Goldluxury Villa

Type of visit: Required - 1 Year

On 9/16/2026, Licensing Program Analyst (LPA) Mia Lankford conducted an unannounced required annual inspection at the above facility. LPA met caregiver Wivina Eulalio and caregiver called the Licensee Lilibeth Grabowski and explained the reason for the visit and the LPA was granted entry. LPA Lankford toured the facility along with the Licensee Lilibeth, and made observations pertaining to the annual visit. LPA inspected the facility inside and outside there were no obstructions or debris to the indoor or outdoor passageways at the time of this visit. Additionally, there were bodies of water on the premises with a black locked gate around the pool located in the back yard. The facility is comprised of a one story home located at 79105 Arbola Circle LaQuinta, Ca. 92253. Physical Plant: The facility phone number is (760) 469-3934 and it is operable. LPA Lankford observed the four resident’s bedrooms, and each was furnished with required fixtures as per Title 22. LPA Lankford inspected the facility bathrooms, and the hot water temperature tested within regulations, and logged. The bathrooms were clean, and appliances were operating appropriately at the time of this visit. The facility is equipped with operating smoke detectors, carbon monoxide alarms, and (2) fire extinguishers. LPA Lankford observed required postings such as "If you See Something, Say Something,” the "Personal Rights," and the LTCO poster. The cleaning supplies and sharp items were locked and inaccessible to the residents in care presently. There were designated storage spaces in the garage for the residents’ and staff’s files, and this file cabinet was locked and inaccessible to residents in care at the time of this annual visit. Medications: The medications were locked and inaccessible to residents in care. The medications were locked in the kitchen cabinet, by the back sliding door. The medications were stored in their original containers during this visit. Furthermore, the LPA observed the pantry to be clean, neat, and organized. Additionally, the pantry was free of odors and/or clutter. Cont.. Cont... Food Service& furniture: The kitchen was clean and free of any seen pest, clutter, or unsightly debris. The non-perishable and perishable food supply is sufficient per regulations, and there are a variety of food types available for the residents in care at the time of this visit. Dishes and utensils were in sufficient supply and stored properly, and sharp items are locked. The overall facility is clean; the furniture is in good condition and arranged in a manner which provides space for the residents to move safely. The facility heating system and other appliances were operable at present. There were safety lights for night throughout the facility, and the LPA observed these as indicated. Care & Supervision/Administration: Currently there are adequate staff present for the care and supervision of the resident in care. There are two staff available at the time of this annual visit. The floor plans, telephone numbers and personal rights were found posted in the facility. The listed Administrator Lilibeth Grabowski possesses a current administrator’s certificate with an expiration date of 9/20/2027. Records Reviewed and Resident/Staff Files: LPA reviewed staff and resident files. The LPA reviewed the facility's staff schedule, requested and received proof of the annual fees being paid. The staff files reviewed have criminal clearance, updated training, along with current First Aid certification. Resident files reviewed possessed the required paperwork as per Regulations at the present. Including current physical and TB test, along with updated IPP’s. Disaster preparedness: LPA Lankkford reviewed the facility's emergency and disaster plan as well as disaster training binder. LPA observed the last fire drill met the Department standards and was conducted as required per standards. Infection Control: LPA Lankford observed the hand washing stations in the facility restrooms. LPA observed PPE equipment and cleaning supplies to do regular cleaning of the facility. LPA reviewed the facility's infection control plan and found required infection control measures met the Department requirements. An exit interview was conducted. A copy of this report was reviewed and given to the Licensee Lilibeth Grabowski.the state’s words, verbatim · CDSS document, Sep 16, 2026

