Joyful Living Rche

Type of visit: Required - 1 Year

On 7/21/26 Licensing Program Analyst (LPA) J. Leffall arrived unannounced to conduct an Annual Inspection. LPA introduced self, stated the purpose of the visit, and was greet by House Manager (HM) Evangeline Matheny, LPA was granted entry. 6 residents were present during inspection. Administrator (A1) Carlo Santos arrived shortly after LPA’s arrival. LPA’s toured facility with Licensee HM. The facility was observed to be at a comfortable temperature, clean, in good repair, and no passageway obstructions or fire hazards were observed inside. An adequate supply of perishable and non-perishable food was observed. Clients’ MARS was reviewed. Upon review LPA observed multiple medications not initialed by staff in the morning after being administered. Fire extinguisher reviewed with a service date of: 8/14/25. Fire drill completed on 7/15/26. Clients' bedrooms were toured and reviewed. Cleaning chemicals were observed stored and locked in cabinet. Residents bedrooms observed to be adequately furnished with bed, dresser, and adequate lighting. All bathrooms are toured and observed to be operational. Hot water temperature was tested at a range of 106.7 to 107.2 degrees in 2 bathrooms. Outside of facility toured. Outside observed free of debris. Side gate was self-closing and self-latching. Outside was observed with adequate outdoor seatings available for clients. Freezer temperature observed at 0 degrees F and refrigerator temperature maintained at 40 degrees F. Smoke detectors and carbon monoxide were tested and observed to be operational. Samples of clients’ files and staff’s files reviewed to have all the required documents. The following deficiency is being cited on the attached 809D in accordance with California Code of Regulations, Title 22, Division 6. Exit Interview conducted. LPA is requesting the following documents be submitted to the Fresno CCL office by 8/4/26: Current copy of Administrator Certificate, Designation of Facility Responsibility (LIC308), Administrator Organization LIC 309, Affidavit regarding Client/Resident Cash Resources LIC 400, Liability Insurance-RCFE, Emergency and Disaster Plan LIC 610E, Personnel Report LIC500, Register of Facility Clients/Residents for LIC9020A A copy of this report with and appeal rights was provided to A1, whose signature on this form confirms receipt of this report.the state’s words, verbatim · CDSS document, Jul 21, 2026

Type of visit: Required - 1 Year

On 7/17/25 Licensing Program Analyst (LPA) J. Leffall arrived unannounced to conduct an Annual Inspection. LPA introduced self, stated the purpose of the visit, and was greet by Staff (S1) Ricardo Pascua, LPA was granted entry. 5 residents were present during inspection. Administrator (A1) Carlo Santos arrived shortly after LPA’s arrival. LPA’s toured facility with Licensee (L1) Delia Galvaz. The facility was observed to be at a comfortable temperature, clean, in good repair, and no passageway obstructions or fire hazards were observed inside. An adequate supply of perishable and non-perishable food was observed. During observation of kitchen, a sharp knife was observed in unlocked kitchen drawer. Samples of resident’s medications were observed unlocked in in Resident’s bedroom. Clients’ MARS was reviewed. Fire extinguisher reviewed with a service date of: 8/19/24. Fire drill completed on 7/3/25. Clients' bedrooms were toured and reviewed. Cleaning chemicals were observed stored and locked in cabinet. Residents bedrooms observed to be adequately furnished with bed, dresser, and adequate lighting. All bathrooms are toured and observed to be operational. Hot water temperature was tested at a range of 105.6 to 117.6 degrees in 3 bathrooms. Outside of facility toured. Outside observed free of debris. Side gate was self-closing and self-latching. Outside was observed with adequate outdoor seatings available for clients. Freezer temperature observed at -10 degrees F and refrigerator temperature maintained at 40 degrees F. Smoke detectors and carbon monoxide were tested and observed to be operational. All clients’ files and staff’s files reviewed to have all the required documents. The following deficiency is being cited on the attached 809D in accordance with California Code of Regulations, Title 22, Division 6. Exit Interview conducted. LPA is requesting the following documents be submitted to the Fresno CCL office by 7/31/25: Current copy of Administrator Certificate, Designation of Facility Responsibility (LIC308), Administrator Organization LIC 309, Affidavit regarding Client/Resident Cash Resources LIC 400, Liability Insurance-RCFE, Emergency and Disaster Plan LIC 610E, Personnel Report LIC500, Register of Facility Clients/Residents for LIC9020A A copy of this report and appeal rights was provided to A1, whose signature on this form confirms receipt of this report.the state’s words, verbatim · CDSS document, Jul 17, 2025

