Happy Life Elder Care

Type of visit: Case Management - Annual Continuation

On 08/26/2026 at approximately 2:00PM, Licensing Program Analyst (LPA) Jose Anguiano conducted an unannounced continuation annual visit to complete the required annual inspection initiated on 08/20/2026. LPA met with Licensee/Administrator Antonia Dionisio and explained the purpose of today’s visit. During today’s visit, LPA continued the inspection of the physical plant and reviewed resident and staff records. LPA reviewed all six (6) resident Medication Administration Records (MARs). Medications were reviewed and no discrepancies were observed at the time of visit. LPA reviewed (2) staff records and six (6) resident records with no discrepancies. Upon arrival, LPA observed one (1) staff member providing care and supervision to six (6) elderly residents, several of whom per caregiver require assistance with activities of daily living. LPA observed cleaning chemicals/disinfectants stored in an unlocked kitchen drawer accessible to residents. LPA also observed cockroaches inside kitchen drawers, excessive clutter and numerous boxes stored in the garage, and a metal bed frame, electrical bed equipment, and trash stored in the backyard area. LPA inspected/tested the facility's smoke and carbon monoxide detectors and were operational and in good repair. Deficiencies are being cited pursuant to the California Code of Regulations, Title 22, Division 6, Chapter 8. Refer to the attached (LIC 809-D’s) for additional information and Plans of Correction. An exit interview was conducted with Licensee/Administrator Antonia Dionisio. A copy of this report, LIC 809-D's, and Appeal Rights were provided.the state’s words, verbatim · CDSS document, Aug 26, 2026

From the deficiency page — Deficiency type: Type A · Section cited: CCR 87309(a) · Plan of correction due date: Sep 2, 2026

Storage Space and Access (a)...licensee shall ensure that disinfectants, cleaning solutions, poisonous substances, knives...sharp objects...which could pose a danger to residents are in locked storage and are not left unattended if outside the locked storage. This requirement is not met as evidenced by: Based on observation, the licensee failed to ensure that chemicals were maintained in locked storage and inaccessible to residents in care. During the facility inspection, LPA observed cleaning chemicals/disinfectants stored inside an unlocked drawer that were accessible to residents. This violation poses an immediate health and safety risk to residents in care.the state’s words, verbatim · CDSS document, Aug 26, 2026

Plan of correction: LIcensee agreed to keep cabinets innacessible to residents in care, and send proof to LPA Jose.Anguiano@dss.ca.gov.

From the deficiency page — Deficiency type: Type B · Section cited: CCR87303(a) · Plan of correction due date: Sep 2, 2026

87303 Maintenance and Operation (a) The facility shall be clean, safe, sanitary and in good repair at all times. This requirement is not met as evidenced by: Based on observation, the licensee failed to maintain the facility in a clean, safe, and sanitary condition. LPA observed cockroaches in kitchen drawers, excessive clutter and boxes in the garage, and a metal bed frame, electrical bed equipment, and trash in the backyard. This poses a potential health and safety risk to residents in care.the state’s words, verbatim · CDSS document, Aug 26, 2026

Plan of correction: Licensee/Administrator agreed to remove the clutter and unsafe items, properly clean and organize the affected areas, and ensure the facility is maintained clean, safe, and sanitary. Proof of correction will be submitted to LPA Anguiano by the POC due date: Jose.Anguiano@dss.ca.gov

From the deficiency page — Deficiency type: Type A · Section cited: CCR 87411(a) · Plan of correction due date: Sep 2, 2026

87411 Personnel Requirements - General (a) Facility personnel shall at all times be sufficient in numbers, and competent to provide the services necessary to meet resident needs. This requirement is not met as evidenced by: Based on observation, the licensee failed to ensure sufficient staffing to meet residents’ care and supervision needs. Upon arrival, LPA observed only one staff member supervising six elderly residents, several of whom appeared to require assistance with ADLs, transfers, and incontinence care. This violation poses an immediate health and safety risk to residents in care.the state’s words, verbatim · CDSS document, Aug 26, 2026

Plan of correction: Licensee/Administrator agreed to develop and submit a written staffing plan describing how the facility will ensure sufficient staff are available at all times to meet the care and supervision needs of all residents. The plan shall be submitted to LPA Anguiano at Jose.Anguiano@dss.ca.gov by the POC due date.

