Exclusive Raya's Paradise

Type of visit: Case Management - Health Checks

At approximately 11:30 a.m. on 04/08/26 Licensing Program Analyst (LPA) Nicholas Reed conducted an unannounced case management visit. LPA met with the assistant administrator and disclosed the reason for the visit. Today’s case management visit was conducted to ensure the health and safety of all residents. LPA toured the facility inside and out at 11:35 a.m. today, interviewed three (03) out of four (04) residents between 11:40 a.m. and 11:55 a.m., and requested pertinent records, including but not limited to admission agreements, medical assessments, care plans, and staff and client rosters at 3:00 p.m. No immediate health or safety concerns were observed during today’s visit. Exit interview conducted. Copy of report provided.the state’s words, verbatim · CDSS document, Apr 8, 2026

Type of visit: Required - 1 Year

On 09/09/25, 10:15 am, Licensing Program Analyst, (LPA) Raymond Comer, conducted an unannounced annual inspection visit. LPA met with the Administrator, and reason for the visit was discussed. Facility is licensed as a single-story residence, fire clearance for six (6) non-ambulatory; Of which, one (1) may be bedridden in room#1. Hospice waiver for six (6). Facility has three (3) bedrooms and three (3) bathrooms. At 10:35 am, LPA conducted a tour of the physical plant with the Administrator and observed the following: Physical plant was inspected for cleanliness and condition. Facility’s main door is the primary entry/exit access. Screening area is located immediately upon entrance. Auditory alarm sensors are present on all exits. Visitor Sign-in sheet, hand sanitizer, gloves and masks are available. Room temperature is comfortable; wall thermostat displays a setting of 74.0°F., within the required range. Approved Mitigation and Infection Control plan is on file. Hand washing, coughing etiquette, and other necessary signage are prominently displayed throughout the facility. Required postings observed to be current. Disaster drills were last conducted: September, 2025. Kitchen area is clean and clear of clutter. LPA observed refrigerator, microwave, stove/oven, dishwasher, and sink to be operational. Knives/Sharps are stored in a locked kitchen drawer inaccessible to residents. A two-day supply of perishable food was observed as properly stored and labeled. A seven-day supply of nonperishable food is stored and available. Dish soap, cleaning solutions, and toxins are stored in a locked lower cabinet underneath the kitchen sink and inaccessible to residents. [LIC 809C-continued] Fire Detection/Protection system is present in the facility. Multiple dual smoke alarm/ carbon monoxide detectors are installed, hardwired, and interconnected. Detectors were tested and function properly. LPA observed two (2) fire extinguishers located in the front and rear areas of the facility. Extinguishers indicate full charge; display service date: 02/07/2025. Medications are stored in a secured medication cart in den area adjacent to the kitchen and inaccessible to residents. Medications are listed on a centrally stored medication and destruction record log. A First Aid kit is complete and stored inside the medication cart. Laundry At 11:30 AM, LPA observed laundry area located in the hallway, across from bedroom #1. Laundry is secured by an electric rolling shutter activated by a key switch only accessible to staff. Laundry soaps and other cleaning agents are stored and inaccessible to residents. Hallway area storage cabinets were observed to contain fresh towels, linens and blankets, sufficient for residents. Commons: LPA observed living room area as clean, organized and clear of obstruction. Furnishings observed in good condition and provide adequate seating for residents. Activities were observed as stored in a dresser located in the living room which contains arts and crafts, board games, puzzles etc. Bedrooms are observed as clean with sufficient lighting, properly furnished with sufficient closet space, bedding, linens, at least one chair, and nightstand. Bathrooms were observed to be clean and sanitary with necessary personal hygiene supplies and required safety fixtures (grab bars, anti-slip floor striping). Hot water temperature measured at 110.0°F. Within the required range. Towels and washcloths are not shared. Garage is detached from the house and observed to be locked and inaccessible to residents. Garage stores emergency water, incontinence and PPE supplies. Outdoor (backyard) area observed to have a shaded patio, with tables and seating sufficient for residents and visitors. Outdoor furniture was observed to be in good condition. There are no bodies of water in the facility. [LIC 809C-continued] Resident records are stored in secured\locked hallway cabinet and inaccessible to residents. Records were reviewed for current IPP and/or Needs and Services plans, physician report, and admission agreements. Resident records appeared to be complete and current. Staff records are stored in secured office area and inaccessible to residents. Staff files contain criminal record clearances and are associated to this facility. Staff records appear to be complete and current. There were no health and safety hazards observed during this inspection. Exit interview conducted and a copy of this report was given.the state’s words, verbatim · CDSS document, Sep 9, 2025