Type of visit: Required - 1 Year

On 9/30/2024, Licensing Program Analysts (LPAs) J. Leffall and M. Garza arrived at the facility unannounced to conduct the Required Annual Inspection. LPAs were greeted by Staff (S1) Kimberly Clark, stated the purpose of the visit. Administrator (A1) Carlos Santos arrived sometime later. LPA’s conducted tour of facility with S1. 5 Residents present during inspection tour. Upon facility entrance LPAs observed no chime alarm sound on front door. The facility was observed to be at a comfortable temperature, clean, in good repair with no inside passageway obstructed or fire hazards. Fire extinguisher was observed with a service date of: 8/19/2024. Kitchen was toured. An adequate supply of perishable and non-perishable food was observed to be improperly stored in freezer and refrigerator. Refrigerator temperature was observed maintained at 40 degrees F. and freezer was observed maintained at 0 degrees F. LPAs observed improperly stored food with no dates. Knobs were observed accessible and exposed on top of stove. LPAs observed pantry area with adequate non-perishable foods for residents. Chemicals were observed accessible in 2 of 4 bathrooms and 1 of 5 resident bedrooms. Resident rooms toured and observed with required furnishings and lighting. LPAs observed securely fastened grab bars next to toilet and all tub/shower areas. LPAs observed restrooms with toilet paper/paper towel not on holders in bathrooms. 1 out of 4 bathrooms observed to not have a non-skid mat in shower. Water temperature measured at 107.2 degrees F in bathroom #1, and 110.8 degrees F in bathroom #2. Laundry room hallway observed to have small hole in the wall. 2 out of 5 client room carpets observed to be in need of cleaning and torn at doorway area. Backyard observed with self-latching gate for exit. 2 chairs on patio area observed blocking walkway. Water hose observed in the middle of walkway in backyard. Backyard observed to have no shade over outdoor table. A gate was observed broken that needs to be secured. CONT.... CONT..... LPAs completed a medication audit. Medications were stored in a locked medication room in a medication cabinet. MARs and medications were reviewed. Review of Centrally Stored Medication Record revealed R1’s medication log was incomplete. Based on record review, LPAs observed 1 out of 1 residents medication count was over the required amount. A sample of staff files reviewed. A sample of resident’s files were reviewed. 1 of 3 resident files reviewed, needed an updated LIC-602. The following documents are being requested and submitted to Fresno CCL by: 10/10/24. Forms requested: LIC 308, LIC 309 (if applicable), LIC 500, LIC 610D, LIC 9282, current Administrator certificate, and control of property. A copy of this report and appeal rights was provided to Administrator, whose signature on this form confirms receipt of this report. LPAs observed missing Restrictive Health Conditions, and Hospice/End of Life training's. Deficiencies cited on attached 809D in accordance with California Code of Regulations, Title 22,Division 6. An exit interview completed with Administrator, Carlos Santos. Report signed on-site; a copy of this report, deficiencies, TV’s and appeal rights were provided.the state’s words, verbatim · CDSS document, Sep 30, 2024

Allegation investigated: Staff are not properly addressing pest infestation in facility

On 10/6/2023 Licensing Program Analyst (LPA) M. Garza arrived at facility to deliver complaint findings. LPA met with Direct Care Staff, Alma Alcantara and Licensee, Delia Galvez explained reason for visit and was permitted entry into the facility. A health and safety check was completed for residents in care. Residents observed in rooms and in common areas. Tour of facility was completed inside and out. During the investigation LPA completed interviews with staff and resident(s) and reviewed documentation (physicians reports and pest control receipts). Records reviewed indicated the facility has pest control services. Althought the allegation may or may not have occurred it does not meet the preponderance of evidence standard per Title 22. The allegation is UNSUBSTANTIATED. Nothe state’s words, verbatim · CDSS document, Oct 6, 2023 · control 24-AS-20230517093734

The state marks this report as 3 pages; the online copy we transcribed has 1. You can request the full file from the county licensing office.

Allegation investigated: Facility staff does not serve nutritious meals.

On 10/6/2023 Licensing Program Analyst (LPA) M. Garza arrived at facility to deliver complaint findings. LPA met with Direct Care Staff, Alma Alcantara and Licensee, Delia Galvez explained reason for visit and was permitted entry into the facility. A health and safety check was completed for residents in care. Residents observed in rooms and in common areas. Tour of facility was completed inside and out. During the investigation LPA completed interviews with staff and resident(s) and reviewed documentation (physicians reports, menus, grocery receipts). Records reviewed indicated the facility is making regular grocery purchases. The facility has menus for the residents, however, LPA observed soups and sandwiches are being served 5 of 7 days for most dinners. This does not meet the dietary nutirients for the daily allowances. The allegation above meet the preponderance of evidence standard per Title 22. The allegation is SUBSTANTIATED.the state’s words, verbatim · CDSS document, Oct 6, 2023 · control 24-AS-20230517093734

From the deficiency page — Deficiency type: Type B · Section cited: CCR 87555 · Plan of correction due date: Oct 18, 2023

87555 General Food Service Requirements(a) The total daily diet shall be of the quality and in the quantity necessary to meet the needs of the residents and shall meet the Recommended Dietary Allowances of the Food and Nutrition Board of the National Research Council. All food shall be selected, stored, prepared and served in a safe and healthful manner. This requirement was not met as evidence by LPA interviews and records review of residents menus showing residents being served soups/sandwiches 5 out of 7 days. This poses a potential health, safety and/or personal rights risk to residents in care.the state’s words, verbatim · CDSS document, Oct 6, 2023

Plan of correction: New menu will be generated. Licensee stated they will include residents in menu planning. Menus will be provided to CCL by POC date. Training will be completed with staff. In-service sign in sheets will be provided to CCL as proof of correction.