Happy Home Villa

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Martha Arroyo arrived at the facility unannounced to conduct the required annual visit today at 09:05 a.m. Upon arrival, there were three (3) staff and four (4) residents present. The LPA was greeted by staff who then contacted the Administrator telephonically. The Administrator, Oskar Arcenas arrived at approximately 10:05 a.m. and the reason for the visit was explained. Entrance interview conducted. Infection Control / Emergency Disaster Planning: The LPA reviewed the facility's infection control plan at approximately 09:15 a.m. The facility’s policies and procedures as they pertain to infection control are adequate. The LPA also reviewed the facility's emergency disaster plan, which was observed to be complete and recently reviewed/updated. Emergency disaster drills conducted quarterly as per regulation; last drill conducted on 01/04/2026. Beginning at 10:15 a.m., the LPA along with the Administrator 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. The following was observed: Kitchen: The LPA inspected the kitchen/food service area at approximately 10:20 a.m. Knives and sharps were observed in a kitchen drawer locked and inaccessible. Cleaning supplies were observed locked and inaccessible under the kitchen sink. Kitchen appliances were in operable condition. The facility has a sufficient supply of perishable and non-perishable food. Refrigerator and food pantry were checked for proper labels and expiration dates. Report Continued on LIC 9099C... Report Continued from LIC 9099... Common Areas: At the time of the visit, furniture in the common areas was observed to be in good condition. The facility maintained a comfortable temperature. The LPA observed a fire extinguisher to be fully charged with a date of 06/13/2025. Required postings were observed throughout the common space. There is a working telephone on premises. Camera observed in the common areas. The LPA observed a fireplace in the living room adequately screened at the time of the visit. Activities were observed in the living room. Auditory alarms were observed functioning at the time of the visit. At 10:15 a.m., the smoke detector, carbon monoxide, and fire door were tested and operational at the time of the visit. No hazards/obstructions observed inside or out. Restrooms: There are two (2) restrooms for residents’ use. Bathrooms were clean and sanitary and in operating condition with grab bars and non-skid surfaces. The bathrooms were sufficiently stocked with supplies and paper towels. Starting at 10:11 a.m., the hot water temperature was measured in bathrooms, and they measured within the required range of 105 – 120 degrees Fahrenheit. Personal hygiene items were observed locked and inaccessible to residents at the time of the visit. Bedrooms: There are four (4) bedrooms for residents’ use. Bedrooms are designated as private / single bedrooms. Bedrooms were observed to be furnished appropriately and had sufficient lighting. Additional clean linens and towels were observed in a closet by the hallway. Staff bedroom was observed locked and inaccessible at the time of the visit. Garage/Laundry Room: The garage was inaccessible to residents in care at the time of the visit. There is a second refrigerator with additional food for both residents and staff. The LPA observed an adequate amount of emergency food and water. A sufficient supply of Personal Protection Equipment (PPE) was observed. Washer and dryer are kept locked at all times. Cleaning supplies and detergents were observed locked and inaccessible at the time of the visit. Report Continued on LIC 9099C... Report Continued from LIC 9099C... Outdoors: The backyard has a covered patio area with adequate furniture for residents’ use. Emergency passageway was observed to be clear of any obstructions. There is one (1) side gate with latching mechanisms. No bodies of water noted at the time of the visit. Records: Record review began at approximately 10:25 a.m. Four (4) resident files were reviewed for, but not limited to, the following: signed admission agreements, current medical assessments with TB results, consent for treatment form, and current needs and services plan/IPP. All files were in order. Four (4) personnel files including the current Administrator’s file were reviewed for, but not limited to: personnel records, health assessments with negative TB test results, criminal record clearances, first aid/CPR training, and the appropriate yearly training. All personnel files were complete. The Administrator’s Certificate is valid until 02/20/2028. During today’s visit, the LPA interviewed one staff member and one resident. No concerns were reported. Medications: Medications review began at approximately 11:40 a.m. Medications are centrally stored and kept in a locked closet by the main hallway. All medications including PRNs were labeled, stored, and locked inaccessible to residents in care. Medications are properly documented on the centrally stored medication and destruction record. Medications appear to be administered as prescribed at the time of the visit. No citations issued. Exit interview conducted. A copy of the report was issued.the state’s words, verbatim · CDSS document, Feb 3, 2026

Allegation investigated: Staff does not ensure facility is free of pests.

