Mesa Board and Care

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Jose De La Cruz conducted an unannounced visit to conduct an annual inspection. The facility file was reviewed prior to the visit. LPA was welcomed by, identified themselves to, and discussed the purpose of the visit with Licensee Cecilia Mesa. The facility's license shows a maximum capacity of six elderly residents, ages 60 and above, two of whom might be non-ambulatory. LPA arrived at the facility at 1:00 PM. Per Licensee, the facility has not had residents in the past five months while they manage personal issues. LPA toured the facility, the interior and exterior and inspected five residents’ rooms. The facility had sufficient space and equipment to facilitate dining, laundry, visitation, meetings, and client activities. Per Licensee, no firearms or ammunition are kept at the facility. Carbon monoxide detectors, and facility telephone were all in working order. Fire extinguisher was recently bought within the last 12 months. First aid kit was complete and readily accessible. No deficiencies were cited by the California Code of Regulations. An exit interview was conducted with Licensee Cecilia Mesa, to whom a copy of this report, and the Licensee/Appeal Rights (LIC9058 03/22) were provided during today’s visit.the state’s words, verbatim · CDSS document, Aug 24, 2026

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Marisela Garcia-Centeno conducted an unannounced visit to complete the required one-year inspection. LPA was greeted by caregiver Melvin Mesa. LPA met with and discussed the purpose of the visit with Acting Administrator Mesa, Nora Liwag. All staff present have current criminal record clearances. The licensee has applied for an increase in capacity from two (2) non-ambulatory residents to four (4) non-ambulatory residents. The facility is licensed for a total capacity of six (6) residents, of whom four (4) may be non-ambulatory. As of today, there is one (1) resident in care. During today’s visit, LPA—accompanied by staff member Mesa—toured the interior and exterior of the facility and inspected each room. The facility was in good repair, clean, organized, and free from clutter. Bathrooms and the kitchen were clean and free of odors. Hallways were free of obstructions and slip hazards. No immediate safety risks were observed. Residents’ bedrooms contained the required furnishings. Doors, windows, screens, toilets, and showers were operational. Extra linens and hygiene supplies were available. The facility had sufficient space and equipment to accommodate dining, laundry, visitation, meetings, and resident activities. Food storage was compliant, with at least two (2) days of perishable food and seven (7) days of non-perishable food available. Cooking and dining equipment and utensils were present. There were no sharp objects, toxic chemicals, poisons, or open-faced heaters accessible to clients. Medications were labeled as required. (Continued at LIC809C) (continue from LIC809) No bodies of water were present on the premises. Staff stated that no firearms or ammunition are kept at the facility. Smoke alarms, carbon monoxide detectors, emergency lighting, and the facility telephone were operational. The fire extinguisher was serviced in February 2025. First aid kits were complete and accessible. Required licensing postings were displayed in visible areas. The room temperature was comfortable at 70°F. LPA interviews did not disclose any concerns. Files reviewed contained the required documentation. Confidential records were stored in locked areas. Hot water temperatures at taps accessible to clients met regulatory requirements. The kitchen sink reached 110°F. The licensee provided proof of current and active business liability insurance. No deficiencies were cited during today’s visit. An exit interview was conducted with staff member Mesa. A copy of this report and the Licensee/Appeal Rights (LIC 9058, 03/22) were provided during the visit.the state’s words, verbatim · CDSS document, Aug 12, 2025

Type of visit: Case Management - Deficiencies

Licensing Program Analyst (LPA) Marisela Garcia-Centeno conducted an unannounced plan of correction Visit. LPA was greeted by, Administrator, Cecilia Mesa to whom she identified herself and discussed the purpose of the visit. All staff present have a current criminal record clearance. During today’s visit, LPAs briefly toured the facility. LPA provided letter of deficiency citations cleared letters of 5/6/2024 and 5/10/2024. No deficiencies were cited during today’s visit. An exit interview was conducted with Administrator,Cecilia Mesa,to whom a copy of this report and the licensee/Appeal Rights (LIC9058 03/22) were provided during the visit.the state’s words, verbatim · CDSS document, Aug 12, 2024

Type of visit: Case Management - Deficiencies

Licensing Program Analyst (LPA), Marisela Garcia-Centeno, conducted a case management visit to cite deficiencies observed during an annual inspection visit on May 3, 2024. LPA was greeted by Caregiver, Melvin Mesa. LPA met with Administrator, Cecilia Mesa to whom she idenify herself and disclosed the purpose of the visit. On Friday, May 3, 2024, during an annual visit it was disclosed that a resident (R1) [an LIC 811 Confidential Names List was provided to staff to identify the resident] expired on February 6, 2024 after an unwitnessed fall incident. Licensee did not submit an Death Report LIC624A as required by Title 22 regulations. Per California Code of Regulations, Title 22. deficiencies were cited in an LIC 809D. An exit interview was conducted with Administrator, Cecilia Mesa to whom a copy of this report, LIC 809D, LIC811 Confidential Names list and Licensee's Rights (LIC 9058 03/22) were provided at the conclusion of the visit.the state’s words, verbatim · CDSS document, May 6, 2024

