Four Diamonds

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Galarza conducted an unannounced annual inspection visit. The purpose of the visit was explained to caregiver Virginia Villacorte. Assistant Administrator Daniel Hurtado and Shanell Hurtado arrived shortly after. The facility serves elderly residents ages 60 and older. The following were observed/inspected: Infection Control: The Infection Control Plan was reviewed and includes environmental cleaning and disinfection activities. Facility has sufficient Personal Protective Equipment. Operational Requirements: A Dementia and hospice waiver for 6 residents and fire clearance for 6 non-ambulatory is approved. Facility does not handle resident resident's monies. Liability Insurance in the amount of at least ($1,000,000) per occurrence and ($3,000,000) in total annual aggregate is current with an expiration date of 6/2/2026. Physical Plant/Environment Safety: The facility is a single story home located in a residential neighborhood. It consists of (3) resident bedrooms, (1) staff room, (2) bathrooms, living room, dining room, kitchen, and attached garage. The front and backyard are well maintained and there are no pools or large bodies of water. There is a shaded seating area for the residents located in the backyard. Smoke and carbon monoxide detectors were tested and are operational. The facility has one (1) fire extinguisher. Water temperature readings measured within the required 105 - 120 degrees Fahrenheit. The facility has a 1st Aid Kit and Manual. Cleaning supplies, knives, and toxic substances are inaccessible to residents. Exit doors are free of any obstruction and there are no pools or large bodies of water. The last Emergency Disaster drill was conducted on October 2025. Staffing: A total 5 staff members provide care and supervision to the clients. Personnel Records/Staff Training: Administrator certificate expires 4/23/2026. Staff have criminal background clearance and training. Six (6) staff files were reviewed. Files had health clearance, and 1st Aid/CPR training. However, proof of staff training was not available for review. Resident Records/Incident Reports: A total of six (6) resident files were reviewed. The majority of the resident files were missing required documents i.e. Pre-Admission Appraisal, ID and Emergency Information, Safeguards for property/valuables, and updated Physician's Reports/Medical Assessment. Medication Administration records are in place, but staff are not documenting daily. RCFE complaint poster is posted in the main entryway of the facility. Planned Activities: Sufficient space to accommodate both indoor and outdoor activities was observed. The facility does not have a Resident Council. Food Service: Sufficient food supply is stored in the kitchen and pantry areas consisting of: 2-day perishables, 7-day non-perishables, and emergency food supplies. Residents have modified diets. Incident Medical and Dental: Centrally stored resident medications were reviewed. 30-day supply of medications was observed. Medical and dental transportation is provided by family. Resident (R6's) is missing 2 medication refills. Disaster Preparedness: Emergency and Disaster Plan LIC 610E was reviewed. Facility has a First Aid Kit and Manual. Residents with Special Health Needs: Two (2) resident receives hospice services and one (1) resident receives home health services. No residents have prohibited health conditions. Residents have half bed rails and/ full rails for mobility assistance. Pursuant to Title 22, deficiencies were observed. An exit interview was conducted with Assistant Administrator Daniel Hurtado. A copy of the report and appeal rights was issued.the state’s words, verbatim · CDSS document, Nov 20, 2025

