John Villa's Home Care I

Type of visit: Required - 1 Year

On August 3, 2026, Licensing Program Analysts (LPAs) Taylor Simerly and Joseph Alejandre made an unannounced visit to conduct a required annual visit. LPAs were greeted and granted entry into the facility by staff and explained the reason for the visit. Facility is licensed for 6 non-ambulatory residents. Facility has an approved hospice waiver for 4 residents and the home currently has 5 residents (2 are currently in the hospital), zero residents are on hospice. Administrators (AD) Villa Diaz and Juan Diaz Jr. were present for the visit. AD Villa Diaz has a current administrator certificate on file from June 23, 2026 to June 22, 2028. The facility has a valid liability insurance from July 1, 2026 to July 1, 2027. The home consists of 3 resident bedrooms, 2 staff rooms, living room, dining room, and kitchen as well as 3 bathrooms. The home has an attached two car garage that is inaccessible to residents. The living room has a two sided fireplace that has a screen. In the garage, there was a three day emergency supply of food and water. The LPAs toured the shed in the backyard that is used for storage and is locked. The backyard includes a shaded seated area for residents. LPAs and the ADs toured the physical plant. There were no bodies of water or obstructions on the premises. LPAs inspected residents’ bedrooms and bathrooms. The beds and bedding supplies were in good condition, adequate lighting was provided, and storage for the residents’ personal belongings was observed. The bathrooms were found to be within Title 22 regulations and were operational. Smoke and carbon monoxide detectors were in operable condition. The water temperature ranged from 117.5°F to 119.1°F. The evaluation Report continues on the next page, LIC 809-C, providing further details of the inspection findings. During the visit, LPAs observed that the facility was appropriately furnished. Storage areas for personal hygiene were in place. Cleaning supplies, toxins, and sharp objects were stored in a way that made them inaccessible to residents in care. The kitchen was inspected, and there were sufficient perishable and non-perishable food available, which was adequately maintained. All fire extinguishers were charged and operable. The last Fire/Disaster Drills were conducted on April 22, 2026. LPAs inspected the first aid kit and it was missing bandages and a first aid manual. A review of (5) residents' service files and (3) staff personnel files was conducted. LPA reviewed (3) Medication Administration Records (MARs) and found no discrepancies. LPAs observed the facility's infection control practices. All mandated inspection control posters were displayed throughout the facility. Deficiencies cited under California Code of Regulations, Title 22, Division 6, Chapter 8. See D page for details. Technical violations were also issued at this time. An exit interview was conducted, and a copy of the Facility Evaluation Report and appeal rights were provided to Villa Diaz, Administrator.the state’s words, verbatim · CDSS document, Aug 3, 2026

Allegation investigated: Staff did not allow resident to meet privately with a visitor

Licensing Program Analyst (LPA) Fred Arias conducted an unannounced complaint visit to finalize an investigation into the above allegation. LPA was greeted and granted entry into the facility and explained the reason for the visit. It was alleged staff did not allow resident to meet privately with a visitor. During the investigation, LPA conducted interviews with residents in care and staff. LPA reviewed records obtained. The investigation determined as follows: Regarding the allegation staff did not allow resident to meet privately with a visitor, it was reported Staff 1 (S1) repeatedly disrupted a visit between Resident 1 (R1) and their visitor on April 26, 2026. LPA interview with R1 stated they recall the incident and does not believe S1 was intentionally disrupting the visit. R1 added S1 entered the room to inform R1 they had a caller on the phone and wanted to speak with them. R1 stated they did not want to speak to the caller during that moment and S1 exited the room. R1 stated staff respects their privacy during visits. Unsubstantiated Interviews with four out of the remaining five residents stated their privacy is respected during visits and staff do not interfere with those visits. The remaining resident could not be interviewed. Interviews with three out of four staff stated when residents receive visitors, the door to the resident room is closed to provide privacy to the resident and their visitor. Two of those three staff stated if they need to enter the room during the visit, they will knock first to gain permission to enter. The remaining staff stated during the incident when R1 had a visitor on April 26, 2026, S1 knocked on the door before entering R1's room. Record review revealed R1 is cognitive based on their medical assessment. Based on interviews and record review, the allegation of staff did not allow resident to meet privately with a visitor is therefore deemed unsubstantiated meaning that although the allegation may have happened or is valid, there is not a preponderance of the evidence to prove that the alleged violations occurred. An exit interview was conducted and a copy of the report was left with the facility representative. Based on interviews, LPA is unable to corroborate the allegation. Therefore, the allegation is deemed to be UNFOUNDED, meaning that the allegation was false, could not have happened and/or is without a reasonable basis. An exit interview was conducted and a copy of the report was left with the facility representative.the state’s words, verbatim · CDSS document, May 7, 2026 · control 22-AS-20260507095259

