Ideal Home Care

Type of visit: Case Management - Other

On 5/22/2026, Licensing Program Manager (LPM) Robyn Clark conducted an in-person office meeting with Administrator (ADM) Gloria Pascua to grant an Emergency Approval to Operate the facility in response to the death of the Facility licensee, Josefina I. Hulsey (LIC). On 5/20/2026, LPM conducted a virtual office meeting with the LIC's next of kin, who produced verification of death, LIC's notarized Trust, as well as a grant deed indicating that LIC's next of kin held legal ownership of the property occupied by the facility, which was being operated by Administrator Pascua. A new control of property (rental lease agreement) was executed and produced to the Department on 5/21/2026, showing Pascua's legal right to occupy the premises to operate the Residential Care Facility for the Elderly. During the meeting, LPM provided Pascua with an LIC 9117, Certificate of Emergency Approval to Operate and explained the terms and conditions of the approval. The certificate is valid for 60 days, and will expire upon the issuance of a provisional license, or denial of application for licensure. LPM Reviewed the LIC 200 and application documents and advised that Pascua must submit a completed application for licensure including payment to the Department's Centralized Applications Bureau (CAB) within 20 days of LICs death. Pascua must also comply with all applicable laws and regulations, and ensure that the needs of all residents are met. Report discussed and provided along with the LIC 9117 to Administrator Pascua, whose signature below confirms receipt.the state’s words, verbatim · CDSS document, May 22, 2026

Type of visit: Case Management - Other

Licensing Program Analyst LPA Amy Rodgers conducted an unannounced case management visit. LPA was welcomed by, identified themselves to, and discussed the process of the facility closure with Administrator Gloria Pascua On May 20, 2026, Community Care Licensing conducted an unannounced facility visit to determine control of property and met with Administrator Pasua to gather documentation and provide guidance to Administrator Pascua regarding the ownership of the facility following the death of the licensee. Additionally, LPA Rodgers was assured by Administrator Pasua staffing and medication management will remain in place throughout the process of obtaining a new license for CCLD. According to a records review families or responsible parties were notified. As of today, no deficiencies were issued and the facility is considered closed. An exit interview was conducted with Administrator Pascua, to whom a copy of this report and the Licensee/Appeal Rights (LIC9058 03/22) were provided during the visit.the state’s words, verbatim · CDSS document, May 20, 2026

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Ramon Serrano conducted an unannounced Required Annual Inspection. The facility file was reviewed prior to the visit. LPA identified himself and discussed the purpose of the visit with Administrator Teresita Lopez. The facility's license shows a maximum capacity of six (6) residents, of which four (4) may be non-ambulatory and two (2) may be bedridden. LPA, accompanied by Administrator toured the interior and exterior of the facility, and inspected each room. The facility was clean, sanitary, and in good repair. Pathways were free of obstruction and slip hazards. Both the facility’s ambient internal temperature and hot water temperature were at compliant readings. Resident bedrooms contained the required furnishings. Doors, windows, toilets, and showers were in working order. Extra linens and hygiene supplies were present, as well as Personal Protective Equipment. The facility had sufficient space and equipment to facilitate dining, laundry, visitation, meetings, and resident activities. There was at least 2 days of perishable food, and at least 7 days non-perishable food present, all safely stored. Cooking/dining equipment and utensils were present. There were no toxic chemicals/poisons accessible to residents. Medications were labeled, as required, and stored in locked areas. No pools or bodies of water on the premises. Per Administrator, no firearms or ammunition are kept at the facility. Carbon monoxide detectors, emergency lighting, and facility telephone were all working. Fire extinguisher(s) were present. First aid kit(s) were complete and readily accessible. Required licensing postings were observed in visible areas of the facility. LPA reviewed multiple staff and resident records/files. LPA file review did not raise any licensing concerns. The files which LPA reviewed contained required documents. Confidential records were stored in locked areas. No deficiencies were observed or cited during today's annual inspection. An interview exit was conducted with Administrator Teresita Lopez to whom a copy of this report and the Licensee/Appeal Rights (LIC9058 03/22) were provided during the visit.the state’s words, verbatim · CDSS document, Mar 23, 2026

Type of visit: POC

Licensing Program Analyst (LPA) Hannah Rodgers conducted a plan of correction visit. LPA was greeted by, identified herself to, and explained the purpose of the visit to Caregiver Teresita Lopez. The purpose of the visit was to verify if the deficiency issued on 3/28/2025 had been corrected. On 3/28/2025, the licensee was issued a deficiency with a correction due date of 4/18/2025. During today’s visit, LPA Rodgers verified that the licensee corrected the deficiency regarding expired canned goods in the pantry. Therefore, the deficiency for general food service requirements is corrected. LPA provided Caregiver Lopez with a letter of Deficiency Cleared. An exit interview was conducted with Caregiver Lopez, whose signature below confirms receipt of a copy of this report and the Licensee Appeal Rights (LIC9058 3/22).the state’s words, verbatim · CDSS document, Apr 24, 2025

