Lourdes Senior Care Home

Type of visit: Required - 1 Year

On 9/11/26 Licensing Program Analyst (LPA) J. Leffall arrived unannounced to conduct an Annual Inspection. LPA introduced self, stated the purpose of the visit, and was greeted by Staff (S1) Marigrace Caliztro , LPA was granted entry. 5 residents were present during inspection. Licensee (L1) Davilyn Mancilla arrived shortly after LPA’s arrival. LPA toured facility with L1. 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. Samples of resident’s medications were checked and observed locked in kitchen cabinet. Clients’ MARS was reviewed. Fire extinguisher reviewed with a service date of: 7/14/26. Fire drill completed on 7/28/26. Clients' bedrooms were toured and reviewed. Cleaning chemicals were observed stored and locked in closet. Resident’s 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 112.5 to 119.3 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 30 degrees F. Smoke detectors and carbon monoxide were tested and observed to be operational. Client’s and staff’s files reviewed to have all the required documents. No deficiencies issued during this inspection. Exit Interview conducted. LPA is requesting the following documents be submitted to the Fresno CCL office by 9/25/26: Current copy of Administrator Certificate, Designation of Facility Responsibility (LIC308), Administrator Organization (LIC 309), Affidavit regarding Client/Resident Cash Resources (LIC 400), Liability Insurance, Emergency and Disaster Plan (LIC 610E), Personnel Report (LIC500), Register of Facility Clients/Residents for (LIC9020A) A copy of this report with 9102 were provided to Administrator, whose signature on this form confirms receipt of these report.the state’s words, verbatim · CDSS document, Sep 11, 2026

Type of visit: Required - 1 Year

On 10/9/2025 Licensing Program Analyst (LPA) B. Miranda arrived to the facility unannounced to conduct an annual inspection. LPA was greeted by staff Teresa Molina and allowed entrance into the facility. Administrator Davilyn Mancilla was contacted and arrived shortly after. Upon entering the facility LPA observed the facility to be clean,clutter & odor free. Facility is currently licensed for 6 residents and has a current census of 5. LPA observed all exits to be free from obstruction. Fire extinguisher was last serviced on 7/15/2025. Back yard is properly secured. LPA observed smoke alarm and carbon monoxide reader to be in working order. Facility does not have any bodies of water such as pool, spa, fountains, etc. Facility has a wood buring fireplace that is not in use & is blocked from view with large wallhanging. LPA observed kitchen to be clean and free from any pests. Facility has adequate amount of food with 7 days supply of non-perishable food items and 2 day supply of perishable food items. LPA observed sharps to be inaccessible in a locked cabinet. Medication is locked in cabinet and inaccessible to residents. LPA observed resident rooms to be clean and odor free. Rooms were properly furnished with sufficient lighting. LPA observed bathroom to be clean with pull bars and non-slip matts. Water temperature read at 106.9 degrees Fahrenheit in the bathroom. LPA reviewed resident files to be complete and current. LPA reviewed administrator and staff on duties files. Exit interview was conducted and a copy of this report LIC809 was provided to Administrator Davilyn Mancilla.the state’s words, verbatim · CDSS document, Oct 9, 2025

