Magdalene Residential Care

Type of visit: Required - 1 Year

On 7/31/2026, the Licensing Program Analyst (LPA) Grace Donato arrived unannounced at the facility to conduct a Required 1-Year Annual inspection. The LPA met with the Administrator/Licensee, Fe Literato-Hilario, and explained the purpose of the visit. LPA toured the facility inside and outside including all of resident rooms, kitchen area and backyard. LPA observed a shed at the back of the facility used for storage. While touring the facility it was observed that the room temperature was at 70 deg F. Water was tested at 106 degF. The facility is observed to be clean, odorless, and well maintained. Residents bedrooms were observed to be well organized and fully furnished with adequate lighting. Sharps and toxic materials were observed locked. Food supply in was observed with an adequate two day perishable and seven day non-perishable food supply. Carbon monoxide/smoke detectors, and fire extinguisher were present throughout the facility. Facility has an updated log for emergency drill is done every quarter. Five resident records and three staff records were reviewed. Centrally stored medication was locked and inaccessible by residents. All medication was labeled and sorted by resident name. All medication logs are complete and updated. No citations issued today. Report is reviewed and copy is provided.the state’s words, verbatim · CDSS document, Jul 31, 2026

Type of visit: POC

On 08/04/2025, Licensing Program Analyst (LPA) Kiran Jain arrived at the facility to conduct a Plan of Correction (POC) visit. Upon arrival, LPA met with the Licensee, Fe Hilario and disclosed the purpose of the visit. The Licensee informed the LPA that there were five (5) residents in care and three (3) staff members present at the time. The Licensee accompanied the LPA during the inspection. On 07/08/2025, the LPA conducted a Required 1-Year Annual inspection at the facility. During the inspection, LPA observed a bedridden resident (R1) in shared room #2. R1 was not on hospice. Room #2 did not have an approved fire clearance for a bedridden resident. Only room #4 had an approved fire clearance for a bedridden resident. LPA observed that resident (R3) used a Foley catheter, but there was no restricted health condition exception applied for or granted for the catheter use. As a result, two (2) deficiencies were issued under regulation 87202 Fire Clearance (a) All facilities shall maintain a fire clearance approved by the city, county, or city and county fire department or district providing fire protection services, or the State Fire Marshal. Prior to accepting or retaining any of the following types of persons, the applicant or licensee shall notify the licensing agency and obtain an appropriate fire clearance approved by the city, county, or city and county fire department or district providing fire protection services, or the State Fire Marshal: (2) Bedridden persons and 87616 Exceptions for Health Conditions (a) As specified in Section 87209…the licensee may submit a written exception request if he/she agrees that the resident has a prohibited and/or restrictive health condition. The plan of corrections (POC) were developed with the Licensee. On 07/17/2025, the Licensee applied for a Suprapubic Catheter exception for R3 and 07/31/2025, the exception was approved by the department. Continued on LIC809-C On 07/09/2025, the Licensee submitted a request for shared room #2 to be inspected for the bedridden fire clearance. On 07/11/2025, a fire clearance inspection request was submitted to the Sunnyvale Fire Prevention Services with a request to inspect shared room #2 for the bedridden fire clearance. On 07/17/2025, a fire clearance inspection was conducted and the requested fire clearance was denied with the reason: Bedroom 2 unsuitable for bedridden residents due to lack of direct exit. The facility was also informed fire sprinkler system would be required if there are more than one (1) bedridden resident. Today (08/04/2025), the LPA inspected Bedroom #2, #4, and #7 and observed that Resident (R1) have been moved to bedroom #4 and the resident (R5) from room #4 was transferred to room #7. The previous resident (R2), who was on hospice and lived in room #7, passed away on 7/14/2025. The previous bed used by R1 was observed to be empty in the shared room #2. The deficiencies for 87202 Fire Clearance and 87616 Exceptions for Health Conditions are corrected and are cleared. No deficiencies were cited during today's visit. An exit interview was conducted with the Licensee. A copy of this report was provided to the Licensee, Fe Hilario, whose signature on this form confirms receipt of the report.the state’s words, verbatim · CDSS document, Aug 4, 2025