Licensing Program Analyst (LPA), Martha Arroyo conducted an initial complaint investigation visit for the above allegation. Upon arrival, there were three (3) staff and three (3) residents present. The LPA was greeted by staff who then contacted the Administrator via telephone. The Administrator, Oskar Arcenas arrived at aproximately 10:25 a.m. and at this time the reason for the visit was explained. Entrance interview. During today's visit, between 09:46 a.m. and 11:30 a.m., the LPA conducted a plant tour, conducted a resident file review, interviewed three staff and two residents and attempted to interview another resident, and obtained copies of pertinent documents relevant to the investigation. Report Continued on LIC 9099C... Unsubstantiated Report Continued from LIC 9099... It was alleged that staff does not ensure facility is free of pests. It was reported that multiple cockroaches have been observed inside the facility. During the facility walkthrough, the LPA observed resident bedrooms, the kitchen, and common areas, including the dining and living rooms. The LPA also reviewed resident binders while conducting a file review. At this time, no cockroaches or other pests were observed inside the facility. Record review and interviews revealed that the facility has contracted Dewey Pest Control to manage all pest control needs. The company recently conducted a treatment to ensure the facility remains pest-free. Staff interviews confirmed that a concern regarding pests had been reported to facility staff, who addressed the issue promptly by contracting a professional pest control service. Staff also mentioned that bug spray is used as a preventative measure to deter future pest activity. Resident interviews revealed that no bugs have been observed. Furthermore, two out of two residents reported no concerns regarding cockroaches or any other pests within the facility. Although the allegation may have happened or is valid, information obtained through record review and interviews, the facility immediately addressed and is continuously making an effort to keep the facility free from pests. Therefore, the allegation of “staff does not ensure facility is free of pests” is deemed Unsubstantiated at this time. Exit interview conducted. A copy of the report was issued.the state’s words, verbatim · CDSS document, Aug 22, 2025 · control 29-AS-20250818145510

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Martha Arroyo arrived at the facility unannounced to conduct a required annual visit today. Upon arrival, there was one staff present. Resident was out in the community at the time of the inspection. The staff contacted the Administrator via telephone and explained the reason for the visit. The Administrator, Oskar Arcenas arrived at 10:42am. Entrance interview conducted. Starting at 10:45am, the LPA along with the Administrator toured the physical plant areas inside and outside to ensure there are no health and safety hazards and that facility is in compliance with Title 22 Regulations. The following was observed: KITCHEN: The LPA observed the kitchen / food pantry area at 10:50am. Kitchen area was clean, and appliances appeared to be in operable condition. The facility has a sufficient supply of non-perishable and perishable food; properly stored. Refrigerator and dry food pantry were checked for proper labels and expiration dates. The LPA observed knives and sharps in a locked drawer. At 10:49am, the kitchen sink was measured for hot water temperature, and it measured 125.8 degrees Fahrenheit. BEDROOMS: There are four (4) bedrooms for resident use, and all are designated for private / single occupancy. The LPA observed all resident bedrooms to be properly furnished and with sufficient lighting. Additional clean linens and towels for resident use were observed in the hallway closet. Staff room observed on premises. Report Continued on LIC 809C... Report Continued from LIC 809... BATHROOMS: There are two (2) bathrooms for resident use. Main bathroom is located in the hallway and second bathroom is located inside bedroom #2. Bathrooms were observed to be equipped with nonskid surfaces and grab bars. The LPA observed bathrooms to be properly supplied and had functional fixtures. Starting at 10:54am., the water temperature was measured in both bathrooms, and they measured within the required range of 105 and 120 degrees Fahrenheit. COMMON AREAS: The LPA observed the living room and dining room area to be furnished appropriately and all furniture was observed to be in good condition at the time of the visit. The facility maintained a comfortable temperature. The LPA observed required postings throughout the common space. Activities for residents were observed in the living room. There is a working telephone on premises. Fireplace was observed adequately covered. At 10:58am, smoke detector(s) and carbon monoxide detector were tested and were operational at the time of the visit. No obstructions or hazards were observed inside or out. The LPA observed all doors to have functioning auditory alarms when opened at the time of the visit. BACKYARD / OUTDOOR: There is a shaded area in the backyard with appropriate furniture for resident use. The exterior passageways were clean and clear of any obstructions in case of an emergency. The LPA observed one (1) gate that self-latched. No bodies of water noted at the time of the visit. GARAGE: The garage is attached to the house and is locked at all times. The laundry room is kept locked and inaccessible at all times. Detergents, disinfectants, and cleaning supplies are stored and inaccessible. Facility has an adequate amount of emergency food and water. Report Continued on LIC 809C... Report Continued from LIC 809C... RECORD REVIEW: The LPA reviewed one Resident Record and three Personnel Records starting at 11:01am. Resident file was reviewed for, but not limited to, the following: signed admission agreements, current medical assessments with TB results, consent for treatment form, and current needs and services plan. Resident file was complete. Personnel files were reviewed for, but not limited to: personnel records, health assessments, criminal record clearances, first aid/CPR certifications, and yearly training. All records were in order. Administrator’s Certificate is valid until 02/20/2026. During today’s visit, the LPA conducted an interview with one staff. No concerns were noted. INFECTION CONTROL/EMERGENCY DISASTER PLANNING: 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. Multiple fire extinguishers were observed to be fully charged with a date of 06/15/2024. Emergency disaster drills are conducted quarterly, last drill was conducted on 11/01/2024. MEDICATION REVIEW: The LPA conducted a medication review at approximately 11:55am. Medications are centrally stored in a locked closet by the main hallway. All medications including PRNs were labeled, stored, and locked inaccessible to residents in care. The LPA observed PRN authorization letter on file. Medications appeared to be given as prescribed at the time of the visit. No citations issued. Exit interview conducted. Report was reviewed and a copy was provided.the state’s words, verbatim · CDSS document, Jan 28, 2025