Type of visit: Required - 1 Year

On this day Licensing Program Analyst (LPA) Fred Arias made an unannounced visit to conduct a required annual visit. LPA was greeted and granted entry into the facility by staff and explained the reason for the visit. Facility is licensed for 6 non-ambulatory residents. Facility has an approved hospice waiver for 4 residents and the home currently has 6 residents, with 1 resident on hospice. Administrator (AD) Juan Diaz conducted facility tour. AD provided updated liability insurance that expires on 07/01/2026. LPA along with AD toured the facility at 9:00 AM. LPA toured the physical plant, checked food service, and facility documentation. The home consists of 3 resident bedrooms, 2 staff rooms, living room, dining room, and kitchen as well as 3 bathrooms. At 9:00AM, LPA observed the kitchen counter attached to the sink and drawers being replaced. Then kitchen sink is currently non-operational. The dish washer has been reconnected and moved outside while the kitchen is being repaired. Perishable and non-perishable food supply was checked and adequately stocked at time of visit. Kitchen appliances were operational during today's visit. Resident bedrooms had the required furniture, bed linens and closet/drawer space to accommodate each resident comfortably. Resident bathrooms were checked. Toilets and water faucets worked properly, grab bars were secure and shower was free of mold/mildew. Water temperature measured at 109.5 degrees F. Resident bath towels, toiletries and personal hygiene supplies were adequately stocked. Common areas were clean and clear of hazards. Auditory exit alarms were operational during today's visit. Smoke detectors tested operational during today's visit. Fire extinguisher was fully charged. LPA reviewed the infection control and emergency disaster plans and plans are complete and thorough. Facility conducts quarterly emergency drills with the last drill conducted on 04/10/2025. Outside grounds were toured. Walkways around the home were clear of hazards. Exit gates are unlocked and operational. There is shaded outdoor seating for residents. Continued on LIC809-C dated 08/07/2025 LPA observed the emergency food supply. First aid kit contained all required items including tweezers, scissors and thermometer. Facility conducts activities in the form of exercise and music therapy. LPA reviewed six resident files and two staff files. Five out of six resident files contained all required documentation including admission agreements, physician reports, personal rights, and resident appraisals. Staff files reviewed contained required documentation including required annual training, medical assessment/ TB, and criminal record clearance. LPA reviewed medication storage and administration. Medications are stored in a locked cabinet. Based on the observations made during today’s visit, deficiencies are being cited per Title 22 Division 6 of the California Code of Regulations. This report was discussed with the facility representative and a copy was provided along with appeal rights.the state’s words, verbatim · CDSS document, Aug 7, 2025

The state marks this report as 9 pages; the online copy we transcribed has 6. You can request the full file from the county licensing office.