Type of visit: Required - 1 Year

On July 08, 2025, the Licensing Program Analyst (LPA) Kiran Jain arrived unannounced at the facility to conduct a Required 1-Year Annual inspection. The LPA met with the caregiver, Elsa Lopez, and disclosed the purpose of the inspection. The caregiver informed the LPA that the facility had five (5) residents in care and three (3) staff members present at the time. At 8:45 AM, the LPA initiated a walk-through of the facility, accompanied by the caregiver. LPA inspected the kitchen and found it clean, with breakfast preparation and cooking in progress at the time. The appliances were checked and observed to be in working order. LPA inspected a locked cabinet containing knives and sharp objects, and a locked cabinet under the sink that stored detergents and cleaning supplies. The refrigerator and pantry cabinets were inspected, and sufficient supplies of fresh perishable food for two (2) days and nonperishable staples for seven (7) days were observed. No expired food or stored medications were noted. LPA inspected the dining area adjacent to the kitchen and found it clean. The dining table and chairs were observed to accommodate the residents, and all the furniture was in good repair. The LPA observed two (2) residents eating breakfast at the dining table. LPA inspected the living room and observed it to be clean, with all furniture in good repair. There were sofas, a recliner chair, and a television in the living room. LPA observed one (1) resident watching TV in the living room. LPA inspected the fire extinguisher mounted on the wall in the living room and found it fully charged, with the last service tag dated 08/05/2024. The caregiver tested the smoke and carbon monoxide detector located in the hallway in LPA’s presence, and it was found to be functional. Continued on LIC809-C Additional smoke detectors were observed in all bedrooms and common areas of the facility during the visit. There were five (5) bedrooms and three (3) bathrooms designated for residents’ use. Four (4) rooms were single occupancy and one (1) room (#2) was a shared occupancy. At 9:10 AM, LPA inspected all five (5) resident rooms and found them clean, well-lit, and equipped with the required furniture. LPA observed a bedridden resident (R1) in shared room #2. R1 was not on hospice. Room #2 did not have an approved fire clearance for a bedridden resident. Only room #4 had an approved fire clearance for a bedridden resident. LPA observed that R3 used a Foley catheter, but there was no restricted health condition exception applied for or granted for the catheter use. LPA inspected three (3) full bathrooms and found them clean, sanitary, and in good working condition. The bathrooms contained soap, grab bars, paper towels, a trash can, a shower chair, and non-slip mats. The hot water temperature at the sink faucet measured 115.3°F in bathroom #1 and 115.8°F in bathroom #2. LPA inspected the two (2) storage closets in the hallway and observed that they contained clean linens, blankets, and towels for residents’ use. LPA inspected the garage. A washer, a dryer, and closets containing incontinence supplies, cleaning solutions, and paper products were observed. LPA toured the backyard area and found ramps and passageways in good condition, clear of obstructions, with no blocking or tripping hazards. No bodies of water were noted. LPA inspected two (2) storage sheds and observed wheelchairs, furniture items, bedframes, mattresses, outdoor furniture, outdoor heaters, and suitcases stored in the sheds. LPA reviewed six (6) staff personnel records and five (5) resident records. LPA observed that five (5) of five (5) residents had an Admission Agreement, Physician's Report, Appraisal/Needs and Services Plan, and CSDMR. LPA observed that six (6) of six (6) staff members had current First Aid certificates, LIC 508 Criminal Record Statements, and LIC 503 Health Screenings, and confirmed that five (5) of five (5) staff members were associated with the facility. LPA observed a locked centrally stored medication cabinet located in the dining area. Medications were organized separately for each resident. All medication bottles and bubble packs were properly labeled. Centrally Stored Medication Records were reviewed and found to be complete. Continued on LIC809-C LPA inspected the first aid kit and found it fully stocked. Emergency Drill Logs were reviewed, and it was observed that Emergency Disaster Drills were conducted quarterly, with the most recent drill completed on 06/07/2025. The following updated forms are requested to be submitted to CCLD by 07/15/2025: LIC 500: Personnel Report LIC 308: Designation of Facility Responsibility LIC 999: Updated Facility Sketch Certificate of Liability Insurance Administrator Certificate(s) Current Property Lease Agreement The deficiencies are being cited based on LPA observations, records reviewed, and interviews conducted in accordance with the California Code of Regulations, Title 22, see LIC809D. An exit interview was conducted, and Plans of Correction were reviewed and developed with the caregiver. A copy of this report and appeal rights were discussed and left with the caregiver, Elsa Lopez, whose signature on this form confirms receipt of these documents.the state’s words, verbatim · CDSS document, Jul 8, 2025

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Simi Rai conducted an unannounced Required 1 Year visit and met with Lead Staff, Ellenelsa Lopez and stated the purpose of today's visit. LPA Rai spoke with Administrator, Fe Literato-Hilario and stated the purpose of today's visit. LPA Rai observed 3 staff and 6 residents at the facility. All 3 of 3 staff were criminal record cleared and associated to the facility. During visit, LPA Rai toured the inside and outside of the facility. LPA Rai observed required posters hanging on the walls of the facility, near the front door and living room. When touring the outside area of the facility, the exits were cleared of obstruction. LPA Rai observed 4 storage sheds that was not used as habitual space. LPA Rai observed the fence shared with the facility on the right side facing the facility from the main street was being replaced and Lead Staff stated they supervise residents when using the backyard. LPA Rai toured the facility kitchen and observed food supply of at least 2 days of perishable food and at least 7 days of nonperishable food. Sharps and medications were locked in secured areas. LPA observed additional food supply areas and secured areas for cleaning supplies and laundry detergents. LPA Rai toured the facility bedrooms. 5 out of 9 bedrooms are being occupied by residents. Rooms had available bedding, drawers, and functioning lights. 4 Out of 9 bedrooms are being occupied by staff who are criminal record cleared and associated to the facility. The facility bathroom had available soap, paper towels, and trash cans with lids. The water temperature in the bathroom sinks ranged from 112.5 degrees F - 114.5 degrees F. The water temperature in the kitchen sink was 108.1 degrees F. Continuation on LIC 809-C, Page 1 of 2. Page 2 of 2. Fire extinguisher was observed and inspected on 10/01/2022 and ADM provided receipt for fire inspection renewal on 05/19/2024. Facility smoke detectors and carbon monoxide detectors were in working condition. The last disaster drill was conducted on 06/03/2024. LPA Rai reviewed facility records for 3 staff and 3 residents. Based on review staff (S1)'s file, S1's first aid was expired and did not have updated first aid training. LPA Rai reviewed resident medications and central stored medication records. Based on review of 1 resident (R2), Centrally Stored Medication Record/Log, 1 centrally stored prescription medication was not logged on the document. Based on review of resident R2 and R4's file, 2 out of 2 resident records did not have a written order from a physician indicating the need for the postural support, such has the half-bed rail for mobility. Deficiencies were cited per California Code of Regulations, Title 22, please see LIC 809-D. Technical Assistance was provided. This report was reviewed with Lead Staff, Ellenelsa Lopez and LPA Rai reviewed this report with Administrator, Fe Literato-Hilario over the phone. Administrator verbally agreed and understood. A copy of the report was provided and Appeal Rights were provided.the state’s words, verbatim · CDSS document, Jul 30, 2024

The state marks this report as 5 pages; the online copy we transcribed has 4. You can request the full file from the county licensing office.