Margaret's Care Home

Type of visit: Required - 1 Year

On 10/07/2025, Licensing Program Analyst (LPA) Arielle Pascua arrived unanounced to this facility to conduct an annual visit. LPA was greeted by Facility Staff Member (SM), Romulado Gusto and explained the purpose of the visit. LPA Pascua asked SM Gusto to call the Facility Designated Administrator (FDA), Margaret Feril to inform them that CCL was present at this time. It was learned that FDA Feril would arrive within the next hour and could continue the visit until she arrives. This facility is licensed to serve 6 residents who are 60 and older. 1 out 6 residents may be non-ambulatory residing in the bedroom with a direct exit. 5 out 6 residents shall only be ambulatory. This facility also holds a dementia plan on file and a holds a hospice waiver for 3. Current census was 3. 1 out 3 residents were out at a medical appointment at this time. It was learned that there is currently one resident on hospice services at this time. A brief interview with SM Gusto was conducted. LPA conducted a record review of 3 resident files and 3 staff files. 3 out 3 resident files did not have a pre-admission assessment on file. 2 out 3 residents were identified as non-ambulatory based on physicians reports conducted. Administrator has a current administrator certificate #7020961740 and expires on 12/05/2025. A review of the facility medication and medication administrator records were conducted. LPA observed, reviewed, and compared medication to medication dispensing logs. First Aid Kit was present and contained all of the required components. Fire Extinguisher was in compliance and has been services by Resilient Fire Protection on 07/20/2025. A tour of the bathrooms was conducted. Hot water temperature was measured and observed to be within the required range of 105-120 degrees. A linen closet was located in the hallway and presented a sufficient amount of linens to adequately supply and meet the needs of the residents at this time. A tour of the bedrooms was conducted. Resident furniture was observed to be sufficient to meet their needs at this time. Common areas were toured. Living room, dining area and all other areas intended for resident use were observed to be furnished and maintained in compliance at this time. A tour of the garage was conducted. All cleaning supplies were locked and made inaccessible to residents at this time. The exterior of the physical plant was toured. Perimeter fence was observed to be stable and gates were in good repair. The following forms and documents were requested to be updated and submitted into CCL -LIC 308 -LIC 400 -LIC 500 -LIC 610 The following deficiencies were observed and cited on the following LIC 809-D pursuant to Title 22 Rules and Regulations, Health and Safety Code. Appeal rights were printed and a copy was given to the facility . Exit Interview.the state’s words, verbatim · CDSS document, Oct 7, 2025

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Jason Lund arrived unannounced to conduct a one year annual/required visit. LPA was greeted by staff and later by Administrator Margaret Feril. LPA Lund explained the reason for the visit. Census: 5 LPA Lund & Administrator Margaret Feril toured/inspected the bathrooms, hot water temperature was measured and observed to be within the required range of 105-120 degrees. A linen closet was located in the hallway and presented a sufficient number of linens to adequately supply and meet the needs of the residents at this time. A inspection of the bedrooms was conducted. Resident furniture was observed to be sufficient to meet their needs at this time. Common areas were inspected, living room, dining area and all other areas intended for resident use were observed to be furnished and maintained in compliance at this time. A inspection of the garage was conducted. Additional non-perishable food supplies were identified. All cleaning supplies were locked and made inaccessible to residents at this time. The exterior of the physical plant was inspected. Perimeter fence was observed to be stable, and gates were in good repair. Medication cabinet was identified in the kitchen. Along with the FDR Feril, LPA observed, reviewed, and compared medication to medication dispensing logs. First Aid Kit was present and contained all of the required components. Fire Extinguisher was in compliance and has been services by Hayden Fire Protection on 07/16/2024. LPA reviewed 3 resident files and 2 staff files was in compliance. No deficiencies were observed and cited on this visit. Exit interview and copy of report was given.the state’s words, verbatim · CDSS document, Oct 24, 2024

