Gables Care for Elderly

Type of visit: Case Management - Annual Continuation

Licensing Program Analysts (LPA) B. Miranda conducted an unannounced visit today for the facility’s annual inspection. LPA introduced themselves and was allowed entrance into the facility. LPA met with Christina Marsy Administrator. Facility is licensed for 6 residents and has a current census of 5. There are 2 residents on hospice and 1 with home health care. Water temperature was checked in the kitchen which read at 110.6 degrees Fahrenheit. Fire Extinguisher was serviced November 3, 2025 and is within the safety regulation period. Smoke and carbon monoxide detectors were tested and in working order. Christina Marsy’s Administrator Certification expires October 25, 2026. Staff files were reviewed, are complete, and current. Resident files were reviewed, complete, and current. Facility provided a log for disaster drills that are conducted quarterly. First aid kit on site. LPA observed cleaning supplies to be accessible inside kitchen cabinet next to the trash can and in R1’s bathroom. There is a locked storage for medications. Sample of medications was reviewed with no discrepancies. LPA inspected the interior and the exterior of the facility including the common living spaces, resident bedrooms, bathrooms, medication storage, kitchen, garage, and outdoor areas. Bedrooms were clean, properly furnished, with adequate lighting, and in good repair. Food supply is adequate for 2-day perishable and 7-day nonperishable. Deficiencies observed were cited during today's inspection per California Code of Regulations, Title 22. LPA is requesting 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 September 4, 2026. Exit interview conducted and a copy of this report LIC809, LIC809D, and appeal rights were provided to Christina Marsy Administrator.the state’s words, verbatim · CDSS document, Aug 28, 2026

From the deficiency page — Deficiency type: Type A · Section cited: CCR 87309(a) · Plan of correction due date: Aug 31, 2026

87309 Storage Space and Access (a) Except as specified in subsection (b), the licensee shall ensure that disinfectants, cleaning solutions, poisonous substances, knives, matches, tools, sharp objects, and other similar items which could pose a danger to residents are in locked storage and are not left unattended if outside the locked storage. Based on observation, the facility did not comply with the regulation listed above due to cleaning products being accessible in kitchen cabinet and R1's bathroom, which poses a potential health and safety risk to residents in care.the state’s words, verbatim · CDSS document, Aug 28, 2026

Plan of correction: Administrator will having cleaning items removed and verification will be sent to the Dept by POC due date.

Allegation investigated: Licensee did not comply with change of ownership requirements Licensee did not maintain operational control of the facility

On 3/10/2026, Licensing Program Manager (LPM) S. Pidgirny and Licensing Program Analyst (LPA) M. Medina conducted an office meeting to deliver findings for this complaint. LPM and LPA met with Licensee, Valerie Civelli and Administrator, Christina Marsy. During the investigation, LPA conducted interviews, gathered information and toured facility. Based on information gathered, Licensee Valerie Civelli transferred the facility or facility property, operations, operational controls and financial obligations to prospective buyer as a part of agreement on/or after March 21, 2025. Licensee entered into a formal written agreement on March 25, 2025, then entered into a formal written contract on July 18, 2025. The facility was not licensed by Department until July 29, 2025. The preponderance of evidence standard has been met; therefore, the above allegations are found to be SUBSTANTIATED. Per California Code of Regulations, Title 22, Division 6, Chapter 8, deficiencies are being cited on the attached 9099-D. Exit interview conducted and a copy of report and appeal rights will be provided for facility records. Substantiatedthe state’s words, verbatim · CDSS document, Mar 10, 2026 · control 24-AS-20251118100418

From the deficiency page — Deficiency type: Type A · Section cited: CCR 87109(b) · Plan of correction due date: Mar 11, 2026

(b) Except as provided in subdivision (e), the property and business shall not be transferred until the buyer qualifies for a license or provisional license within the appropriate provisions of this chapter. **This was not met as evidenced by Licensee entered into a formal written agreement on March 25, 2025, then entered into a formal written contract on July 18, 2025. The facility was not licensed by Department until July 29, 2025.the state’s words, verbatim · CDSS document, Mar 10, 2026

Plan of correction: Licensee to provide written statement to Department acknowledging that regulation has been read and submit to by plan of correction due date.

From the deficiency page — Deficiency type: Type A · Section cited: CCR 87205(a) · Plan of correction due date: Mar 11, 2026

(a) The licensee, whether an individual or other entity, shall exercise general supervision over the affairs of the licensed facility and establish policies concerning its operation in conformance with these regulations and the welfare of the individuals it serves. **This was not met as evidenced by Licensee transferred operational control to 3rd party including but not limited to payroll, facility utility bills, expenses of facility.the state’s words, verbatim · CDSS document, Mar 10, 2026

Plan of correction: Licensee to provide written statement to Department acknowledging that regulation has been read and submit to by plan of correction due date.

