Green Valley Home Care

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Brian Balisi arrived at the facility unannounced to conduct a required annual visit at 9:30am. Upon arrival LPA met with staff and explained the reason for the visit. Licensee Norma Zanders arrived shortly after. At approx. 09:45am, LPA toured the physical plant areas inside and outside to ensure there are no health and safety hazards and facility is in compliance with Title 22 Regulations. Facility is a single-story residence and consists of a total of five (5) bedrooms and two (2) bathrooms. During physical plant tour LPA observed the required postings throughout the facility. The kitchen appeared to be clean and the appliances and fixtures functional during the time of visit. LPA observed a sufficient amount of perishable and non-perishable food at the facility; properly stored. Sharp objects are stored underneath the sink no cleaning supplies or products were observed stored in this area. There was a staff room next to the kitchen. LPA observed it inaccessible to residents in care and empty at the time of the visit. The resident bedrooms were properly furnished with a bed, night stand, and sufficient lighting for each resident. The bedrooms had appropriate and adequate bedding and linens such as sheets, pillowcases, mattress pads, and blankets. Hallway closest near Room #4 was observed to be to store a sufficient supply of linen. LPA observed bathrooms to be clean, properly supplied and had functional fixtures. LPA observed non-skid mats. The hot water was measured in each bathroom between 105 - 120 degrees Fahrenheit. Laundry area located next to bedroom #3. LPA observed cleaning supplies and detergent inaccessible to residents in care. The common areas were checked for cleanliness and furniture was checked for functionality during time of visit. Medications are stored in a locked cabinet next to the television. LPA observed it to be inaccessible to residents in care. There is a dedicated area for the posting of required documents located in the sunken living room in the office area. There is a fireplace that is non-operable at this time. It is screened and there are no tools. LPA observed appropriate signage regarding infection control posted throughout the facility. The facility maintained a comfortable temperature. Smoke detector(s) and carbon monoxide detectors were operational at the time of the visit. Fire extinguishers were observed fully charged and last serviced July 29, 2025. The exterior passageways were clean and clear of any obstructions. The entire property is not fenced. The back and sides of the house are separated from the front yard by gates at the east and west side passageways. The gates in the backyard has a self-latching mechanism for persons to exit the backyard. LPA observed appropriate furniture for outdoor use. There is an attached garage that is only accessible from the exterior of the home. LPA observed it to be used as a storage area at this time. LPA observed a 30 day supply of PPE, incontinent supplies, extra perishable food stored in the an extra fridge and freezer along with a 30 day emergency food supply. Records review, six (6) client records were reviewed for, but not limited to: appraisals, medical records, admissions agreement, consent forms. Six (6) Personnel records were reviewed for, but not limited to: personnel records, health assessments, criminal record clearances, first aid/CPR training, and the appropriate training. All files were observed to be in order at this time . Medication review, medications for all residents were observed. All medications were stored properly and were appropriately documented on their respective centrally stored medication and destruction record sheets. No deficiencies were observed during medication review. Infection control / Emergency Disaster plan: During today’s visit, the LPA reviewed the facility's infection control practices and the facility's emergency disaster plan. The facility’s policies and procedures as it pertains to infection control are adequate. Emergency disaster drills are to be conducted quarterly; the facility’s last emergency disaster drill was conducted on 01/15/2026. The facility’s emergency disaster plan is up to date and is adequate. Both the infection control plan and the emergency disaster plan are reviewed/updated annually by the facility’s administrator. Smoke detectors and carbon monoxide detectors were tested, all alarms were functional at the time of the visit. During today’s visit LPA obtained a copy of the facility’s LIC 500 and resident roster. Exit interview conducted and copy of the report was issued.the state’s words, verbatim · CDSS document, Jan 23, 2026