Type of visit: Required - 1 Year

On 08/20/26 Licensing Program Analyst (LPA) Jose Anguiano, conducted an unannounced annual required visit. LPA met with licensee/administrator Antonia Dionisio and explained the purpose of today’s visit. The facility is licensed to operate for six (6) elderly residents (1) may be bedridden and (3) non-ambulatory ages 60 and above. The facility is approved for (4) hospice residents. Currently, the facility has (3) residents in hospice care. The facility consists of five (5) bedrooms, (1) staff bedroom, two (2) bathrooms, (1) staff bathroom a one-story home with a one (1) car garage, a living area, a dining area, a kitchen, and an outside seating area. The Department toured the physical plant with Administrator. No bodies of water were observed in the facility. Beds and bedding supplies were in good condition, adequate lighting was provided, storage for resident personal belongings was observed. Bed linens, comforters, and bath towels were adequately stocked at the time of visit. Bathrooms were found to be within Title 22 regulations and were clean and operational. Water temperature was measured at 116 degrees Fahrenheit. The kitchen was inspected and there was sufficient perishable and non-perishable food available maintained properly. New Fire extinguisher was observed in the facility. A land line telephone was in working condition. During the visit, The Department observed the facility's infection control practices. Screening protocols for visitors, staff, and residents, and sanitizing stations in common areas and restrooms. The facility had supply of Personal Protective Equipment (PPE). 2- First Aid Kits at the facility were observed. The facility has current liability insurance on file effective until 03/27/27 policy #0100359573-1. Due to insufficient time to complete the required annual visit, a continuation visit will be necessary. No deficiencies cited in today’s visit. An exit interview was conducted with Administrator Antonia Dionisio.the state’s words, verbatim · CDSS document, Aug 20, 2026

Type of visit: POC

On August 28, 2025, Licensing Program Analyst (LPA) Ernand Dabuet conducted an unannounced Proof of Correction visit at the facility and met with Administrator Antonia Dionsio and explained the purpose of today’s visit is to conduct a plant inspection and health and safety check. The facility was cited with a Type B Section 87411(c)(3)(A-F) Personnel Requirements and 87412(a)(2) Personnel Records were cited on July 28, 2025. 87412(a)(2) correction due on August 19, 2025, and corrected on August 28, 2025. 87411(c)(3)(A-F) correction due on August 19, 2025, and corrected on August 28, 2025. The facility is still now incompliance with the California Code of Regulations Title 22 Division 6. An exit interview was conducted and a Facility Evaluation Report was provided to Antonia Dionsio.the state’s words, verbatim · CDSS document, Aug 28, 2025

