Mountain View Cottages-VI

Type of visit: POC

Licensing Program Analysts (LPAs) LaVette Farlow and Michelle Echeverria conducted an unannounced Plan of Correction (POC) visit for deficiency cited for 87555(b)(26) on form LIC9099-D issued on 1/28/2026. During this visit, LPA inspected the physical plant and non-perishable and perishable food supply. LPAs observed that Staff 1 (S1) preparing lunch for residents in care. LPAs conducted staff interviews and explained the importance of maintaining the regulation of food supply for residents in care. Cleared POC letter and LIC809 was issued during today's visit. This report was reviewed with, and a copy was provided to Norma Martinez.the state’s words, verbatim · CDSS document, Feb 5, 2026

Type of visit: Required - 1 Year

Licensing Program Analysts (LPAs) LaVette Farlow and Renese Howell-Small made an unannounced visit to the facility. The purpose of the visit was to conduct a required comprehensive annual inspection. LPAs met with caregiver Bernard Carpio and was granted entry to the facility. Caregiver Bernard notified Licensee of our arrival. Licensed capacity is (6) current census (3) with one of the three resident in the hospital and two (2) residents at the Day Program. The facility is vendorized by Inland Regional Center, Level 4I. LPAs were accompanied by Caregiver Bernard and Administrator Trupti Mody to conduct a general overall inspection, which included, but was not limited to, the following: Physical Plant: The facility is operating in the capacity approved by Community Care Licensing (CCLD). There are no obstructions to indoor and outdoor passageways. The facility is maintained at a comfortable temperature. LPAs inspected resident bedrooms; they are equipped with required furniture such as: mattresses, night stands, storage space, and sufficient lighting; bathrooms were clean, and appliances were operating appropriately. LPAs notice one (1) restroom did not have a slip resistant mat in the shower area. A technical advisory issued. LPAs observed sufficient furniture and lighting throughout the facility. The facility is equipped with operating smoke detectors and carbon monoxide alarms. Posters such as personal rights, the CCLD complaint poster were posted in a common area. LPAs observed the Licensee had the LIC 610E (Emergency Disaster Plan) but the Licensee did not review and update the report since 2019. A Technical violation issued. Cleaning supplies, toxins, sharps, and other dangerous items were kept inaccessible to residents in care. There was a designated space for residents/staff files. Overall, the facility is clean, in good repair, and operating in safe conditions for residents in care. ***Continued on LIC809C*** Food Service: Non-perishable and perishable food supply were low and not sufficient for number of residents in care. A deficiency was cited. Dishes, cups, and utensils were also stored properly. Care & Supervision: Facility has sufficient care staff for coverage 24 hours a day, 7 days a week. Record Review: LPAs reviewed (2) resident files for admission agreements, updated physician reports, and needs and services plans. LPAs audited 2 out of 2 resident P&I funds and observed the Licensee did not have the P&I funds available to audit. A deficiency cited. LPAs reviewed (2) resident medications. 1 out of 2 residents medication(s) and MARs did not match the record and medication storage. Licensee called the pharmacy during the visit to place the refill. A Deficiency cited. At the moment, the facility did not have Hospice residents. LPAs also reviewed (4) staff files for First Aid/CPR certification, criminal record clearance, training's, CPI and health screenings. The personnel file appeared to be maintained. LPAs review the facility first aid kit and LPAs observed the Licensee did not have scissors for the first aid kit. A technical advisory issued. Based on the observations made during today’s visit, three (3) deficiencies and (3) technical violation or technical advisory were cited per Title 22, Division 6, of the California Code of Regulations. An exit interview was conducted, and this report LIC809, LIC809C, LIC809D, LIC9102TV, and LIC9102TA were discussed and provided to Administrator, Trupti Mody.the state’s words, verbatim · CDSS document, Jan 28, 2026

The state marks this report as 8 pages; the online copy we transcribed has 5. You can request the full file from the county licensing office.