Type of visit: Required - 1 Year

An unannounced Annual visit was conducted on the date & times indicated above by Licensing Program Analyst (LPA) K. McClurg. LPA was greeted @ door by Caregiver 1 (CG1) Anterlyn "Lyn" Molina. LPA introduced self, stated purpose of visit, provided business card & was allowed entry. CG1 called Licensee/Administrator (L/A) Davilyn Manilla to notify that LPA was at facility. LPA spoke with L/A over phone, greeted L/A, stated purpose of visit, & inquired if L/A would be able to join LPA for visit. L/A arrived at facility afterwards & joined LPA during mid-physical plant tour. Facility does not have any bodies of water such as pool, spa, fountains, etc. Facility has a wood buring fireplace that is not in use & is blocked from view & use by large wallhanging. When LPA entered facility, residents were observed in living area of dining room watching television. LPA greeted residents. CG1 stated that residents had just completed lunch. Caregiver 2 (CG2) Tereza Molina was at dining table eating. L/A was contacted. LPA began physical plant tour inviting CG1 to accompany L/A. Physical plant toured. Tour began in hallway & proceeded through laundry room. Laundry appliances observed to be in use, with no laundry detergent, etc. accessible to residents. Garage accessible through laundry room. Glass cleanser observed accessible on open shelf under sink in garage. Cleanser made inaccessible @ time of visit. Over/under freezer/refrigerator labelled as "staff food". It was later determined that this appliance did contain food for resident use as well. L/A cautioned about circulating freezer items so as ice accumulation to prevent significant amount of icing to occur & to prevent freezer burn. Resident bedrooms off of hallway toured. Bedrooms sufficiently furnished with adequate lighting. All bedrooms, including front bedroom off of facility entryway, have doors that open to backyard or side yards. Each exit door appropriately identified with Exit sign. Auditory alarms on all exit doors, including door between garage & laundry room. Auditory alarms signals in the kitchen/dining/living room area alerting staff to location of open exterior door. Continued. Continued. Facility has 2 bathrooms. Both bathrooms appeared to be clean with no unpleasant odors. Fixtures operational. Grab bars in toilet & shower areas. Non-skid mat in roll-in showers. Hot water measured at 110 degrees F. Front/hallway bathroom (bath1) identified by L/A as the "staff" bathroom. Shower area used primarily by staff only, with toilet available to visitors, & occasionally by residents when toilet in bath2 is in use. Master bathroom (bath2) off of master bedroom identified by L/A as the "resident" bathroom. Majority of toileting & all showers done in this bathroom. Access to Bath2 is through master bedroom. Staff bedroom opposite bath1. Bedroom unlocked making contents accessible, including spray body mists, 2 bottles of room freshener liquid, eye drops, & acetone nail polish remover. Other personal items observed in clear box with locking mechanism making contents inaccessible to residents. Hazardous items made inaccessible @ time of visit. Baseboards throughout facility in need of dusting/cleaning. All ceiling fan body & blades in need of dusting - significant accumulation of dust/fuzz observed. Air filter cover also in need of dusting/cleaning. Air filter in need of replacement. Toilet paper roll holder in need of tube mechanism. Kitchen toured. Freezer side observed to be over-full to point of compromising circulation required. In door of refrigerator, an over half-full bottle of Pepto-Bismol observed accessible. Medication made inaccessible @ time of visit. Continued. Outside area toured. Access through sliding glass door off of dining/living room onto covered patio. Seating & table available. Backyard & side yards have rose buses. Both side yards have gates. Gate on "southwest" side of building is self-closing & self-latching. Front room egress opens directly onto this area. Other egress at back & on opposite side yard that has gate that is not self-closing & self-latching. Passageway to gate that is not self-closing/self-latching is clear & free of obstruction. This passageway is also cemented from back to front allowing steady surface for walking, walkers, & wheelchairs. "Southwest" side yard with access to gate that is self-closing/self-latching is obstructed with rose bushes & does not have a solid surface to walk on, leaving it to be muddy &/or difficult terrain to navigate with unsteady gait, walker, &/or wheelchair. Discarded mop/mop-like item observed on ground in back corner of backyard. Item removed @ time of visit. Outside yard, including front, maintained & free of any other debris. Medications observed to be locked. Smoke detectors tested& observed to be operational. Carbon monoxide detector operational. Fire extinguisher service date: 7/2/2024. Deficiencies issued. Exit interview conducted with L/A. Report provided.the state’s words, verbatim · CDSS document, Oct 28, 2024

Type of visit: Required - 1 Year

An unannounced Annual/year visit was conducted on the date & times indicated above by Licensing Program Analyst (LPA) K. Mcclurg. LPA met with Care Giver (CG)Theresa Cumlat, introduced self & asked if Licensee/Administrator (L/A) Davilyn Mancilla was on the premises. CG stated no, but would call L/A. LPA called L/A to notify them that LPA was @ facility & purpose of visit. L/A stated that they would come to facility. L/A joined LPA during this visit. LPA observed 4 of 5 residents in living room watching television. Residents appeared to be appropriately dressed & groomed. Facility toured. Dining & living rooms have required seating & lighting. Resident bedrooms toured. Bedrooms have furnishings & lighting. No unpleasant odors detected throughout facility. Observations of floors, counters, resident belongings indicating sufficient housekeeping.Fire extinguisher service date 7/14/2023. Annual visit to be continued at a later date due to time restrictions. Exit interview conducted with L/A. Report provided @ time of visit.the state’s words, verbatim · CDSS document, Nov 30, 2023