Type of visit: Required - 1 Year

On July 28, 2025, Licensing Program Analyst (LPA) Ernand Dabuet conducted an unannounced annual required visit using the CARE Inspection Tool. LPA met with licensee/administrator Antonia Dionisio and explained the purpose of today’s visit. The facility is licensed to operate for six (6) elderly residents (1) may be bedridden and (3) non-ambulatory ages 60 and above. The facility is approved for (4) hospice residents.Currently, the facility has (3) residents in hospice care. The facility consists of five (5) bedrooms, (1) staff bedroom, two (2) bathrooms, (1) staff bathroom a one story home with a one (1) car garage, a living area, a dining area, a kitchen, and an outside seating area. LPA and administrator toured the physical plant. There were no bodies of water or obstructions on the premises. All rooms were inspected. Beds and bedding supplies were in good condition, adequate lighting was provided, storage for resident personal belongings was observed. Bed linens, comforters, and bath towels were adequately stocked at the time of visit. Bathrooms were found to be within Title 22 regulations and were clean and operational. The water temperature measured 112.7 degree F. A comfortable temperature of 77 degree F. was maintained in the facility. LPA observed the facility to be sanitary and appropriately furnished at the time of visit. Storage areas for personal hygiene, cleaning supplies, toxins, and sharps objects were stored and not accessible to residents. The kitchen was inspected and there is sufficient perishable and non-perishable food available maintained properly. Evaluation Report Continues LIC 809-C Fire extinguisher was charged, smoke detectors and carbon monoxide were operable. The last fire drill conducted on 07/04/25. A review of the Medication Administration Record (MAR) was complete and accurate. A landline telephone was in working condition. During the visit, LPA observed the facility's infection control practices. LPA observed screening protocols for visitors, staff, and residents, and sanitizing stations in common areas and restrooms. LPA observed the facility has a 30-day supply of Personal Protective Equipment (PPE). All mandated inspection control posters were posted. LPA observed First Aid Kit was maintained.The facility has current liability insurance on file effective 03/27/25 03/27/26 policy #0100359573-0 . The facility is current on Community Care Licensing annual dues. An audit of residents #1-#6 (R1-R5) service files were complete and staff #1-#5 (S1-S5) personnel files were partially complete. Deficiencies: LPA observed that the centrally stored medications for Resident #1 were not kept in a secure, locked location, making them accessible to the residents in care. Additionally, Staff #1 and Staff #2 did not have their Health Screen records on file. Furthermore, Staff #4 and Staff #5 had not completed the required initial training, and there were no records to confirm this. An exit interview conducted with Antonia Dionisio and a copy of report and appeal rights were provided.the state’s words, verbatim · CDSS document, Jul 28, 2025