From the deficiency page — Deficiency type: Type B · Section cited: CCR 87811(a)(1)(A) · Plan of correction due date: May 10, 2024

87211(a)(1)(A) Reporting Requirements. (a) Each licensee shall furnish a written report to the licensing agency and to the person responsible for the resident within seven days of the occurrence of a death of any resident from any cause regardless of where the death occurred. This requirement was not met. Based on staff interviews and records review, the licensee did not report the death of a resident (R1). This posed a potential safety risk to 1 of 3 residents in carethe state’s words, verbatim · CDSS document, May 6, 2024

Plan of correction: Licensee agreed to submit an incident report along with death report for R1 by POC date. In addition, LIcensee agreed to conduct additional training on reporting requirements by a third party provider. LIcensee will submit supporting documentation of training conducted or scheduled by POC date 5/10/2024.

Type of visit: Case Management - Annual Continuation

Licensing Program Analyst (LPA) Marisela Garcia-Centeno conducted an unannounced visit to complete the Required 1-Year Visit from May 3, 2024. LPA was greeted by, Caregiver, Melvin Mesa. LPA met and discussed the purpose of the visit with the Administrator, Mesa. All staff present have a current criminal record clearance. Licensee applied for increased capacity from two (2) non-ambulatory residents to four (4) non-ambulatory residents. Fire Clearance was approved on June 23, 2022, for a total capacity of six (6) of whom four (4) may be non-ambulatory. As of today, there were two (2) residents in care of whom one (1) was non-ambulatory. LPA toured the facility and discussed with the Administrator regarding operation. On May 3, 2024, LPA, accompanied by Administrator, Mesa, toured the interior and exterior of the facility and inspected each room. The facility was in good repair. Some areas of the facility, bathrooms, and kitchen were observed with clutter, and the floors and area rugs were dirty. Some areas inside and outside the facility were observed with clutter, however, hallways were free of obstruction and slip hazards. No immediate safety risk was observed. Residents’ bedrooms contained the required furnishings. Doors, windows, screens, toilets, and showers were in working order. Extra linens and hygiene supplies were present. The facility had sufficient space and equipment to facilitate dining, laundry, visitation, meetings, and resident activities. There were at least 2 days of perishable food, and at least 7 days of non-perishable food present, all safely stored. The food sitting on the kitchen counter accessible to residents contained items with expiration dates dating back to 2021 and 2022. (Continue at LIC 809C) (continue from LIC809) The licensee discarded expired food during the visit. The refrigerator was observed with spoiled food in unmarked containers which were also discarded during the visit. It was observed that cooking/dining equipment and utensils were present. There were no sharp objects, toxic chemicals/poisons, or open-faced heaters accessible to clients. Medications were labeled, as required, however, the medication for one resident was not centrally located in the designated storage area. In addition, it was observed that old medication had not been discarded as required. The facility had no pools of water on the premises. Per staff, no firearms or ammunition are kept at the facility. Smoke alarms, carbon monoxide detectors, emergency lighting, and facility telephone were all working. The facility fire extinguisher was serviced in April 2024. First aid kit(s) were observed to be complete and accessible as required. Required licensing postings were observed in visible areas of the facility. The room temperature in the facility was comfortable at 70 degrees. LPA interviewed staff and residents and reviewed multiple staff and resident records/files. LPA interviews did not raise any licensing concerns. The files that LPA reviewed contained the required documents. However, the residents’ Physician’s Reports and the Appraisal/Needs and Services Plan were not updated as required by Title 22 regulations. Confidential records were stored in locked areas. During today’s visit, LPA observed via measurement with a thermometer device, that hot water temperature at taps accessible to clients complied with regulations. Water from the kitchen sink reached 110 F. The licensee did not have proof of current/active business liability insurance. Deficiencies were cited per California Code of Regulations, Title 22 (refer to the attached LIC 809-D pages). Plans of Correction were jointly developed with the licensee. An exit interview was conducted with Administrator, Cecilia Mesa, to whom a copy of this report, LIC 809D and LIC811 and the Licensee/Appeal Rights (LIC9058 03/22) were provided during the visit.the state’s words, verbatim · CDSS document, May 6, 2024

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Marisela Garcia-Centeno conducted an unannounced Required 1 - Year Visit. LPA was greeted by, Administrator, Cecilia Mesa to whom she identified herself and discussed the purpose of the visit. All staff present have a current criminal record clearance. During today’s visit, LPAs briefly toured the facility, reviewed staff and resident records, and interviewed staff and residents. No deficiencies were cited during today’s visit. Due to time constraints, a return visit on a subsequent day is needed to complete the annual inspection. An exit interview was conducted with Administrator,Cecilia Mesa,to whom a copy of this report and the licensee/Appeal Rights (LIC9058 03/22) were provided during the visit.the state’s words, verbatim · CDSS document, May 3, 2024