Marcosa's Villa

Type of visit: Required - 1 Year

On August 20, 2024, Licensing Program Analyst (LPA) Deborah Lee conducted an unannounced annual required visit using the CARE Inspection Tool. LPA met with Licensee Rose Matute and explained the purpose of today’s visit. LPA was granted entry to this facility. The facility is licensed to operate for six (6) non-ambulatory elderly residents ages 60 and over. The facility has a hospice waiver approved for six (6). Structure This facility is a single-story residence located in a residential neighborhood. The home consists of five (5) bedrooms, four (4) bathrooms, kitchen, living room, laundry area and a dining room. The home has a detached garage and an outside shaded sitting area. Physical Plant LPA and Licensee toured the facility inside and outside. LPA observed that there were no bodies of water on the premises. All rooms were inspected. Beds and bedding supplies were in operational condition, lighting was provided, and storage for the resident's personal belongings was observed. Page 1 of 4 Bed linens, comforters, and bath towels were available during the visit. Bathrooms were operational. A comfortable temperature of 75 degrees F. was maintained in the facility Bedrooms LPA inspected all 5 bedrooms. All bedrooms were observed to have the required furniture including beds, dressers, nightstands with lamps, chairs, and ample storage space for personal belongings. All bedrooms were observed to be clean, in good repair, and have ample lighting. Bathrooms LPA inspected the facility bathrooms. In the resident’s bathroom the toilet, faucets, and shower were fully operational. All safety handrails were securely fastened. LPA observed the showers to be clean and free of mold or mildew. The shower had a nonskid material in bottom and shower chair. Resident’s toiletries are secured in a cabinet under the sink. The water temperature measured 111.7-degrees Fahrenheit. The Staff bathroom was observed to be clean. The toilet and faucets are operational. Both bathrooms were observed to be clean, in good repair and within Title 22 regulations. Linens & Hygiene LPA observed all beds to have the required linens including mattress cover, fitted sheets, blanket, comforter, and pillow. LPA observed an ample supply of linens, towels, and blankets in the hall closets. LPA observed incontinence care products stored in the resident’s closets and in the hall closet. Kitchen LPA inspected the kitchen and observed all appliances to be in good working repair, including stove/oven, microwave, dishwasher, washer, dryer, refrigerator, and additional freezer. LPA observed an ample supply of cutleries, pots, pans, and bowls to be in good repair. LPA observed knives and additional sharps to be secured in locked drawers in the kitchen and are inaccessible to residents. Page 2 of 4 LPA observed a 2-day supply of perishable foods and a 7-day supply of nonperishable foods. All food was properly stored and labeled. Cleaning products and toxins were secured in a locked in a closet in the laundry room inaccessible to residents. Common Rooms In the living room, LPA observed, ample seating for all residents. In the dining room, LPA observed a 6 seated rectangle table and chairs to accommodate all residents. LPA observed all walkways and hallways to be clear, clean, and free of obstructions and hazards. LPA observed ample lighting is all rooms. The facility is maintained at a comfortable temperature. Safety LPA observed and tested smoke/carbon monoxide detectors to be fully operable. LPA observed 2 fully charged fire extinguisher mounted on the wall, last serviced on 11/6/24. The last emergency drill was conducted on 4/15/25. LPA inspected the First Aid kit and found it contained an ample supply of required items and a manual. LPA observed the required posting in the facility. LPA observed all exits to be clear and easily accessible. Medications LPA observed all centrally stored medications in their original packaging and are secured in a locked cabinet in the kitchen area. Page 3 of 4 Files LPA reviewed 5 resident files and found 5 out of 5 contained all the necessary documentation. LPA reviewed 3 staff files and found 3 out of 3 contained the required documentation, certification, and training. Liability Insurance, Liability Insurance expiration date 9/20/25. Infection Control During the visit, LPA observed the facility’s infection control practices. LPA observed a sanitizing station at the facility entrance; visitors log with PPE supplies are readily available to staff, and an additional 30-day supply of PPE was observed. Sufficient paper towels, cleaning, and disinfecting supplies were observed. LPA observed required postings throughout the facility. LPA did not observe any deficiencies during the time of visit. An exit interview was conducted with Rose Matute, Licensee and a copy of this report was provided. Page 4 of 4the state’s words, verbatim · CDSS document, Aug 20, 2025