Type of visit: Case Management - Other

Licensing Program Analysts (LPAs) Angela Panushkina and Perchui Milena Khurshudyan conducted an unannounced site visit at this facility for the purpose of obtaining records. LPAs met with Administrator, Brian Rosales and Owner Moti Michael Gamburd and explained the purpose of the visit. During this visit, LPAs obtained the following information: 1. Census 2. Personnel Report (LIC500) 3. Identification and Emergency Information (LIC601) 4. Physician’s Report (LIC602) 5. Admission Agreement (LIC604A) 6. Register of Facility Clients/Resident (LIC9020) 7. Power Of Attorney (POA) or Conservator (Contact Information) 8. Rent Payment Source Exit interview conducted and copy of this report signed and delivered.the state’s words, verbatim · CDSS document, Jun 11, 2025

Allegation investigated: Staff speak inappropriately to residents. Staff left resident soiled for an extended period of time. Staff did not seek timely medical attention for a resident. Staff handled resident roughly. Resident sustained unexplained bruises while in care.

Licensing Program Analyst (LPA) conducted an unannounced subsequent complaint visit at this facility to further investigate the above allegations. LPA met with Rocia Fonseca and explained the reason for the visit. LPA conducted physical plant tour at 9:34 AM, requested copies of facility documents relevant to the investigation at 10:00 AM, reviewed records between 10:15 AM to 11:15 AM and interviewed staff and residents between 11:15 AM to 1:35 PM. Regarding the allegation that Staff speak inappropriately to residents, it was alleged that Staff #1 (S1) was rude Residents #1 (R1) and Resident #2 (R2). LPA's inteview with two (2) staff present today who worked with S1 beween 11:15 AM to 1:35 PM today revealed that they did not witness S1 being rude or speak inappropriately to any resident at the facility while working at the facility. LPA's interview with Resident #3 (R3) or the only aware resident of the facility today also revealed that R3 did not witness S1 or any staff being rude or speak inappropriately to R3 or any resident of the facility. LPA attempted to interview the other four (4) residents but one (1) out of four (4) resident was asleep during the visit and the other three (3) are diagnosed with Dementia. (continued on LIC 9099-C) Unsubstantiated (continued from LIC 9099) Regarding the allegation that Staff left resident soiled for an extended period of time, it was alleged that Staff left R3 soiled for an extended period of time. LPA's record review today between 10:15 AM to 11:15 AM revealed that R3 is not incontinent both bladder and bowel but needed assistance with toileting. LPA's interview staff today revealed that they assist R3 to change and dress only in the morning upon getting up. Further, R3 is aware and would call for help when R3 needed one. LPA observed a bell beside R3's bed that R3 used to call for assistance. LPA's interview with R3 today confirmed that staff check on R3 regularly whole day round. Regarding the allegation that Resident sustained unexplained bruises while in care, it was alleged that Resident #4 (R4) had multiple bruises while living at the facility. LPA's record review today revealed that R3 in on blood thinners and easily get bruised. LPA also observed that R3 had multiple small bruises on R3's arm. LPA's interview with R3's family member today revealed that they are aware of R3's condition and are not worried about it because facility staff always report to them regularly as to the condition of R3. Regarding the allegation that Staff handled resident roughly, it was alleged that S1 physically jerks R1 when moving R1 around. LPA's record review today revealed that R1 is non-ambulatory but LPA observed during today's visit revealed that R1 was able to ambulate on R1's own. LPA's interview with staff today revealed that R1 only need assistance to get up from sitting too long but not to ambulate. Further interview with staff also revealed that they did not witness S1 jerking or being rough with R1 in anyway. LPA's interview with R3 or the only aware resident of the facility also revealed that R3 did not witness any staff jerking or being rough to any resident at the facility. Regarding the allegation that Staff did not seek timely medical attention for a resident, it was alleged that R4 had a foul smell coming from R4 which the Reporting Party (RP) thinks that R4 has an infection somewhere that is not being treated appropriately. LPA's record review today revealed that R1 did not have any recorded infection in 2023 and the last hospital visit was 08/02/23 for other medical condition not related to any kind of infection. LPA's interview with R4's family member today revealed that they did not smell R4 nor reported to have an infection while living at the facility. Based on the information gathered during this and prior visit, the allegations are deemed unsubstantiated at this time. Exit interview conducted. Copy of this report issued.the state’s words, verbatim · CDSS document, Dec 14, 2024 · control 31-AS-20230816102458