Type of visit: Case Management - Other

Licensing Program Analyst (LPA) Lydia Martinez conducted this Case Management visit in conjunction with a Complaint Control Number 22-AS-20250115125037. LPA Martinez toured facility and observed clutter in the back yard and on both side walkways of the house leading to the exit gates. LPA observed 10 huge truck tires on one side and bags, boxes, tools, ladder, kids toys, fans, 2 propane tanks, 3 oxygen tanks, wheelbarrow, empty plastic bins, and trash cans on the other side and in front of the shed. Based on the observations made during today’s visit, deficiency is being cited per Title 22 Division 6 of the California Code of Regulations. This report was discussed with Administrators and a copy was sent to email on file.the state’s words, verbatim · CDSS document, Jan 22, 2025

From the deficiency page — Deficiency type: Type A · Section cited: CCR 87303(a) · Plan of correction due date: Jan 23, 2025

The facility shall be clean, safe, sanitary and in good repair at all times. Maintenance shall include provision of maintenance services and procedures for the safety and well-being of residents, employees and visitors. This requirement is not met as evidenced by: LPA observed clutter in the back yard and on both sides of the house leading to the exit gates; 10 huge tires on one side and bags, boxes, tools, ladder, kids toys, fans, 2 propane tanks, 3 oxygen tanks, wheelbarrow, empty plastic bins, and trash cans on the other side and in front of the shed.the state’s words, verbatim · CDSS document, Jan 22, 2025

Plan of correction: Licensee to ensure the facility is clean, safe, sanitary and in good repair at all times. Licensee to clear back yard of clutter and clear walkway on both side leading to exits and submit proof of correction to LPA by 01/31/2025.. Since this a second violation within 12 months, an LIC 421 Civil penalty was assessed today in the amount of $250.00 for the repeat violation.

Type of visit: Required - 1 Year

Licensing Program Analysts (LPs) Alvaro Ramirez, Jr. and Samer Haddadin conducted an unannounced visit for the Required 1 Year Inspection. LPAs explained the purpose of today’s visit, and were greeted and granted entry by Caregiver Leonor Salazar and Administrator (AD) Juan Diaz. For today’s visit, LPA observed a total of six residents in care and two staff members on duty. AD provided proof of payment to show that the certificate is in renewal process. Renewed certificate has not yet been received and is pending. LPA reminded Licensee to post certificate once received. LPAs toured the interior and exterior portions of the facility with AD Diaz. The facility is a single level structure and is licensed for six non-ambulatory residents, of which four may be on hospice and zero bedridden. There are a total of five bedrooms, of which three are resident bedrooms. LPA Ramirez toured each bedroom in the facility and observed that bedrooms were provided with furniture in good repair, clean linens, adequate storage space, and kept free of tripping hazards. Smoke and carbon monoxide detector and auditory exit alarms were tested and operational. There are a total of two restrooms of which one is for staff and one is for residents. Restrooms and toilets were operational, and grab bars and non-skid floor mats were provided. In the staff restroom LPA observed that the sink hot water faucet was off. Per AD the hot water in one of two restrooms was off because the hot water faucet leaks. Water temperature tested 107.7 degrees Fahrenheit. Facility met the minimum two-day perishable and seven-day non-perishable food supplies. Sharp items and knives were locked and inaccessible to residents in care. Fire extinguisher was charged, mounted and located by the kitchen. CONTINUED ON LIC809-C.. LPA Ramirez observed the emergency disaster and evacuation plan, which is posted by the hallway. LPA observed that First Aid Kit had all the required components. LPA observed that medications and toxins were locked and inaccessible to residents in care. For the exterior portion, LPA Ramirez observed a shaded area and patio furniture. During the tour LPA also observed clutter on the back yard and on the side of the house leading to the exit gate. There are two gates in the backyard, which both are self-closing and self-latching. No bodies of water were observed. LPA reviewed six resident files and two staff files. LPA interviewed residents and staff present. For today's visit deficiencies were issued per Title 22 Division 6 of the California Code of Regulations. An exit interview was conducted with AD Diaz. A copy of this report was provided at the time of exit.the state’s words, verbatim · CDSS document, Aug 16, 2024