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Galarza conducted an unannounced annual inspection visit. The purpose of the visit was explained to caregiver staff Virginia Villacorte. Administrator Helen Torres arrived shortly after. The facility serves elderly residents ages 60 and older. A hospice and Dementia waiver is in place. It consists of (3) resident bedrooms, (1) staff room, (2) bathrooms, living room, dining room, kitchen, and attached garage. The front and backyard are well maintained and there are no pools or large bodies of water. There is a shaded seating area for the residents located in the backyard. Twelve (12) CARE tools domains were reviewed. The following were observed/inspected: Infection Control: The Infection Control Plan was reviewed. The facility has a supply of Personal Protective Equipment (PPEs). Operational Requirements: A hospice waiver for 6 residents has been approved. A fire clearance for 6 non-ambulatory residents. Facility does not handle resident P & I monies. Liability Insurance in the amount of at least ($1,000,000) per occurrence and ($3,000,000) in total annual aggregate is current with an expiration date of 6/2/2025. Physical Plant/Environment Safety: The interior and exterior physical plant was inspected. Exit doors are free of any obstruction and there are no pools or large bodies of water. Cleaning supplies and toxic substances are inaccessible to residents. The facility has fully charged fire extinguishers. Water temperature readings measured within the required 105 - 120 degrees Fahrenheit. Facility has a fire pull-alarm and sprinklers. Room #3 has a toilet leak and walls are in disrepair. Staffing: A total of 5 staff members provide care and supervision to the clients. Personnel Records/Staff Training: Administrator certificate expired 4/23/2024. Staff have criminal background clearance and training. Four (4) staff files were reviewed. Proof of staff training, health clearance, and 1st Aid/CPR training. Resident Records/Incident Reports: A total of 5 resident files were reviewed. All files were missing required documents. R1 has a Physician Report that is for ARFs, R4 is a hospice resident whose file was missing a Physician's Report, Appraisals, Needs and Services Plan, and none of the files had pre-admission appraisals. Centrally stored medication records are in place. RCFE complaint poster and Personal rights were observed posted. Planned Activities: Sufficient space to accommodate both indoor and outdoor activities was observed. The facility does not have a Resident Council. Food Service: Sufficient food supply is stored in the kitchen and pantry areas consisting of: 2-day perishables, 7-day non-perishables, and emergency food supplies. All residents are on modified diets. Incident Medical and Dental: Centrally stored resident medications were reviewed; containing a 30-day supply of medications. Medical and dental transportation is provided by family. Disaster Preparedness: Emergency and Disaster Plan LIC 610E was reviewed. Facility has a First Aid Kit and Manual. Residents with Special Health Needs: Four (4) residents are receiving hospice services and two (2) residents receive home health services. Two (2) residents have a Dementia diagnosis. Full bed rails for mobility assistance were observed in hospice resident's rooms. No residents have prohibited health conditions. Per California Code of Regulations, Title 22, deficiencies were cited. Exit interview was conducted with Licensee Helen Torres. A copy of the report and appeal rights was issued.the state’s words, verbatim · CDSS document, Dec 9, 2024

Allegation investigated: Staff are using methamphetamines on the facility premises. Staff are intoxicated while providing care to residents in care.

Licensing Program Analyst (LPA) Galarza conducted a subsequent visit to deliver findings on the investigation conducted by DSS Investigation Branch (IB) Investigator Christine Ferris. LPA explained the purpose of the visit to staff Virginia Villacorte. Staff Shanelle Hurtado was explained the purpose of the visit telephonically. The investigation consisted of the following: On 6/15/2022, a physical plant tour of the interior and exterior was conducted. No staff or resident interviews were conducted on that date. LPA reviewed resident and staff files and obtained records of resident IIdentification and Emergency Information, Admission Agreements, Physician Reports, Personnel Records of staff (S1-S5), resident roster and, and LIC 500 Personnel Report. IB investigator interviewed residents, staff, and conducted multiple attempts to locate staff (S1) and their spouse, visitor (V1). ***Narrative summary continues next page. Unsubstantiated Staff are using methamphetamines on the facility premises. It is alleged that live-in staff (S1) and their spouse, whom visits the facility often (V1), but is not employed at the facility brought into the facility methamphetamines and marijuana and smoked the drugs in the garage. It is also alleged that neighbors complained. Based on record review, S1's spouse is listed on the Facility Personnel Report Summary as a staff. However, Licensee and other staff interviewed denied V1 was employed at the facility as a caregiver. According to interviews conducted by DSS Investigations Branch (IB) Investigator Christine Ferris, between July 2021 and November 2021 staff (S7) observed on several occasions, staff (S1) and their spouse whom frequently visited S1 at the facility, smoking marijuana and methamphetamines in the garage. Staff (S7) reported the observations to lead caregiver staff (S2), who has worked at the facility since 2016, but did not report drug use to Administrator/Licensee because they assumed the lead caregiver informed Administrator. Additionally, staff (S7) stated "I thought they were going to stop." IB interviewed a total of seven (7) staff, of which only one (1) staff confirmed the allegation. Lead caregiver (S2) stated that staff (S1’s) spouse (V1) visited the facility approximately “ten times” a month, and did see V1 smoke marijuana outside the facility due to “back issues”, but did not smoke near the facility, in the garage, or around residents. All staff denied that neighbors complained about former staff (S1). Staff (S2) acknowledged smoking cigarettes with V1 in the front yard courtyard area, but stated that the smoke did not enter the home. Administrator/Licensee denied knowledge of drug use in the premises. A total of three (3) residents were interviewed, of which all reported no knowledge or observation of drug use by former staff (S1) or their spouse. Multiple attempts to locate staff (S1) and their spouse (V1) using information by witnesses, employment information, and departmental resources were unsuccessful. There is insufficient evidence to substantiate conduct inimical against staff (S1). Allegation: Staff are intoxicated while providing care to residents in care. It is alleged that staff (S1) and their spouse (V1) got drunk off of alcohol (vodka and brandy) in the garage. According to staff interviews, caregiver staff (S7) confronted staff (S1) and told them to stop, but S1 "did not listen." It is also alleged that lead caregiver staff (S2) was aware of the situation, but never reported it to Administrator and also did not report neighbor complaints. Staff (S2) was interviewed and denied the allegation. Only one (1) out of seven (7) staff confirmed the allegation. All residents interviewed denied seeing former staff (S1) and their spouse intoxicated while providing care to the residents. Multiple attempts to locate staff (S1) and their spouse (V1) using information by witnesses, employment information, and departmental resources were unsuccessful. There is insufficient evidence to substantiate conduct inimical against staff (S1). Although the allegations may have happened or are valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur, therefore the allegations are Unsubstantiated. Exit interview conducted with staff Virginia Villacorte. A copy of the report was issued.the state’s words, verbatim · CDSS document, Dec 11, 2023 · control 28-AS-20220614122804

