Legacy Villa Senior Care

Type of visit: Annual/Random

Licensing Program Analyst (LPA) Tena Herrera conducted the required annual inspection. LPA arrived unannounced and met with Caregiver Jay Francisco and explained the purpose for today’s visit. The facility is licensed to serve 2 Ambulatory and 4 Non-Ambulatory (in rooms 2,3,5) Residents Ages 60 and over.. The facility currently has and approved hospice waiver for 6 and has an approved dementia plan. The facility is a single-story home located in Torrance, Ca. A tour of the facility includes: 5 Resident bedrooms, 3 bathrooms, 1 staff room, living room, dining area, family room, kitchen, laundry area, front yard, back yard and attached garage. LPA utilized the Compliance & Regulatory Enforcement (CARE) tools for the visit todays visit and observed the following: Infection Control: The facility maintains a copy of the required Infection Control Plan. Operational Requirements: The facility has an approved fire clearance and maintains the required liability insurance. Physical Plant & Environment Safety: LPA toured facility, residents’ bedrooms were checked and closet/drawer space to accommodate each resident comfortably was available. The front yard is free of debris/hazards and the outdoor and passageways are free of obstruction. No bodies of water were observed at the facility. There are no security bars or weapons on the premises. Hygiene products are readily available for clients. The hot water temperature was tested throughout the facility and measured within the required range of 105-120 degrees F. Grab bars were observed in restrooms near toilets and showers. All storage areas for cleaning solutions, toxins, knives, and hazardous items are kept in a locked and are inaccessible to residents. Smoke detectors and carbon monoxide detectors are operable and in compliance. There fire extinguisher was observed and is fully charged. (Continued on LIC809-C) Staffing & Personnel Records-Training: Staff has criminal record clearance, current First-Aid/CPR/AED training along with training in postural supports, medication assistance, dementia and other ongoing training are documented in personnel files. LPA attempted to review 3 staff files, however, they were not available during visit, Technical Violation was issued and LIC9102 was provided. Administrator Joel Morales certificate expires on 9/8/2026, it was advised that they complete their renewal asap. Resident Records-Incident Reports: There appears to be sufficient staffing at all times in the facility. Resident files are kept in a secure location and have the following documents in their files - Pre-admission appraisal/Appraisal Needs & Services Plan, Admission Agreements, Identification & Emergency Information and current Physician's Report. LPA reviewed 4 and 3 out of 4 files were missing the required yearly re-appraisal/needs and service plan, citation issued and detailed on LIC809-D. Residents Rights-Information: Residents are provided with telephone and internet at the facility. The facility has the following posters posted: Residents Rights, Complaint Poster, and Ombudsman. Planned Activities: Facility provides scheduled activities and have a variety of activities to choose from within the facility. There is an outdoor activity area available for the residents. Food Service: The kitchen was observed for the ability to prepare and serve food. LPA observed an appropriate food supply of two (2) days of perishables and one week (7 days) of non-perishables. Incidental Medical & Dental: Medication is properly labeled and are centrally stored in a closet and are in their original containers. LPA reviewed 4 residents’ medications and there were no issues observed. Disaster Preparedness: The facility has an Emergency Disaster Plan with contact numbers and at least 2 relocation sites. Last fire/disaster/earthquake drill was conducted on 6/10/26. Residents with Special Health Needs: The residents using hospice services have the required documentation on file. Per California Code of Regulations, Title 22, and California Health and Safety Code, the deficiency observed during the visit will be documented on the LIC809-D page. Exit interview held and a copy of the report and appeal rights were provided..the state’s words, verbatim · CDSS document, Sep 5, 2026

From the deficiency page — Deficiency type: Type B · Section cited: CCR 87463(a) · Plan of correction due date: Sep 21, 2026

87463 Reappraisals (a) The pre-admission appraisal, as specified in Section 87457, Pre-Admission Appraisal, shall be updated in writing as frequently as necessary or once every 12 months, whichever occurs first, to note significant changes in condition, as defined in Section 87101, Definitions, and to keep the appraisal accurate. For the purposes of this section, the updated pre-admission appraisal shall be referred to as the reappraisal. This requirement was not met as evidence by: During file review LPA observed that R2-R4 were missing the required yearly (every 12 months) re-appraisal. R2's last Reappraisal was dated 9/2023, R3's last Reappraisal was dated 6/2022, R4's last Reappraisal was dated 6/2022, this poses a potential health and safety risk to residents in care.the state’s words, verbatim · CDSS document, Sep 5, 2026

Plan of correction: Licensee/Administrator to provide LPA with a copy of the updated Re-Appraisals for each resident via email by POC due date.