Type of visit: Prelicensing

Licensing Program Analyst (LPA) Brian Balisi conducted a pre-licensing visit to the above noted facility. The LPA met with applicants Norma and Vanessa Zanders. This is a change of ownership. The facility is currently operating as Green Valley Home Care #565800073 . A dementia program was included in the plan of operation. A Hospice Waiver has been requested. The current capacity is for six (6) residents, the facility has (5) residents in care. The fire clearance was cleared for (6) non-ambulatory. The facility is one story. At approx. 11:15 am, a physical plant tour was conducted inside and out. The facility has five (5) resident bedrooms. Bedroom # 3 is the only shared room. Bedroom #2 and #4 have direct exits to the outside. There are no fire sprinklers in the facility. There are no fire doors in the facility. All resident rooms are set up with beds, nightstands, lamps, chests of drawers, chairs and closet space. The beds are furnished with box springs, comfortable mattress and clean linen; which includes, a mattress pad, top and bottom linens, pillowcases, blanket (if needed) and a bedspread. Lighting in the rooms appeared adequate. In addition, no bedroom was used as a passageway to another room, bath or toilet. There is a staff room located next to the kitchen. LPA observed it to be empty at this time. For NOC , there will be awake night staff only. All rooms were free of odors. All window screens were clean and maintained in good repair. There are two (2) bathrooms total. The resident bathroom(s) have a shower with non-skid materials. The toilet and shower have grab bars. The hot water temperature was tested in the bathrooms and the kitchen and was found to be within the range of 105*F and 120*F. Resident and staff records are to be stored inaccessible in the office area, located in the living room next to the entrance. Medications are centrally stored and locked in a cabinet adjacent to the kitchen. Continued from 809 The first aid supplies were complete , including a thermometer and a current version of a first aid manual. First aid was observed stored inaccessible in the hallway closet as well. Kitchen knives are stored inaccessible underneath the sink. Stove burners are rendered inaccessible to the residents by removing the knobs when not in use. The supply of dishes, utensils, pots, pans and drinkware is adequate. The freezer was maintained at zero degrees Fahrenheit (0*F) and the refrigerator was maintained at 40*F. The supply of nonperishable food is adequate. There are no pesticides (poisons) or toxins stored in any food storage area or preparation area with utensils. Appliances in the kitchen were clean and all appeared functional at the time of the visit. Trash cans had tight fitting lids. No flies or other vermin were observed. The common areas were appropriately furnished, and the lighting was adequate. There is a television in the living room. Entertainment equipment, games and/or activity supplies was observed on a shelf in the living room. There was sufficient space to accommodate both indoor and outdoor activities. Night lights were maintained in hallways and passageways to non private bathrooms. There is a fireplace in the facility that is secured and properly screened. The facility has emergency exit signs . The facility has a furnace, which is able to heat rooms that residents occupy to a minimum of 68 degrees Fahrenheit; and, they have central air conditioning and are able to cool rooms to a comfortable range, not to exceed 85 degrees Fahrenheit. The facility smoke alarm system is hard-wired. The smoke detector and carbon monoxide detectors were tested and functioned properly during the time of visit. Fire extinguishers were observed fully charged and serviced in July 2024. The laundry area is located next to bedroom #3 and is inaccessible to residents in care. LPA also observed personal hygiene items properly stored in this area as well. Cleaning supplies and toxins were observed stored here and the room will be inaccessible to residents in care. The garage is attached to the home and only accessible from the outside. LPA observed extra facility supplies emergency food supplies, extra non-perishable food, and facility equipment, tools, PPE and décor Continued from 809-C There is a functioning telephone on the premises. The emergency exiting plans/sketch are posted at the entrance, in the main hallway and in the bedrooms. The emergency telephone numbers are posted on the bulletin board near the front entry way. Other required postings are posted on the bulletin board as well. The exterior passageways were clean and clear of any obstructions. There is a covered patio area in the rear of the home. LPA observed appropriate furniture for outdoor use. The outside area was observed to be large enough to conduct outdoor activities. The LPA observed two (2) self-latching gate with clear passageways clear of obstruction. There were no bodies of water noted at the time of the visit. Medications review began at approx 1:00 p.m. The medications are centrally stored. Medications are labeled and checked for expiration dates. No errors found during medication audit. The entire property is not fenced. There is no body of water observed at this time. Component III was conducted in conjunction with the visit. No corrections required on a pre-licensing visit at this time. Exit interview conducted. Report issued and provided to Licensee. This report will be sent to the Centralized Application Bureau (CAB). You will be notified by the CAB Analyst when your license has been approved. You are not allowed to begin operating until you have been notified that your license has been approved by the CAB Analyst. Failure to comply could affect approval of your license.the state’s words, verbatim · CDSS document, Dec 10, 2024

Type of visit: Office

COMP II by CAB successfully completed Method: Phone Call at CAB Applicant/administrator participated in COMP II at CAB telephone call with analyst at CAB. Identification of the applicant and administrator was verified by presenting photo ID via phone. During COMP II, applicant and administrator confirmed the understanding of Title 22. Component II was successfully completed. Applicant and administrator were advised to email/fax signed LIC 809 with copy of photo ID to CAB. During COMP II, CAB analyst confirmed Applicant/Administrator’s understanding of following areas: 1. Facility operation: License type, client/resident populations, and program 2. Staff qualifications and responsibilities 3. Applicant and Administrator qualifications 4. Program policy: Abuse, admission agreement, medication management, reporting incidents to CCL, restricted & prohibited conditions 5. Grievances, Complaints, Community resources 6. Physical plant, food service 7. Application document review and technical assistance: Criminal record clearance, Health screening, Fire clearance, First Aid/CPR certificate, Administrator certificate, Financial verification, Pre-licensing inspection, Compliance history, Control of propertythe state’s words, verbatim · CDSS document, Oct 4, 2024