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Galarza conducted an unannounced Required- 1 year visit using the full Care Compliance and Regulatory Enforcement (CARE) Tools. The purpose of the visit was explained to caregiver staff Virginia Villacorte. Administrator Helen Torres arrived shortly after. There are currently 4 elderly residents 60 years and older residing in the facility. Twelve 12 (CARE) tool domains were utilized during the inspection. Infection Control: Infection control practices and Personal Protective Equipment (PPEs) were observed Staff are no longer wearing masks or screening visitors. A visitor sign-in station is still in place. The facility has submitted a COVID-19 Mitigation Plan and Infection Control Plan. Operational Requirements: A current Plan of Operation was reviewed. The facility has a Dementia Waiver in place. A Hospice Waiver for 6 is approved. Facility has a fire clearance for 6 non-ambulatory adults 60 and over. Liability Insurance in the amount of at least ($1,000,000) per occurrence and ($3,000,000) in total annual aggregate is in place and expires 6/2/2024. A surety bond is not applicable. Facility does not handle resident's money. ***Narrative continues next page.**** Physical Plant/Environment Safety: The facility is a single story home located in a residential neighborhood that is licensed for six (6) non- ambulatory residents. The facility consists of (3) resident bedrooms, (1) staff room, (2) bathrooms, living room, dining room, kitchen, and attached garage. The front and backyard are well maintained and there are no pools or large bodies of water. There is a shaded seating area for the residents located in the backyard. Exit doors are free of any obstruction. Kitchen drawers containing knives/sharp objects were unlocked. Citation was issued. The facility has one (1) fully charged fire extinguisher, fire pull alarm, and fire sprinklers. Water temperature readings did not measure within the required 105 - 120 degrees Fahrenheit. Water temperature ranged between 119.3 DF - 126.7 DF. Citation was issued. Staffing: A total of 5 caregiver staff provide care and supervision to the clients. Personnel Records/Staff Training: Administrator certificates expires 4/23/2024. Personnel files/training were reviewed. Proof of staff training, health clearance, criminal background clearance and 1st Aid/CPR training was observed in staff files. Resident Records/Incident Reports: A total of four (4) resident files were reviewed. Files contained admission agreements, Physician's Reports, Appraisals, TB clearance, COVID-19 vaccine cards, Functional Capability Assessment, and emergency information. RCFE complaint poster and Personal rights were observed posted. Planned Activities: Sufficient space to accommodate both indoor and outdoor activities was observed. Minimal activities are in place and the facility does not have a Resident Council. Food Service: Sufficient food supply is stored in the kitchen and pantry areas consisting of: 2-day perishables, 7-day non-perishables, and emergency food supplies. Physician orders for modified diets are in place. Sanitation practices and kitchen cleanliness was observed. Incident Medical and Dental: Four (4) centrally stored resident medications/30-day supply of medications were reviewed. Medication errors were observed. In addition, unlocked resident and staff medications were observed in a kitchen cabinet. Citation was issued. Medical and dental transportation is provided by family members and 3rd party transportation services. Disaster Preparedness: Emergency and Disaster Plan LIC 610D was posted, but the revised required form has not been developed. The last emergency disaster drill was conducted on 10/5/2023. Residents with Special Health Needs: No residents are receiving home health services. One (1) resident is enrolled in palliative care. No postural support physician orders are on file. Full bed rails for mobility assistance were observed in resident beds, but residents are not enrolled in hospice. Citation was issued. Individual Service Plans and Appraisals were not observed in resident files. No residents have prohibited health conditions. Per California Code of Regulations, Title 22, deficiencies were cited. Exit interview was conducted with Administrator Helen Torres. A copy of the report and appeal rights were issued.the state’s words, verbatim · CDSS document, Nov 30, 2023