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA), Armando Perez made an unannounced visit to the facility for the purpose of conducting a required annual inspection. The LPA was granted entry by staff to conduct the inspection and met with administrator, Lilibeth Grabowski. The LPA informed the Administrator of the purpose for the visit. The inspection included the following: LPA toured the facility inside and outside. LPA observed the facility to be clean and in good repair. The facility consists of four (4) resident bedrooms, one (1) staff room, three (3) bathrooms, a kitchen and dinning area, a living room area, a garage and laundry area, and a patio and yard with sufficient seating and space for activities. The home is maintained at a comfortable temperature for the clients. Lighting is sufficient for safety and comfort. Water temperature measured 111.3 degrees F. Laundry facilities and a locked cabinet is present for storing laundry soap. All outdoor and indoor passageways are free of obstruction. Emergency lighting is available. There is a telephone working at this location. The LIC 610, emergency disaster plan is maintained. There are no firearms at this home. LPA observed a pool in the backyard with the required fencing and locked gate. LPA began review of client records. Five (5) records were reviewed. LPA reviewed for identification and emergency information, admission agreement, medical assessment, and TB test results, needs and service plans, placement, functional assessment, centrally stored medication/destruction records, safeguard for personal property/valuables, and personal rights notification. LPA recommended that 4 residents with Dementia have their LIC602 Physicians Report updated due to being assessed longer than 12 months. LPA observed client records to be available and complete. Continued on LIC 809-C. LPA began review of employee records- Three (3) records were reviewed. LPA reviewed employee records for first aid certification, criminal record clearance or an exemption, health screening and TB test results, employee rights and training verification. The current administrator certification is in process and pending for renewal. LPA observed personnel records to be available and complete. LPA observed facility kitchen had the ability to prepare food in clean environment and possessed equipment in good working condition. Food supply meets the requirement of one (1) week supply of nonperishable and two (2) day supply of perishables. Emergency food and water supply is present. There is a locked location for chemicals and sharps in the kitchen. Medications are centrally stored. There is a locked cabinet in the kitchen allocated for medication storage. Centrally stored medication and destruction logs are maintained. Medications reviewed appear to have been dispensed accurately. LPA made observation throughout the inspection process to assess if the facility remains in conformity with the State Fire Marshall regulations. Smoke detectors and carbon monoxide detectors were tested and found to be operational. Fire extinguishers was serviced on 05/09/2025. Emergency drills are conducted quarterly at the facility with the last drill on 09/11/2025 . Based on the information received during this visit today in the areas reviewed, there are no deficiencies that are being cited per Title 22, Division 6 of The California Code of Regulations. This LIC 809 report was reviewed with the facility representative and a copy was provided.the state’s words, verbatim · CDSS document, Sep 19, 2025

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Yolanda Delgado arrived unannounced to conduct an annual inspection. Upon arrival LPA was greeted by facility staff and granted entry. LPA began inspection with introduction, visit purpose and provided the facility caregiver with LPA identification and business card. Resident record review began- Two (2) records were reviewed. LPA reviewed for admission agreement, medical assessment and TB test results, consent forms, identification and emergency information, appraisal needs and service plans, centrally stored medication/destruction records, safeguard for personal property/valuables, and personal rights notification. This facility is meeting documentation requirements. Physical Plant and Safety of Environment/Operational Requirements- LPA toured the facility inside and outside. The home is maintained at a comfortable temperature for the clients. Lighting is sufficient for safety and comfort. Water temperature measured 108.0 degrees F. Laundry facilities and a locked cabinet is present for storing laundry soap and other chemicals. All outdoor and indoor passageways are free of obstruction. A locked area is provided for medications and sharp objects. LPA verified there is a telephone working at this location. Food Service- Food supply meets the requirement of one week supply of nonperishable and 2 day supply of perishables food on hand. A menu is posted, foods are dated to assure safety. Food prep areas are clean and organized. LPA began review of employee records- Two (2) records were reviewed. LPA reviewed employee record for first aid certification, fingerprint clearance, personnel/job application, health screening and TB test results, criminal record statement, employee rights, training verification, some documents missing from file and current administrator certification. CPR and requirements have been met. The facility employs enough staff to maintain cleanliness and meet the needs of the clients in care. Administrator certification is present and current. (Continued on next page) (Continued on from page 1) LPA made observation throughout the inspection process to assess if the facility remains in conformity with the State Fire Marshall regulations. The facility has not exceeded its capacity limitation; however review of records revealed three (3) residents are on hospice and a waiver is approved for two (2) and the structure is changed according to the approved floor plan; During tour the LPA observed there is a staff room located in a portion of the garage which is converted, LPA research revealed in 2016, an LPA documented the licensee must submit a revised facility sketch and approved permit for this alteration. The LPA instructed the licensee to submit this information to licensing by 07/13/2016, Licensee stated she submitted. Smoke detectors and carbon monoxide detectors were tested and found to be operational. Fire extinguishers are tested or replaced annually and were last done so on 02/22/2024. The facility is conducting emergency disaster drills; not quarterly. The last disaster drill was conducted on 06/29/2024. LPA allocated time to prepare this report for delivery. Based on the information received during this visit today, there four (4) deficiencies is being cited per Title 22, Division 6 of The California Code of Regulations. This report was reviewed with and a copy provided to the facility representative. Appeal Rights were also provided at the time of the exit interview.the state’s words, verbatim · CDSS document, Sep 18, 2024