Type of visit: Prelicensing

On 07/20/24, Licensing Program Analyst (LPA) Ernand Dabuet conducted announced visit to this home. LPA was greeted by applicant Antonia Dionisio and explained the purpose of today’s pre-licensing inspection visit. An application was submitted to CCLD on 04/02/23 in the initial license application for a Residential Facility for the Elderly, ages 60 years and above. The applicant requested a capacity of six (6) individuals, of which maybe two (2) non-ambulatory, three (3) ambulatory, and one (1) bedridden. Structure: The home consists of five (5) bedrooms, (1) staff bedroom, two (2) bathrooms, (1) staff bathroom a one story home with a one (1) car garage situated in a residential neighborhood. The home includes a living, dining, kitchen, and laundry area. The living room did not include a fireplace. The living area included recliner seating. The kitchen has a refrigerator and stove. The rear exterior is fenced throughout. The passageways, walkways, and steps are free from obstructions. Bedrooms Residents: The facility had five (5) bedrooms for residents. There are two (2) bedrooms for non-ambulatory, three (3) bedrooms for ambulatory residents and one (1) bedroom specific for the bedridden. All rooms include a twin-size bed, one (1) chair, one (1) night stand, and one (1) table lamp. All bedrooms are equipped with a ceiling light. All rooms had a dresser, which complies with the requirement of 8 cubic feet of space. All rooms had closets for ample storage. The room also included wall night lights. Evaluation Report Continues Bedrooms Staff: Bedroom #6 is designated for live-in staff. Bathrooms: The home has two (2) bathrooms. Bathrooms are accessible in all rooms. All bathrooms have a working toilet, washbasin, and shower with grab bars and non-skid mats. Linens & Hygiene Supplies: Beds have the required linen supplies which include, pillowcases, mattress pads, fitted sheets, blankets, and bedspreads. An adequate supply of linen is stored in the hall closet inside the bedrooms. Emergency Phone Numbers, Exit Plan & Menu: Emergency phone numbers. The exit plan and menu are posted and readily available for review throughout the home. There is one (1) fire extinguisher located in the kitchen mounted on the wall. A telephone line is available in the kitchen, living, and dining rooms. Emergency supplies and Personal Protective Equipment supplies are stored in the garage. The applicant as an approved Infection Control Plan on file. Food Service: Dishes, cups, and flatware are stored in the kitchen cabinets, inspected, and in good repair. Knives, cutlery, and other sharp kitchen utensils are stored in a locked kitchen drawer. Food supply is adequately stored in kitchen cabinets and consists of the can goods. The kitchen counters also had small appliances. Smoke Detectors: Smoke and carbon monoxide detectors throughout the interior space. Hardwired smoke detectors in all six (6) bedrooms and hallways. Carbon monoxide is in the living room area. Toxins: All toxins are locked and stored under the kitchen sink cabinet. Evaluation Report Continues Appliances: Stove burners, oven, microwave, washer, and dryer are working. The kitchen counters also had small appliances which includes toaster, air fryer, built-in microwave oven, and coffee maker. There is one (1) refrigerator in the home. The refrigerator measured a temperature of at least 40 degrees Fahrenheit for appropriate food storage. The home with electric fans and heaters. The living area has a cooling/heating split system. Water Temperature: The water temperature is 115.8 degrees F. throughout the kitchen and bathrooms. Medications, First-Aid Kit & Book: A first aid kit is stored in the medication cabinet inspected which has at least the following: thermometer, tweezers, scissors, antiseptic, bandages, gauze, and current first aid manual locked and inaccessible to residents. The resident's medications will be stored in a mental cabinet locked in the dining room area and inaccessible to residents. Resident & Staff Files: The applicant is not handling the cash resources for residents. Records of staff and residents will be stored in a metal cabinet in the dining room area. Reading Material, Games, Equipment & Materials: The facility has board games, books, magazines, and other recreational materials for the resident's use all stored in the living room. Pool/Jacuzzi & Pets: There are no pets, jacuzzi, or pool in the fenced area. Evaluation Report Continues Fire clearance: A Fire Clearance inspection was conducted on 05/15/24 approved for a capacity for two (2) non-ambulatory, one (3) for ambulatory, and one (1) for bedridden. Component III: LPA Dabuet conducted the Pre-Licensing inspection along with the information provided about how to operate the facility within substantial compliance with Component III PowerPoint. LPA Dabuet observed the following corrections: · Bedroom #1 is missing a window screen - corrected 07/03/24 · Bedroom #2 window screen has a small hole and will need to be replaced or repaired - corrected 07/03/24 · Bedroom #2 closet doors missing for privacy - corrected 07/02/24 · Outdoor furniture missing an outdoor umbrella - corrected 07/02/24 · Exterior gate missing an emergency latch release - corrected 07/02/24 An exit interview was conducted, and a copy of this report has been furnished to the applicant Antonia Dionisio. LPA Dabuet will submit a copy of this facility evaluation report to the Central Applications Unit (CAU) for review. If the applicant has questions regarding the status of the application, they have been instructed to communicate with the CAU Analyst assigned to their application. END OF REPORTthe state’s words, verbatim · CDSS document, Jul 2, 2024

The state marks this report as 8 pages; the online copy we transcribed has 4. You can request the full file from the county licensing office.

Type of visit: Office

Facility Type: RCFE Application Type: Initial Capacity: 6 COMP II Participant: Antonia Dionisio, CEO/Administrator Interview Method: Telephone interview On 6/7/24, applicant/administrator participated in COMP II. Identification of the applicant/administrator was verified through interview questions based on photo ID and other identifying personal information. During COMP II, applicant/administrator confirmed that they have read and understand community care facility licensing laws included in the Health and Safety Codes and the California Code of Regulations Title 22. Signed LIC 809 with copy of photo ID have been obtained. During COMP II, CAB analyst confirmed Applicant/Administrator’s understanding of following areas: 1. Facility operation: License type, client/resident populations, and program 2. Admission Policies 3. Staffing requirements & Training 4. Restrictive/Prohibited Health Conditions 5. General provisions 6. Emergency Preparedness 7. Complaints & Reporting 8. Pre-licensing readinessthe state’s words, verbatim · CDSS document, Jun 7, 2024