Type of visit: Case Management - Annual Continuation

On August 23, 2024 Licensing Program Analyst (LPA) conducted unannounced Case Management-Annual Continuation for the purpose of completing the Annual required inspection started on August 22, 2024. LPA met with Rosita Matute, Licensee and explained purpose of today's visit. During this visit, LPA reviewed six (6) staff files. Six (6) out of six (6) files met licensing requirements. All staff were During this visit LPA reviewed six (6) Residents files. Six (6) out of six (6) files met licensing requirements. No deficiencies are being cited. An exit interview was conducted. A copy of this report was provided to Rosita Matute, Licensee.the state’s words, verbatim · CDSS document, Aug 23, 2024

Type of visit: Required - 1 Year

On August 22, 2024, Licensing Program Analyst (LPA) Deborah Lee and Licensing Program Manager Eva Alvarez conducted an unannounced annual required visit using the CARE Inspection Tool. LPA met with Licensee Rose Matute and explained the purpose of today’s visit. LPA was granted entry to this facility. The facility is licensed to operate for six (6) non-ambulatory elderly residents ages 60 and over. The facility has a hospice waiver approved for six (6). This facility is a single-story residence located in a residential neighborhood. The home consists of five (5) bedrooms, four (4) bathrooms, kitchen, living room, laundry area and a dining room. The home has a detached garage and an outside shaded sitting area. LPA toured the physical plant with Licensee Rose Matute. All rooms were inspected. Beds and bedding supplies were in good condition, adequate lighting was provided, and storage for resident personal belongings was observed. Bed linens, comforters, and bath towels were adequately stocked at the time of the visit. The bathrooms were found to be within Title 22 regulation. Water temperature properly measured 110 degrees F. A comfortable temperature was maintained in the facility. LPA observed the facility to be furnished at the time of the visit. Storage areas for personal hygiene were stored and not accessible to residents. The kitchen was inspected and there is sufficient supply of perishable and non-perishable food available and maintained properly. Two fire extinguishers were fully charged. Smoke detectors and carbon monoxide were tested and operable. First aid kit was checked an in order with manual. Toxins and sharps were locked and inaccessible to clients. Outside grounds were toured and no bodies of water were observed. Shaded patio furniture was accessible. Exits and walkways around the home were free of debris and hazards. Facility has a working telephone landline. A review of Medication Administration Records and Fire Drill are maintained and in order. The last fire drill was conducted on 8/2/2024. Due to time constraints LPA was unable to complete this annual visit and willreturn in the near future. No citation was issued today and copy of this report was provided to the licensee Rosita Matute.the state’s words, verbatim · CDSS document, Aug 22, 2024

Type of visit: Required - 1 Year

On 12/14/23, Licensing Program Analyst (LPA) Elvira Gonzalez conducted an unannounced annual required visit using the CARE Inspection Tool. LPA met with Administrator Rose Matute and explained the purpose of today’s visit. LPA was granted entry to this facility. The facility is licensed to operate for six (6) non-ambulatory elderly residents ages 60 and over. The facility has a hospice waiver approved for six (6). This facility is a single-story residence located in a residential neighborhood. The home consists of five (5) bedrooms, four (4) bathrooms, kitchen, living room, laundry area and a dining room. The home has a detached garage and an outside shaded sitting area. LPA toured the physical plant with Administrator Rose Matute. All rooms were inspected. Beds and bedding supplies were in good condition, adequate lighting was provided, and storage for resident personal belongings was observed. Bed linens, comforters, and bath towels were adequately stocked at the time of the visit. The bathrooms were found to be within Title 22 regulation. Water temperature properly measured between 105F-120F. A comfortable temperature was maintained in the facility. LPA observed the facility to be furnished at the time of the visit. Storage areas for personal hygiene were stored and not accessible to residents. The kitchen was inspected and there is sufficient perishable and non-perishable food available maintained properly. Two fire extinguishers were fully charged. Smoke detectors and carbon monoxide were operable. First aid kit was checked an in order with manual. Toxins and sharps were locked and inaccessible to clients. Outside grounds were toured and no bodies of water were observed. Shaded patio furniture was accessible. Exits and walkways around the home were free of debris and hazards. Facility has a working telephone landline. A review of Medication Administration Records and Fire Drill are maintained and in order. The last fire drill was conducted on 10/01/23. During the visit, LPA observed the facility infection control practices. LPA observed screening protocols for visitors, staff and residents, sanitizing stations (Located in common areas and restrooms). LPA observed the facility has a 30-day supply of Personal Protective Equipment (PPE). No deficiencies were cited at the time of this visit. An exit interview was conducted, and a copy of this report along with appeal rights was provided to Administrator Rose Matute.the state’s words, verbatim · CDSS document, Dec 14, 2023