Type of visit: Required - 1 Year

On 10/09/2023, Licensing Program Analyst (LPA) Arielle Pascua arrived unannounced to conduct an annual visit. LPA was greeted by staff member, Antoinette Garcia, and explained the purpose of the visit. LPA Pascua asked that SM Garcia call the Facility Designated Administrator, Margaret Feril, to inform them that CCL was present. It was learned at this time that FDA Feril was unable to come to the facility at this time. Shortly after, LPA met with Facility Designated Representative, Ralph Feril and explained the purpose of this visit. There were no other staff members present at this time. Current census was 6. A brief interview with FDR Feril was conducted. This facility is licensed to serve 6 residents, 5 of which are ambulatory and 1 non-ambulatory. This facility has a dementia plan on file and has a hospice waiver for 3. It was learned that only the administrator and the representative have access to the facility files. LPA explained that facility records must be made available at all times to CCL staff. LPA reviewed 3 resident files and 3 staff files. Administrator has a current administrator certificate #6054358740 and expires on 12/05/2023. A medication cabinet was identified in the kitchen. Along with the FDR Feril, LPA observed, reviewed, and compared medication to medication dispensing logs. First Aid Kit was present and contained all of the required components. Fire Extinguisher was in compliance and has been services by Hayden Fire Protection on 07/13/2023. A tour of the bathrooms was conducted. Hot water temperature was measured and observed to be within the required range of 105-120 degrees. A linen closet was located in the hallway and presented a sufficient amount of linens to adequately supply and meet the needs of the residents at this time. A tour of the bedrooms was conducted. Resident furniture was observed to be sufficient to meet their needs at this time. Common areas were toured. Living room, dining area and all other areas intended for resident use were observed to be furnished and maintained in compliance at this time. A tour of the garage was conducted. Additional non-perishable food supplies were identified. All cleaning supplies were locked and made inaccessible to residents at this time. The exterior of the physical plant was toured. Perimeter fence was observed to be stable and gates were in good repair. The following forms and documents were requested to be updated and submitted into CCL -LIC 308 -LIC 400 -LIC 500 -LIC 610 The following deficiencies were observed and cited on the following LIC 809-D pursuant to Title 22 Rules and Regulations, Health and Safety Code. Appeal rights were printed and a copy was given to the facility . Exit Interview.the state’s words, verbatim · CDSS document, Oct 9, 2023

Type of visit: Case Management - Incident

On 10/09/2023, Licensing Program Analyst (LPA) Arielle Pascua arrived unannounced to this facility to conduct a case management visit. LPA met with Facility Designated Representative (FDR), Ralph Feril and explained the purpose of this visit. The purpose of this visit was in response to the annual visit conducted on 10/09/2023. It was learned during this visit that on 10/08/2023, R1 left the facility and walked down the street with Modesto Police Department at approximately 6:00pm. LPA obtained R1's physicians report and learned that R1 is allowed out of the facility without assistance. It was learned that the facility has not provided a Special Incident Report to the department as of this date. Based on interview and records review there were the following deficiencies that were cited during this case management visit. A copy of this report was provided to the facility and an exit interview was conducted.the state’s words, verbatim · CDSS document, Oct 9, 2023

From the deficiency page — Deficiency type: Type B · Section cited: CCR 87211(a)(1)(D) · Plan of correction due date: Oct 30, 2023

(D) Any incident which threatens the welfare, safety or health of any resident, such as psychological abuse of a resident by staff or other residents, or unexplained absence of any resident. This is not met as evidenced by: Based on interview and record review, the Licensee did not ensure that they have provided an incident report to the department after an incident that occured on 10/08/2023. This poses an potential health, safety, and personal rights risks to persons in care.the state’s words, verbatim · CDSS document, Oct 9, 2023

Plan of correction: Facility Administrator stated that a review of the section, 87211(a)(1)(D), will be conducted. A statement of correction, along with proof of staff training for no less than (1) hour in duration, for the cited section will be completed and submitted to the LPA's email at arielle.pascua@dss.ca.gov. by the due date of 10/30/2023 COB. Information submitted must include attendees, trainers, and information discussed.