Green Gables Care Facility

Type of visit: Case Management - Annual Continuation

Licensing Program Analyst (LPA) Daiquiri Boyd made a subsequent visit to the facility to complete the Annual Inspection visit. LPA met with Mario Ramos and provided the final paperwork and issued the deficiencies that LPA was unable to provide at the previous visit.the state’s words, verbatim · CDSS document, Nov 20, 2025

Type of visit: Case Management - Annual Continuation

Licensing Program Analyst (LPA) Daiquiri Boyd returned to the facility to complete an Annual Inspection visit. LPA was greeted by caregiver staff Hazel Flores. Staff called Administrator to come to the facility. The residence was set at 78 degrees F temperature. LPA found obstructions of passageway in bedroom. LPA observed six bedrooms in the residence. Residents' rooms were toured and inspected. Rooms were found to be clean, and furnishing was in good condition. Kitchen toured. LPA did not observe adequate supply of food. Food storage was discussed for perishable fruits. Medication and knives are locked next to the kitchen area. Cleaning supplies were locked in the hallway. Smoke detectors and carbon monoxide were checked and operating. Fire extinguisher was purchased on 10/17/25. Last drill completed on 11/02/2025. There was outdoor seating for the residents. Emergency food supply was observed and found to be adequate. There is no water on site, but staff stated it is at another facility. Staff said they will bring it to keep here. Administrator was advised to update the Emergency Disaster Plan and to post it on the wall. A tour of the exterior of the home found the yard flooded and muddy, with no known cause. During the visit a file review was conducted for six residents and two staff files. Hospice and home health plans were reviewed. Deficiencies were cited. An exit interview was conducted, and a copy of this report was provided to Assistant Administrator whose signature confirms receipt. LPA requested the following updated forms faxed to CCLD by 11/26/25: Designation of Facility Responsibility (LIC308), Administrative Organization (LIC309), Personnel Report (LIC 500), Proof of current Liability Coverage.the state’s words, verbatim · CDSS document, Nov 12, 2025

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Daiquiri Boyd arrived at the facility unannounced to conduct a required annual visit. LPA was granted entry by caregiver staff and explained the purpose of the visit. Assistant Administrator Mario Ramos arrived at the facility soon after to complete this annual visit. The residence was set at 78 degrees F temperature and free of passageway obstructions inside and outside. LPA observed six bedrooms in the residence. Residents' rooms were toured and inspected. Rooms were found to be clean, and furnishing was in good condition. Hot water temperature was measured at 108.9 degrees F. A test of the smoke alarm and carbon monoxide system was conducted and found to be in compliance. During the visit a file review was conducted for six residents files. LPA reviewed hospice and home health plans. A review of medication was completed. An exit interview was conducted, and a copy of this report was provided to Assistant Administrator whose signature confirms receipt. LPA to return at a later date to complete this inspection.the state’s words, verbatim · CDSS document, Nov 6, 2025

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Daiquiri Boyd arrived at the facility unannounced to conduct a required annual visit. LPA was granted entry by caregiver staff and explained the purpose of the visit. Administrator Lorik Sheakalee arrived at the facility sometime after to complete this annual visit. The residence was set at 78 degrees F temperature and free of passageway obstructions inside and outside. LPA observed six bedrooms in the residence. Residents' rooms were toured and inspected. Rooms were found to be clean, and furnishing was in good condition. Hot water temperature was measured at 112.5 degrees F. Kitchen toured, supply of food observed, and food stored properly for perishable and nonperishable. During the kitchen tour, LPA discussed cleaning out of kitchen cabinets of crumbs. Medication and knives are locked next to the kitchen area. Cleaning supplies were locked in the hallway. Smoke detectors and carbon monoxide were checked and operating. Fire extinguisher was purchased on 10/12/23. Last drill completed on 09/05/24. There was outdoor seating for the residents. Emergency food supply was observed and Administrator was advised to update the current supply of emergency food and water. Administrator was advised to update the Emergency Disaster Plan and to post it on the wall. During the visit a file review was conducted for three residents and two staff files. An exit interview was conducted, and a copy of this report was provided to AD1 whose signature confirms receipt. LPA requested the following updated forms faxed to CCLD by 10/09/2024: Designation of Facility Responsibility (LIC308), Administrative Organization (LIC309), Personnel Report (LIC 500), Proof of current Liability Coverage..the state’s words, verbatim · CDSS document, Oct 2, 2024

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) M. Flores and B. Miranda arrived at the facility unannounced to conduct a required annual visit. LPA was granted entry by caregiver staff and explain the purpose of the visit. Administrator Assistant Mario Ramos arrived at the facility minutes after to complete this annual visit. The residence was set at 72 degrees F temperature and free of passageway obstructions inside and outside. LPAs observed six bedrooms in the residence. Residents' rooms were toured and inspected. Rooms were found to be clean, and furnishing was in good condition. Hot water temperature was measured at 115.2 degrees F. Kitchen toured, supply of food observed, and food stored properly for perishable and nonperishable. Medication and knives are locked next to the kitchen area. Cleaning supplies were locked in the hallway. Smoke detectors and carbon monoxide were checked and operating. Fire extinguishers was purchased on 10/12/23. Last drill completed on 09/01/23. There was outdoor seating for the residents. During the visit a file review was conducted for residents and staff files. An exit interview was conducted, and a copy of this report was provided to AD1 whose signature confirms receipt. LPA requested the following updated forms faxed to CCLD by 11/07/23: Designation of Facility Responsibility (LIC308), Administrative Organization (LIC309), Personnel Report (LIC 500), Proof of current Liability Coverage, and Plan of Operation, fire drill training.the state’s words, verbatim · CDSS document, Oct 31, 2023

The state marks this report as 2 pages; the online copy we transcribed has 1. You can request the full file from the county licensing office.