Green Gables Care Home II

Type of visit: Required - 1 Year

On 10/1/25 Licensing Program Analyst (LPA) J. Leffall arrived unannounced to conduct an Annual Inspection. LPA introduced self, stated the purpose of the visit, and was greeted by Staff (S1) Marcos Tioanen. LPAs was granted entry. All 5 residents were present during inspection. Designee Mario Ramos (D1) was called and arrived shortly after LPA’s arrival. LPA toured facility with D1. The facility was observed to be at a comfortable temperature, clean, in good repair, and no passageway obstructions or fire hazards were observed inside. An adequate supply of perishable and non-perishable food was observed. Freezer temperature was maintained at 0 degrees F and refrigerator temperature was maintained at 35 degrees F. LPA observed 1 medication bottle with tablets unlocked in kitchen drawer. Fire extinguisher was observed with a purchase date of: 10/14/24. Fire drill last completed on 9/9/25. Washer and dryer observed operational during visit. Carbon monoxide and smoke detectors were tested and observed to be operational. Residents' bedrooms were toured and observed to be adequately furnished with bed, dresser, and adequate lighting. All bathrooms are toured and observed to be operational. Hot water temperature was tested at a temperature of 113.1 degrees F in bathroom 1, and 111.7 degrees F in bathroom 2. Non-skid mat and grab bars observed in bathrooms. Outside of facility toured. Side gate was self-closing and self-latching. Outside was observed with adequate outdoor seatings available for residents. All medications were checked and observed kept locked in the hall closet. Residents’ MARS was reviewed. 1 medication tablet was short one day of punch out. Medication should have been punched out for 16 days but was only punched out for 15 days. First aide kit observed with all of the required items. All residents and a samples of staff files reviewed to have all the required documents. Deficiencies are being cited on the attached 809D in accordance with California Code of Regulations, Title 22, Division 6. Exit Interview conducted. The following documents requested to be updated and submitted to Fresno CCL by 10/16/25: Lic 308, Lic 500, Lic 610E, Current Liability Insurance and current Administrator’s certificate. A copy of this report was provided to Designee, whose signature on this form confirms receipt of these report.the state’s words, verbatim · CDSS document, Oct 2, 2025

Type of visit: Required - 1 Year

On 10/31/24 Licensing Program Analyst (LPA) J. Leffall arrived unannounced to conduct an Annual Inspection. LPA introduced self, stated the purpose of the visit, and was greeted by Staff (S1) Marcos Tioanen. LPAs was granted entry. All 5 residents were present during inspection. Designee Mario Ramos (D1) was called and arrived shortly after LPA’s arrival. LPA toured facility with D1. The facility was observed to be at a comfortable temperature, clean, in good repair, and no passageway obstructions or fire hazards were observed inside. An adequate supply of perishable and non-perishable food was observed. Freezer temperature was maintained at -13 degrees F and refrigerator temperature was maintained at 40 degrees F. Fire extinguisher was observed with a purchase date of: 10/14/24. Fire drill last completed on 9/5/24. Washer and dryer observed operational during visit. Carbon monoxide and smoke detectors were tested and observed to be operational. Residents' bedrooms were toured and observed to be adequately furnished with bed, dresser, and adequate lighting. All bathrooms are toured and observed to be operational. Hot water temperature was tested at a temperature of 116.4 in bathroom 1, 115.5 in bathroom 2 and 116.2 degrees F. in bathroom 3. Non-skid mat and grab bars observed in bathrooms. Outside of facility toured. Side gate was self-closing and self-latching. Outside was observed with adequate outdoor seatings available for residents. Samples of medications was checked and observed kept locked in cabinet. Residents’ MARS was reviewed. First aide kit observed with all of the required items. All residents files and a samples of staff files reviewed to have all the required documents. No deficiencies issued during this inspection. Exit Interview conducted. The following documents requested to be updated and submitted to Fresno CCL by 11/14/24: Lic 308, Lic 500, Lic 610E, Current Liability Insurance and current Administrator’s certificate. A copy of this report was provided to Designee, whose signature on this form confirms receipt of this report.the state’s words, verbatim · CDSS document, Oct 31, 2024

Type of visit: Required - 1 Year

On 11/16/2023, Licensing Program Analyst (LPA) M. Medina conducted an unannounced Annual Required inspection. LPA introduced self, stated purpose of visit and allowed entrance by direct care staff. Administrator and Licensee contacted by telephone and unavailable to conduct today's inspection. Mario Dan Ramos, Supervisor arrived a short time later to meet with LPA Medina. Facility tour conducted with caregiver. Facility tour began in resident bedrooms. Rooms observed to be sufficiently furnished with adequate lighting. Residents bathrooms observed to be clean and in good repair. Bath/tub are have non-skid mats and grab bars. Hot water tested in both bathrooms with a water temperature of 118 degrees F. Dining room and living room have adequate seating and lighting for all residents in care. Tour of kitchen conducted. LPA observed a two day supply of perishable food and a seven day supply of nonperishable food available. All foods and leftovers stored in the refrigerator and/or freezer observed to be properly stored and labeled. All medications observed to be locked and secured in kitchen cabinet. Medication observed to have all original labels and to be administered as prescribed. All sharps are locked and secured and inaccessible to residents. All cleaning supplies are locked and secured in cabinet in laundry room. Outside of facility toured. Seating is available for residents, small shed in backyard is locked, secured and inaccessible to residents. All exits observed to be free of obstruction. Staff and resident files reviewed. No deficiencies observed. Exit interview was conducted, facility report signed and a copy provided for facility records.the state’s words, verbatim · CDSS document, Nov 16, 2023