method: Telephone call with CAB COMP II Participants: ELIZABETH RAMOS (Administrator/Licensee) & JOSHUA DEGMETICH (Analyst). Administrator/Licensee participated in COMP II via telephone call with CAB analyst. Identification of the Administrator/Licensee was verified by confirming driver’s license number. During COMP II, Administrator/Licensee confirmed the understanding of Title 22. Component II was successfully completed. Administrator/Licensee was advised to email signed LIC 809 with copy of photo ID to CAB. During COMP II, CAB analyst confirmed Administrator/Licensee'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, May 12, 2025