Type of visit: Prelicensing

Licensing Program Analysts (LPAs), Martha Arroyo Valeria Conway conducted a pre-licensing visit to this property at 9:00 a.m. on 01/19/2024 and met with Applicant Representative Julie Ann Arcenas as this is a change of ownership application from Bernadette Home Care III #567609985 to Happy Home Villa #565850405. The applicant has obtained fire clearance for a total capacity of six (6) non-ambulatory residents in bedrooms #1 - #4. The facility has a dementia program in place. LPAs inspected facility for Fire Safety, Personal Accommodations and Services, and Food Service. At 9:26 a.m., all hard-wired smoke alarms and carbon monoxide detectors were tested and function properly. LPAs observed two (2) fire extinguisher to be new and fully charged on 06/15/2023. There are two (2) single occupancy bedrooms and two (2) double occupancy bedrooms for resident use and one (1) staff room. Each bedroom is equipped with clean mattresses, pillows, and bedding. There is a closet in the hallway with a sufficient supply of linens, including blankets, bath towels and wash cloths. Bedrooms have sufficient lighting. The facility has two (2) bathrooms for resident use. Resident bathrooms contained appropriate non-skid mats and grab bars. Bathrooms have sufficient paper products. Hot water temperature was measured in both bathrooms, and they measured between 105- and 120-degrees Fahrenheit. LPAs observed trash cans with tight fitting lids at the time of the visit. LPAs toured the kitchen area at 9:20 a.m. The facility has at least seven (7) day supply of non-perishable food and two (2) days perishable food. Appliances and all equipment appear to be clean and in good repair. Kitchen knives and sharps were observed in a drawer next to the kitchen sink locked and inaccessible. The kitchen has a sufficient supply of plates, cups, cookware and utensils. (Report Continued on LIC 809C...) (Report Continued from LIC 809..) The living areas and dining areas are clean and properly furnished. All window screens and coverings are in good repair. Enough seating for six (6) residents at the same time in the dining room table. A working telephone is present. There are activity supplies in the living room. Night-lights were present in the main hallway and common areas. All doors have functioning auditory alarms when opened. Facility will have one central entry point designated for universal screening. Alcohol-based hand sanitizer and masks available upon entry. Facility has an adequate 30-day supply of Personal Protection Equipment (PPE). Medications are stored and locked in the hallway closet. Facility records are stored in a file cabinet adjacent to the kitchen. First aid kit was observed to have bandages, thermometer, scissors, tweezers and a current first aid manual. The garage is attached to the house and is locked at all times. The laundry room is kept locked and inaccessible at all times. Detergents, disinfectants, and cleaning supplies are stored and inaccessible. There will be no firearms/ammunition stored on the property. There is a sufficient supply of emergency food and water. The facility has required postings, including emergency exit plan, Licensing Complaint Poster, Resident Personal Rights, Theft and Loss Policy, and Resident Council Rights. The exterior passageways were clean and clear of any obstructions. There is one (1) self-latching gate for emergency use. There are no bodies of water on the premises at the time of the visit. LPAs observed the backyard, which has a covered outdoor area with a table and chairs for resident use. Physical plant is consistent with the submitted facility sketch / floor plan. Comp III conducted with Applicant Representative. 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. Exit interview conducted. The report was reviewed, and a copy was provided.the state’s words, verbatim · CDSS document, Jan 19, 2024