Type of visit: Required - 1 Year

On 08/08/2025 at 08:00 AM, Licensing Program Analyst (LPA) Jose Calderon conducted an unannounced annual inspection visit at the Legacy Villa Senior Care Facility. LPA Calderon was allowed entry into the facility by Administrator Joel Morales. The facility is licensed for six (6) adults aged 60 and above. The facility currently has a hospice waiver for six (6) adults. Currently, there are five (5) residents residing in the facility 60 and above. LPA Calderon explained to Administrator Joel Morales, the purpose of the one-year Annual Inspection visit, and escorted LPA Calderon on a tour of the entire inside and outside facility grounds. As part of the inspection, LPA Calderon reviewed: Five (5) client service records, five (5) client medication records, two (2) staff records, and inspected the inside facility and outside grounds. The facility’s last fire drill was conducted on 05/01/2025. The one-story residential home consists of five (5) client bedrooms, two (2) client bathrooms, living room, family room, dining room, kitchen, staff room, office area, garage with washer and dryer/ storage area, backyard with table and chairs. No weapons are stored on the premises. The kitchen was inspected and observed to be clean and operational. A two-day supply perishable and seven-day supply of non-perishable foods are present in the facility. Emergency Water Storage is found in the garage and kitchen area. LPA Calderon observed that all facility rooms are clean and in good repair. A comfortable temperature was observed, and the facility has central air and heating. LPA Calderon observed the following during inspection of client’s rooms: mattresses are in good condition, adequate lighting present, plenty of dresser/closet space is present, and all bed linens present. All bedrooms contain furniture, lighting fixtures and personal storage space as required, all beds have the required amount of linen and mattress covers, LPA Calderon observed fully stocked closet with bedding, towels, and toiletries supplies. Bathroom fixtures are clean, in good repair, and working properly and contain the required nonskid mats and grab bars. LPA Calderon observed bathrooms were found to be within Title 22 regulation. Bathroom #1 hot water temperature properly measured at 108 degrees Fahrenheit. Bathroom #2 hot water temperature properly measured at 110 degrees Fahrenheit. Kitchen hot water temperature is properly measured at 108 degrees Fahrenheit. Facility two (2), Carbon Monoxide and seven (7) Smoke Detectors, hard-wired and connected, were tested and are working properly. The facility one (1) Fire Extinguishers was checked and found to be fully charged and accessible. All exit doors in the facility have alarm systems. All toxins and knives are locked/secured and inaccessible to clients. Medications are centrally stored and in a locked storage cabinet. Facility one (1) first aid kit is fully stocked with manuals was checked and in order. Outside grounds were toured and no bodies of water were observed. All Exits/ Walkways around the home were free of debris and hazards. Outside patio accessible to clients. Five (5) client files were reviewed and found to be complete. LPA Calderon reviewed five (5) resident medications, and they were all found to be administered according to doctor's orders. Two (2) staff files were checked, and they have the required documents. LPA Calderon noted the Administrator Joel Morales Certification # 6063841740 expiration date of 09/08/2024 was NOT valid at time of visit. Commercial General Liability Policy #001608080 policy period from 01/08/2025 to 01/08/2026 underwritten by James River Insurance Company, coverage 1,000,000/3,000,000 is valid at time of inspection. All the required documents are posted in the facility in a clearly visible area. According to the California Code of Regulations (Title 22, Division 6, Chapter 8), LPA Calderon did not observe deficiencies therefore no citations were issued at this time. Annual Licensing Fee is CURRENT. An exit interview was conducted, and a copy of the Facility Evaluation Report was provided to Administrator Joel Morales.the state’s words, verbatim · CDSS document, Aug 8, 2025

