Holy Spirit Residential Care Home Inc. II

Type of visit: Required - 1 Year

At approximately 10:00AM, Licensing Program Analyst (LPA) Chris Arnhold arrived at this facility unannounced to conduct a Required-1 Year inspection. LPA met with Administrator Genaro Gonzalez and explained the purpose of the visit. Administrator certificate is current. Facility has a Hospice waiver for 2 residents. At approximately 10:20AM, LPA toured the facility to ensure the health and safety of residents in care. The facility was observed to be at a comfortable temperature. Areas toured include but are not limited to resident rooms, common areas, bathrooms, kitchen, storage areas and back yard. In the areas toured no immediate health, safety, or personal rights violations were observed. One of two fire extinguishers were fully charged. Administrator contacted the vendor to have the extinguisher serviced during visit. Smoke detectors are all operational. Carbon Monoxide Detector was present. The common areas, bathrooms and kitchen were clean and in good repair. All bedrooms had required furniture, bedding, and lighting. The kitchen equipment was clean and in good repair. Dishware appeared to be stored in a sanitary manner. Food appears to be stored and prepared properly. Refrigerators and freezers were maintained at the proper temperature. Facility has required supply of perishable and non-perishable food. Emergency water was present to ensure facility can be self-sufficient for 72 hours. Facility has a generator to supply power in an emergency. Emergency lighting devices were present. First aid kit was present. No pools/bodies of water are on the premises. Facility has been conducting Emergency drills every 3 months. At approximately 10:45AM, LPA reviewed 6 of 6 resident files. All resident files contained the required documentation. 4 of 6 reappraisals were conducted within the last 12 months. A technical violation was given. Documentation of a physician visit within the last 12 months was present. Medication records were organized and contained orders for each medication. Medications were secured in a locked cabinet. Continued on LIC809-C… At approximately 11:30AM, LPA reviewed 5 of 5 staff files. Staff files reviewed contained evidence of completed annual training. First Aid/CPR certification was current. All employees requiring background checks are cleared. Updated copies of the following documents were requested for facility file and are to be submitted to CCL within 30 days of this visit: LIC500- Personnel Report LIC610E- Disaster Plan Evidence of Liability Insurance No deficiencies were observed in the areas inspected, No citations were issued during today’s visit.the state’s words, verbatim · CDSS document, Nov 4, 2025

The state marks this report as 4 pages; the online copy we transcribed has 3. You can request the full file from the county licensing office.

Type of visit: Case Management - Annual Continuation

At approximately 11:40AM, Licensing Program Analyst (LPA) Chris Arnhold arrived unannounced to continue an unannounced annual required inspection. LPA met with Administrator Genaro Gonzalez. At approximately 11:45AM, LPA reviewed 5 staff records that were unavailable during the last visit. Staff files reviewed contained evidence of completed annual training, Health screenings and verification of a cleared background clearances. First Aid/CPR certification was current. No citations issued during this visit.the state’s words, verbatim · CDSS document, Apr 8, 2025

Type of visit: Required - 1 Year

At approximately 11:30AM, Licensing Program Analyst (LPA) Chris Arnhold made an unannounced annual required inspection of this licensed senior care facility. LPA met with Administrator Perla Gonzalez . At approximately 11:40AM, LPA toured the building and grounds which was found to be clean and in good repair. LPA observed all walkways and exits to be unobstructed. All notices that are required to be posted have been posted and are in a highly visible area. LPA observed activity supplies for resident use. The amount of fresh and nonperishable foods is within regulation. Facility kitchen, refrigerators and freezers were clean, and food was stored properly. Toxins are stored in a locked storage closet. Water temperature measured within regulation between 105 and 120 degrees F at faucets accessible to residents. Fire extinguishers inspected were charged. Smoke detectors were found to be in working order. Carbon Monoxide detectors were present. There was enough lighting in all common areas, resident rooms, and hallways. Medication is centrally stored and secure. At approximately 12:00PM, LPA reviewed 5 of 5 resident records. All records contained current appraisals and completed physician reports. Admission agreements were signed and present in the records. LPA will return at a later date to review staff records. No citations issued during today's visit.the state’s words, verbatim · CDSS document, Jan 24, 2025

Type of visit: Case Management - Annual Continuation

At approximately 8:30AM, Licensing Program Analyst (LPA) Chris Arnhold made an unannounced annual required inspection of this licensed senior care facility. LPA met with Administrator Perla Gonzalez. At approximately 9:00AM, LPA reviewed 6 of 6 resident records and found 6 of 6 residents had current physician's reports and care plans. 6 of 6 records contained current and signed admission agreements. Medication records are thorough and contained physician's orders for each resident. At approximately 11:00AM, LPA reviewed 7 staff records. 7 of 7 records did not contain documentation of completed training records as required. Evidence of current first aid and CPR training were current. At approximately 11:45AM, LPA reviewed the facility emergency disaster plan. Facility has a generator to supply power during an outage. The plan outlines evacuation routes, which are shown on facility sketch and has alternative meeting locations. Facility has supplies enough to operate for more than 72 hours in an emergency. Facility conducted and documented a disaster drill on 12/12/2023. Deficiencies are cited from the California Code of Regulations (CCRs), and/or the Health and Safety Code. Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment. This report was reviewed with Administrator and Appeal rights were given.the state’s words, verbatim · CDSS document, Feb 22, 2024

Type of visit: Required - 1 Year

At approximately 11:00AM, Licensing Program Analyst (LPA) Chris Arnhold made an unannounced annual required inspection of this licensed senior care facility. LPA met with Genaro Gonzalez . At approximately 11:30AM, LPA toured the building and grounds which was found to be clean and in good repair. LPA observed all walkways and exits to be unobstructed. All notices that are required to be posted have been posted and are in a highly visible area. LPA observed activity supplies for resident use. The amount of fresh and nonperishable foods is within regulation. Facility kitchen, refrigerators and freezers were clean, and food was stored properly. Toxins are stored in a locked storage closet. Water temperature measured above regulation between 105 and 120 degrees F at faucets accessible to residents. Fire extinguishers inspected were charged. Smoke detectors were found to be in working order. Carbon Monoxide detectors were present. There was enough lighting in all common areas, resident rooms, and hallways. Medication is centrally stored and secure. LPA will need to return at a later date to review resident and staff records. LPA received Evidence of Liability Insurance. Deficiencies are cited from the California Code of Regulations (CCRs), and/or the Health and Safety Code. Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment. This report was reviewed with GENARO GONZALEZ and Appeal rights were given.the state’s words, verbatim · CDSS document, Jan 4, 2024