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Abeye Duguma met with Brian Rosales for a Required One (01) Year visit. LPA explained the reason for the visit. A tour of the physical plant was conducted at around 1:30 PM and the following was noted: There is one entrance being utilized at the facility. The facility has a total of three (03) bedrooms and three (03) bathrooms. The facility is fire cleared for six (06) non-ambulatory. The facility is currently occupying six (06) residents. The facility has outdoor furniture with a covered shaded area for residents and visitors. The facility does not have a swimming pool/body of water. Laundry detergents, cleaning agents and other toxins are locked away. Kitchen is sufficiently stocked with at least two (02) days perishable and seven (07) days non-perishable food. Frozen foods are wrapped and stored appropriately. Food storage and preparation areas are clean and inaccessible to pests. Knives and sharps are observed to be locked and inaccessible to residents. The living and dining room are neat and clean. The facility maintains a comfortable temperature at 76°F. The smoke and carbon monoxide detectors are hardwired, interconnected and observed to be operational. Fire extinguisher is located near the front entrance, observed to be fully charged and last inspected on 02/12/2024. (continued on LIC 809-C) The residents' rooms are adequately furnished with appropriate lighting system. Hallways are well lit. Residents have enough personal hygiene product provided by the licensee. The bathroom was checked for cleanliness and proper operations. The hot water temperature was measured at 114.1°F. Towels and washcloths are not shared. There was enough clean linen available in the cabinets. LPA observed medication to be locked and inaccessible to residents. Facility maintains a complete first aid kit. No health and safety hazards noted during the visit. Exit interview conducted. Copy of this report issued.the state’s words, verbatim · CDSS document, Sep 7, 2024

Allegation investigated: Staff are not trained appropriately to provide care to residents

Licensing Program Analyst (LPA) Gary Tan conducted an unannounced subsequent complaint visit at this facility to further investigate the above allegation. LPA met with staff Rocio Fonseca who called the administrator Brian Rosales and explained the reason for the visit. Mr. Rosales designated Ms. Fonseca to sign the report. LPA conducted physical plant tour at 9:45 AM, requested copies of facility documents relevant to the investigation at 10:13 AM, reviewed facility documents from 10:30 AM to 11:30 AM and interviewed staff and resident between 12:00 PM to 12:45 PM. It was alleged that Staff who are present are allowed to start working without any training or prior experience. LPA's record review today at 10:30 AM revealed that all the staff present during visit on 01/05/24 and today have initial and yearly training record on file. LPA's interview with three (3) staff on 01/25/24 between 11:00 AM to 1:00 PM and today at 12:00 PM revealed that three (3) out of three (3) staff had undergone training before they started working and had a minimum eighty (80) hours on-the-job training/shadowing at the facility. (continued on LIC 9099-C) Unsubstantiated (continued from LIC 9099) Based on the information gathered during this and prior visit, the allegation is deemed unsubstantiated at this time. Exit interview conducted. Copy of this report issued.the state’s words, verbatim · CDSS document, Jul 19, 2024 · control 31-AS-20240103153651

Allegation investigated: Licensee did not provide adequate notice of fee increases to residents Staff do not assist residents with care needs in a timely manner