Type of visit: Required - 1 Year

On 06/19/24, Licensing Program Analyst (LPA), Wendy Gibbs, conducted an unannounced visit to the facility listed above. LPA met with Administrator, Joel Morales, and the purpose of today’s visit was explained. The facility is licensed for six (6) adults aged 60 and above. They have a hospice waiver for six (6). During time of visit all six (6) residents were present Physical Plant/Structure The facility is a single-story home in a residential neighborhood. The facility consists of five (5) bedrooms, three (3) bathrooms, two (2) car garage, living room, family room, dining room, kitchen, laundry area, and a shaded patio. LPA observed a table, chairs, and couch under the shaded patio. LPA observed all walkways around the home to be clean, clear, and free of obstructions, debris, and hazards. LPA did not observe any bodies of water on the premises. Bedrooms LPA inspected all bedrooms and observed the walls and floors to be clean and in good repair. All rooms had the required furniture including a bed, dresser, nightstand, chair, and storage space for personal belongings. LPA observed beds had the required linens including a mattress cover, fitted sheets, blanket, comforter, and pillows. LPA observed bed linens to be in good repair. An ample supply of bed linens was observed in the hall cabinet. Continued on LIC809-C Bathrooms LPA inspected the facility bathrooms and found them to be within Title 22 regulations. All bathrooms were observed clean and operational. LPA observed storage area for personal hygiene products. LPA observed an ample supply of towels and personal hygiene products available for residents. All showers had a nonskid mat, shower chair, and secured safety handrails. The water temperature measured between 111.2 and 113.6-degrees Fahrenheit. Kitchen LPA inspected the facility kitchen and found it to be clean and sanitary. LPA observed all appliances to be operational and in good repair. LPA observed an ample supply of dishware, cookware, and cutleries in good repair. LPA observed a 3-day supply of perishable foods and a 7-day supply of non-perishable foods, properly stored and labeled. LPA observed knives and other sharps secured in a locked drawer and are inaccessible to residents. Cleaning supplies are secured in a locked cabinet in the laundry area and are inaccessible to residents. The water temperature measured 111.5-degrees Fahrenheit. Common Rooms In the living room, LPA observed a couch and two (2) chairs to accommodate residents. In the family room, LPA observed 7 recliners to accommodate residents. LPA observed games and reading material available to residents. LPA observed a fireplace that was properly screened. The dining room has a large table and chairs to accommodate all residents. LPA observed all walkways and hallways in the home to be clean, clear, and free of obstructions and hazards. All rooms have ample lighting. The facility was maintained at a comfortable temperature. Continued on LIC809-C Safety LPA observed multiple fully charged fire extinguisher in the facility, last serviced on 05/01/23. All smoke and carbon monoxide detectors are operable. The last emergency drill was conducted on 05/06/24. LPA inspected the First Aide Kit and observed it had the required items and a manual. All exits are marked with an EXIT sign. The facility’s Emergency and Disaster Plan is posted in the family room. LPA observed all required documents posted in the facility. The facility has a working landline telephone. There are no firearms are ammunition stored at the facility. Files/ Interviews LPA reviewed the files for the six (6) residents and observed they had the required documents. LPA spoke with six (6) residents, and all were happy with the care they receive at the facility. LPA reviewed the administrator and two (2) staff files and found they contained the required documents, certification, and training. The administrator’s Administrator Certificate is valid till 09/08/24. LPA spoke with two (2) staff, and all were able to answer questions regarding policy, procedure, and resident care and personal rights. LPA received and reviewed the facility Liability Insurance which is valid till 01/08/25. Medication LPA observed all Centrally Stored Medications secured in a locked cabinet in the kitchen, and are inaccessible to residents. All medications were observed in their original packaging. LPA reviewed the medications and Medication Administration Record (MAR) for the six (6) residents. Six (6) out of six (6) resident’s MARs and medication are consistent with properly documented records. Continued on LIC809-C Infection Control Upon entry, LPA observed a sanitizing station and visitor sign-in log. LPA observed on the table there is hand sanitizer and masks available. LPA observed all required Infection Control signs posted in the facility. LPA observed a 30-day supply of Personal Protective Equipment (PPE). During today’s visit, LPA did not observe or cite any deficiencies. An exit interview was conducted with Administrator, Joel Morales, and a copy of this report was provided.the state’s words, verbatim · CDSS document, Jun 19, 2024