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Mary Rico made an unannounced visit to the facility. The purpose of the visit was to conduct a required comprehensive annual inspection. LPA met with caregiver Bernado Carpio and was granted entry to the facility. Licensed capacity is (6) current census (3). The facility is vendorize by Inland Regional Center Level 4I. LPA was accompanied by Administrator Trupti Mody to conduct a general overall inspection, which included, but was not limited to, the following: Physical Plant: The facility is operating in the capacity approved by Community Care Licensing (CCL). There are no obstructions to indoor and outdoor passageways. The facility is maintained at a comfortable temperature. LPA inspected resident bedrooms; they are equipped with required furniture such as: mattresses, night stands, storage space, and sufficient lighting; bathrooms were clean, and appliances were operating appropriately. LPA observed sufficient furniture and lighting throughout the facility. The facility is equipped with operating smoke detectors and carbon monoxide alarms. Posters such as personal rights, the CCL complaint poster, and the disaster plan were posted in a common area. Cleaning supplies, toxins, sharps, and other dangerous items were kept inaccessible to residents in care. There was a designated space for residents/staff files. Overall, the facility is clean, in good repair, and operating in safe conditions for residents in care. Food Service: Non-perishable and perishable food supply is sufficient for number of residents in care. Facility has a variety of food available for residents. Dishes, cups, and utensils were also stored properly. Care & Supervision: Facility has sufficient care staff for coverage 24 hours a day, 7 days a week.Record Review: LPA reviewed (3) resident files for admission agreements, updated physician reports, and needs and services plans. LPA reviewed (3) resident medications. At the moment, the facility did not have Hospice residents. LPA also reviewed (2) staff files for First Aid/CPR certification, criminal record clearance, training's, and health screenings. Based on the observations made during today’s visit, no deficiencies were cited per Title 22, Division 6, of the California Code of Regulations. An exit interview was conducted, and this report (LIC809) was discussed and provided to Administrator Trupti Mody.the state’s words, verbatim · CDSS document, Feb 26, 2025

Type of visit: Required - 1 Year

Licensing Program Analyst, Amber Coleman, (LPA) arrived at the Mountain View Cottages - VI unannounced to conduct an Annual Inspection. LPA knocked on the door and was greeted by Caregiver, Mijo Suzuki. LPA introduced self and stated purpose of the visit. LPA was granted entry and signed in. LPA was informed that the current census is 1. Other residents in care had been picked up and taken to their day programs. LPA was provided a place to work then accompanied by Staff on a walk through of the facility. The facility is comprised of, six (6) Bedrooms, 2 Bathrooms, Living Room, Den, Office Space, Kitchen, Backyard and attached garage. The facility is a Residential Care Facility Elderly. The facility also maintains partnership with the Inland Regional Center at Level 4I. Facility is approved for 6 non-ambulatory, 1 bedridden and Hospice Waiver approval for 2 residents. The facility is operating in the capacity approved by Community Care Licensing (CCL). Physical Plant: The facility is maintained in comfortable temperature. Sufficient lighting was provided throughout the facility by various lamps, light fixtures and night-lights. Pathways were free of obstruction and clutter. Smoke detectors and carbon monoxide alarms were observed throughout the facility. They were tested and found operational. A fully charged fire extinguisher was located in the kitchen; last inspection date February 2024. Resident rooms all contained adequate furniture such as: beds with required linens, adequate storage space, seating and sufficient lighting. At approximately 10:40 am LPA observed a yellow colored bottle of pledge sitting unattended in a Resident Room. Staff secured the bottle of pledge upon observation. Extra linens and hygiene supplies were stored in a hallway closet. The hallway lead to the facility's laundry room and attached garage. LPA observed that the garage door was secure. Laundry room also contained secure cabinetry for laundry supplies. Please see LIC809-C Bathrooms contained operational appliances, handrails, non-slip materials and adequate paper supplies. Both dining rooms, den and living rooms provide adequate seating for residents, guests and visitors. Activity materials were observed in each common space. Food Service: LPA observed the facility kitchen, which contained operable appliances and sufficient dishware, cups, and utensils for residents in care. The facility food supply was observed to have sufficient amounts of both non-perishable and perishable foods. Inside the facility refrigerator. LPA observed fresh fruit and vegetables, beverages, milk, breads, cheese, frozen meats and meals. Chemicals and Sharp objects were observed in secure locations inaccessible to residents in care. Water temperature was tested in the kitchen and measured between 100 and 104 degrees. Emergency supply of food, water, additional PPE, and supplies were observed in the attached garage. Adjacent to the kitchen stands a secure cabinet for Resident Medications and files. Signs and Posters: LPA observed the following posters in prominent places throughout the facility. Posters such as: Long Term Care Ombudsman, Resident Council, Resident Rights, House Rules, Facility Sketch/Evacuation Plan, Labor Laws, SEE/SAY, Food Menu, Activities Calendar, Infection Control and Facility License. Record Review: LPA reviewed resident files for Admission's Agreements, Appraisals, Needs and Services, IPPs and Physician's Report. LPA requested staff records/files. Administrator arrived shortly after request to provide LPA with staff records. Staff records reviewed contained current Health Screenings, Personnel Records, Criminal Background, Fingerprints, CPR/1st Aid and annual required training. Based on observations, interviews and record reviews no deficiencies will be cited per Title 22, California Code of Regulations. A technical violation will be issued to address an above mentioned concern. An exit interview was conducted where this report was reviewed, discussed, then provided to Facility Representative.the state’s words, verbatim · CDSS document, Feb 20, 2024

The state marks this report as 4 pages; the online copy we transcribed has 2. You can request the full file from the county licensing office.