Type of visit: Office

On 3/10/2026, an informal office meeting was conducted at Fresno Regional Office to obtain information regarding complaints, operations, operational control, and Title 22 regulations. In attendance from Fresno Regional Office: Sergiy Pidgirny, Licensing Program Manager Alexandria Walton, Licensing Program Manager Shawna Doucette, Licensing Program Manager Melinda Medina, Licensing Program Analyst Licensee provided documentation during meeting. No deficiencies cited. A copy of report was provided for facility records.the state’s words, verbatim · CDSS document, Mar 10, 2026

Type of visit: Case Management - Health Checks

On 2/24/2026, Licensing Program Analyst (LPA) M. Medina conducted an unannounced Case Management for health and safety of residents in care. LPA conducted inspection with Administrator, Christina Marsy. Currently, there are 4 residents in care, of those 3 are currently receiving hospice services. LPA observed facility to be clean and a comfortable temperature during visit. Facility has a 2-day supply of perishable food and a 7-day supply of non-perishable food. The following documents were provided to LPA during facility visit by Administrator: LIC 500 LIC 9020 Exit interview was conducted and a copy of this report was provided to Administrator for facility records. No deficiencies cited during visit.the state’s words, verbatim · CDSS document, Feb 24, 2026

Type of visit: Case Management - Other

Licensing Program Analysts (LPA) B. Miranda conducted an unannounced visit today to conduct a case management visit. LPA introduced themselves and was allowed entrance into the facility. LPA met with Administrator Christina Marsy. The Dept received an incident report indicating R1 was moved from a previous facility owned by the same owner to this current facility. LPA asked if notice was given to R1's family was notified and administrator stated yes, but she would have to call the owner to get a copy. LPA asked for R1's current care plan. Facility does not have a current hospice care plan for R1. The care plan currently on file is from 8/29/2024- 11/26/2024. Facility was not able to provide training verification of staff for R1's hospice care plan. Facility did not have a doctor's order to crush medication on file, but was able to obtain an order while LPA was at the facility. The deficiencies observed during today's inspection will be cited per California Code of Regulations, Title 22. Exit interview conducted and a copy of this report LIC809, LIC809D, and appeal rights were provided to Administrator Christina Marsy.the state’s words, verbatim · CDSS document, Jan 26, 2026

From the deficiency page — Deficiency type: Type B · Section cited: CCR 87633(b)(6)(B) · Plan of correction due date: Jan 30, 2026

87633 Hospice Care of Terminally Ill Residents (b) A current and complete hospice care plan shall be maintained in the facility for each hospice resident and include the following: (6) Identification of the training needed, which staff members need this training, and who will provide the training relating to the licensee’s responsibilities for implementation of the hospice care plan. (B) The hospice agency will provide training specific to the current and ongoing needs of the individual resident receiving hospice care and that training must be completed before hospice care to the resident begins. This requirement is not met as evidenced by: Based on observation, interview, and record, facility did not comply with the regulation listed above, which poses a potential health and safety risk to residents in care. Facility did not provide R1's training specific to the current and ongoing needs of the R1 receiving hospice care.the state’s words, verbatim · CDSS document, Jan 26, 2026

Plan of correction: Administrator contacted hospice to have nurse come to the facility and conduct training by POC date.

From the deficiency page — Deficiency type: Type B · Section cited: CCR87633(d) · Plan of correction due date: Jan 30, 2026

87633 Hospice Care of Terminally Ill Residents (d) The licensee shall ensure that the hospice care plan is current, accurately matches the services actually being provided, and that the client’s care needs are being met at all times. This requirement is not met as evidenced by: Based on observation, interview, and record, facility did not comply with the regulation listed above, which poses a potential health and safety risk to residents in care. Facility did not provide R1's current hospice care.the state’s words, verbatim · CDSS document, Jan 26, 2026

Plan of correction: Adminitrator contacted hopice and will be getting a current care plan by POC date.