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Hannah Rodgers conducted an unannounced Required Annual Inspection. The facility file was reviewed prior to the visit. LPA was greeted by, identified themselves to and discussed the purpose of the visit with Administrator Josefina Hulsey. The facility's license shows a maximum capacity of six (6) residents, of which four (4) may be non-ambulatory and two (2) may be bedridden. During today’s inspection, there were a total of three (3) residents in care. LPA with Administrator Hulsey toured the interior and exterior of the facility, and inspected each room. Pathways were free of obstruction and slip hazards. Resident bedrooms contained the required furnishings. Doors, windows, screens, and showers were in working order. Extra linens and hygiene supplies were present. The facility had sufficient space and equipment to facilitate dining, laundry, visitation, meetings, and resident activities. The facility contained at least 2 days of perishable food, and at least 7 days non-perishable food. LPA observed expired canned goods in the pantry. Cooking, dining equipment, and utensils were present. No toxic chemicals or poisons were accessible to residents. Medications were labeled, as required, and stored in locked areas. No pools or bodies of water exist on the premises. Per Administrator Administrator Hulsey, no firearms or ammunition are kept at the facility. Carbon monoxide detectors, emergency lighting, and facility telephone were all in working order. Fire extinguisher(s) were serviced within the last 12 months. First aid kit was complete and readily accessible. Required licensing postings were observed in visible areas of the facility. [CONTINUED ON LIC809-C] LPA reviewed facility records. Administrator Hulsey could not provide proof of conducted quarterly emergency drills, as required. Confidential records were stored in locked areas. For one (1) of the three (3) resident records reviewed the Licensee did not possess a written Needs and Services Plan or equivalent care plan for the client which had been updated within the last year, as required. Two (2) deficiencies were cited per California Code of Regulations, Title 22 (refer to the attached LIC 809-D pages) and one (1) deficiency was cited per California Health and Safety Code. Plans of Correction were jointly developed with Administrator Hulsey. An exit interview was conducted with Administrator Hulsey, to whom a copy of this report, the LIC 809-D pages, the LIC811 Confidential Names List, and the Licensee/Appeal Rights (LIC9058 03/22) were provided for today’s visit.the state’s words, verbatim · CDSS document, Mar 28, 2025

Type of visit: Required - 1 Year

Licensing Program Analyst’s (LPA) Alyssa Ramirez conducted an unannounced Required Annual Inspection. The facility file was reviewed prior to the visit. LPA was welcomed by, identified themselves to, and discussed the purpose of the visit with Licensee Josefina Hulsey. The facility is currently licensed for a maximum capacity of six (6) residents, of which four (4) may be non-ambulatory and two (2) may be bedridden. During today’s inspection, there were a total of four (4) clients in care. LPA, accompanied by staff, toured the interior and exterior of the facility, and inspected each room. The facility was clean, sanitary, and in good repair. Pathways were free of obstruction and slip hazards. Client bedrooms contained the required furnishings. Extra linens and hygiene supplies were present, as well as Personal Protective Equipment. The facility had sufficient space and equipment to facilitate dining, laundry, visitation, meetings, and client activities. Hot water temperature was compliant. There was at least 2 days of perishable food, and at least 7 days non-perishable food present, all safely stored. Cooking/dining equipment and utensils were present. There were no sharp objects, toxic chemicals/poisons, or open-faced heaters accessible to clients. Medications were labeled, as required, and stored in locked areas. No pools or bodies of water were observed on the premises. Per staff no firearms or ammunition are kept at the facility. Smoke alarms, carbon monoxide detectors, emergency lighting, and facility telephone were all working. Fire extinguisher(s) were present. First aid kit(s) were complete and readily accessible. Required licensing postings were observed in visible areas of the facility. [CONTINUED ON LIC 809-C] [CONTINUED FROM LIC 809] LPA interviewed staff and reviewed staff and client records/files. The files which LPA reviewed contained required documents. LPA interviews did not raise any licensing concerns. Deficiencies were cited per California Code of Regulations, Title 22 (refer to the attached LIC 809-D). A Plan of Correction was jointly developed with the Licensee. An exit interview was conducted with Licensee, to whom a copy of this report, the LIC 809-D, the LIC811 Confidential Names List, and the Licensee/Appeal Rights (LIC9058 03/22) were provided during the visit.the state’s words, verbatim · CDSS document, Feb 29, 2024