Licensing Program Analyst (LPA) Gary Tan conducted an unannounced complaint visit to this facility to investigate the above allegation. LPA met with administrator Brian Rosales and explained the reason for the visit. LPA conducted physical plant tour at 9:48 AM, requested copy of facility documents relevant to the investigation at 10:29 AM and interviewed staff and residents between 11:00 AM to 1:00 PM. Regarding the allegation that the licensee did not provide adequate notice of fee increase to residents, it was alleged that a family member (FM) of Resident #1 (R1) recently received notice of an increase in costs for medical transportation services provided to residents by the facility with only a one-week notice. LPA's record review today revealed at 1:00 PM revealed that the general increase letter was issued on 12/22/23 with effective date of 03/01/24, or more than 60 days’ notice. Another letter was issued for the transportation/operations increased issued on 12/27/23 with the effective date of 02/01/24. (continued on LIC 9099-C) Unsubstantiated (continued from LIC 9099) LPA's interview with the licensee today at 12:00 PM revealed that he made the mistake on the 2nd letter which was an amendment of the addendum of the admission agreement supposed to take effect on 03/01/24, same as the previous letter and not 02/01/24. The licensee stated that he will rescind the prior letter and re-issue the same letter with the corrected effective date or sixty (60) days after the issuance date. Regarding the allegation that Staff do not assist residents with care needs in a timely manner, it was alleged that a caregiver refused to shower R1 because the staff came to work ill and told R1 that they were unable to help shower R1 because they were sick. LPA's interview with the staff today at around 11:22 AM revealed that there was no staff who came here to work sick. LPA's interview with the administrator confirms that all staff are not allowed to work here when they are sick and that is why they did not have any case of Covid at this facility. Further interview with staff also revealed that it was R1 who refused to get showered because R1 was coughing at that time. LPA's interview with R1 today at around 12:42 PM revealed that staff gave R1 showers regularly and no staff refused to shower R1 at any given time. LPA's interview with three (3) other aware residents also revealed that the staff provide showers regularly and no staff refused to provide showers to any of the residents interviewed. Based on the information gathered during this visit, the allegations are deemed unsubstantiated at this time. Exit interview conducted. Copy of this report issued.the state’s words, verbatim · CDSS document, Jan 5, 2024 · control 31-AS-20240103153651

The state marks this report as 3 pages; the online copy we transcribed has 2. You can request the full file from the county licensing office.

Type of visit: Required - 1 Year

Licensing Program Analysts (LPAs) Chris Alemoh and Michael Cava conducted an Annual Required visit and inspection of the facility. LPA met with the administrator, Brian Rosales and explained the reason for the visit. At approximately 11:00am, with the assistance of staff and the administrator, LPAs took a tour of the physical plant. Required postings were observed in the entry area. The smoke alarms and carbon monoxide are dual and is battery operated. The fire extinguisher is located at the back entry way. The charge date is March 1, 2023. Kitchen: The kitchen appliances and fixtures were functional. LPA found a sufficient amount of perishable and non-perishable food at the facility; properly stored. Knives were stored in a locked drawer in the kitchen. Properly labeled medications were locked in one of the kitchen cabinets. Facility does food preparation at 846 Sierra Bonits St. The facility has a food waiver to prevent contamination and keep served meals warm or cold. Bedrooms: There were three (3) bedrooms designated for residents' use. Three of the bedrooms, in use by residents were were properly furnished with appropriate beddings and linens with sufficient lighting. Bathrooms: There are three (3) bathrooms designated for residents' use. Both bathrooms were properly supplied and had functional fixtures. Hot water temperature was measured at 115 degrees Fahrenheit. Cleaning supplies are being stored in the hallway bathroom. Common Areas: These included the living room and dining area. The common areas were properly furnished. The auditory alarms on all exit doors were on and functional at the time of the visit. Surrounding Grounds: Entry/exits were free of obstruction. There was furniture appropriate for outdoor use. The outdoor area was free of hazards. The laundry area and detergents are located by the kitchen. Resident Files: LPA conducted a file review of resident records to insure compliance of licensing forms. Files are maintained electronically. Staff Files: LPA also conducted a file review of staff records to insure forms and training are up to date and compliance with licensing forms. Files are also maintained electronically. Medications: Medication and Medication Records were review for proper documentation. Pursuant to Title 22 Division 6 of the CA Code of Regulations, there were no deficiencies observed during the visit. Exit Interview Conducted. A Copy of the Report Issued.the state’s words, verbatim · CDSS document, Oct 3, 2023