Type of visit: Post Licensing

Licensing Program Analysts (LPA) B. Miranda conducted an unannounced visit today for the facility’s post inspection. LPA introduced themselves and was allowed entrance into the facility. LPA met with Administrator Christina Marsy. Facility is licensed for 6 residents and has a current census of 4. There is currently 1 residents on hospice. Water temperature was checked in the kitchen which read at 108.1 degrees Fahrenheit and in the common bathroom which read at 110.3 degrees Fahrenheit. Fire Extinguisher was serviced 11/3/2025 and still has current charge. Smoke and carbon monoxide detectors were tested and are in working order. Christina Marsy's Administrator Certificate expires 10/25/2026. Resident files were reviewed, complete, and current. LPA conducted interviews and found staff are performing glucose testing and injections. Toxins and cleaning supplies are locked and inaccessible. There is a locked storage for medications. There is an additional lock added to the exterior front door. LPA inspected the interior and the exterior of the facility including the common living spaces, resident bedrooms, bathrooms, activity rooms, medication storage, kitchen, garage and outdoor areas. Bedrooms were clean, properly furnished, with adequate lighting, and in good repair. Food supply is adequate for 2-day perishable and 7-day nonperishable. Deficiencies observed during today's inspection were cited per California Code of Regulations, Title 22. Exit interview conducted and a copy of this report LIC809, LIC809D, and appeal rights were provided to Administrator Christina Marsy.the state’s words, verbatim · CDSS document, Jan 26, 2026

Type of visit: Case Management - Health Checks

On 12/05/2025 Licensing Program Analyst (LPA) M. Medina conducted an unannounced Case Management for health and safety of residents in care. LPA conducted visit with Administrator, Christina Marsy. Currently, there are 3 residents in care, there are no residents receiving hospice services. LPA observed facility to be clean and a comfortable temperature during visit. Facility has a 2-day supply of perishable food and a 7-day supply of non-perishable food. The following documents were provided to LPA during facility visit by Administrator: LIC 500 LIC 9020 Liability Insurance Copy of message sent to families on 11/17/2025 Per previous telephone conversation with Valerie Civelli, a spreadsheet will be provided via e-mail by close of business on 12/05/2025 which documents all utilities and account holder for the facility. Exit interview was conducted and a copy of this report was provided to Administrator for facility records. No deficiencies cited during visit.the state’s words, verbatim · CDSS document, Dec 5, 2025

Type of visit: Office

On 11/25/2025, a office meeting was conducted at Fresno Regional Office to obtain information regarding operations, operational control, and licensure. In attendance from Fresno Regional Office: Brenda White, Regional Manager Sergiy Pidgirny, Licensing Program Manager Melinda Medina, Licensing Program Analyst Licensee provided documentation during meeting. No deficiencies cited. A copy of report was provided for facility records.the state’s words, verbatim · CDSS document, Nov 25, 2025

Type of visit: Prelicensing

Licensing Program Analyst (LPA) J. Leffall conducted a Pre-licensing Inspection on this 7/2/25. LPA met with Administrators Christina Marsy and Antionette Sillas and was granted entry. A tour of the facility was conducted together. This is a new Community that is a change in ownership and 3 residents were present during inspection. The facility was observed to be at a comfortable temperature, clean, and in good repair. No passageway obstructions or fire hazards were observed inside or outside. Common areas were properly furnished and well-lit throughout. The dining room is equipped with a table and chairs, living room is equipped with adequate sofas and chairs for residents, adequate outside space for rest and recreational. Seating and shaded area provided by large patio umbrella. Gate is self-closing and self-latching. Perishable and non-perishable food supply appeared adequate. Knives were observed locked in kitchen cabinet with medications. First Aide kit observed to have all of the required items. Cleaning and Chemical supplies are kept locked in the laundry room cabinet. Residents' bedrooms were observed to be adequately furnished with bed, dresser, folding chair and adequate lighting. Mattresses and linen were in good condition. Extra linen and towels are available. Carbon monoxide and smoke alarm detectors installed and operational. 3 bathrooms observed with grab bars installed in shower. Bathroom temperature ranged from 114.2 to 115.8 degrees F in all 3 bathrooms. Toilet equipped with grab bars. Freezer was observed with at temperature of -4 degrees F. Refrigerator was observed with a temperature of 37 degrees F. Non-skid mats in place, hand soap and paper towels available for use. Trash cans with tight fitting lids are in place. Fire extinguisher was serviced and fully charged with a purchase date of 9/18/24. Complaint poster posted, resident council info posted, residents' rights posted; emergency disaster plan posted. First aide kit observed to have all of the required items. Component III was completed by Licensee. Exit interview was conducted. Pre-licensing requirements were met. An exit interview was conducted with Licensee. Report signed on-site by Administrator and printed copy provided.the state’s words, verbatim · CDSS document, Jul 2, 2025

Type of visit: Office

Component II completion: Successful Facility Type: RCFE Application Type: CHOW Capacity: 6 Census : 2 Method: Telephone call with CAB COMP II Participants: MARSY, CHRISTINA (ADMINISTRATOR) & DEGMETICH, JOSHUA(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 30, 2025