Mountain View Residential Care for the Elderly

Type of visit: Required - 1 Year

On 7/3/2026, Licensing Program Analyst (LPA) Mia Lankford arrived unannounced to conduct an annual inspection. Upon arrival LPA was greeted by facility Caregiver Rose Marie and granted entry. LPA explained the reason for the visit and was granted entry.. The facility is a one story home with four (4) bedrooms and two (2) bathrooms with attached garage, and pool in the backyard. The facility does not have any firearms or ammunition on the premises. The clients served are elderly adults 65 years and older. LPA conducted a tour of the interior and exterior, reviewed facility documents and conducted a staff and resident interviews. LPA observed the following: Resident record review began-Five (5) client records were reviewed. LPA reviewed for admission agreement, medical assessment and TB test results, consent forms, identification and emergency information, appraisal needs and service plans, centrally stored medication/destruction records, safeguard for personal property/valuables, and personal rights notification. This facility is meeting documentation requirements. Physical Plant and Safety of Environment/Operational Requirements- LPA toured the facility inside and outside. The home is maintained at a comfortable temperature for the clients. Lighting is sufficient for safety and comfort. Water temperature measured 109.0 degrees F. Laundry facilities and a locked cabinet is present for storing laundry soap and other chemicals in the garage. All outdoor and indoor passageways are free of obstruction. A locked area is provided for medications and sharp objects. LPA verified there is a telephone working at this location. Cont.. Cont... Infection Control: The LPA observed the hand washing stations in the facility restrooms and kitchen had hand hygiene supplies and hand washing signs. LPA observed PPE equipment and cleaning supplies to do regular cleaning of the facility. LPA reviewed the facility's infection control plan which met department requirements. LPA reviewed staff records and found that all staff had infection control training. Food Service- Food supply meets the requirement of one week supply of nonperishable and 2 day supply of perishables food on hand. A menu is posted, foods are dated to assure safety. Food prep areas are clean and organized. A copy of this report was left with the caregiver Maria Rosario Dela Roma.the state’s words, verbatim · CDSS document, Jul 3, 2026

Allegation investigated: Facility is not meeting resident's medical needs.

On July 31, 2025, Licensing Program Analyst (LPA), Venus Mixson arrived at the facility unannounced and met with Licensee. LPA explained the reason for the visit was to provide findings for the complaint investigation. On November 14, 2022, Community Care Licensing received a complaint alleging Facility is not meeting resident's medical needs. During the investigation, LPA conducted interviews, record reviews, and made observations. LPA was not able to locate and interview R1 due to R1 passing away. Regarding the allegation facility is not meeting resident's medical needs, it was reported the facility prevented Resident #1 (R1) from obtaining an assessment to determine if a higher level of care was needed. Information obtained from an interview with Administrator denied the allegation. It was stated that R1 requested to be transported to the hospital and was done so immediately. The administrator indicated there was not a request for a need of higher level of care, and there was no information obtained requesting an assessment. Information obtained from interviews with additional staff indicated facility is meeting R1’s medical needs by following the doctors’ orders and making sure R1 attends all medical and dental appointments as required. Unsubstantiated LPA’s observations of record reviews revealed there was a hospital visit on November 11, 2022. No concerns or advisements were notated. LPA also reviewed weekly notes from the home health nurses attending to R1’s medical needs. A review of the records confirmed there was no documentation requesting assessment for a higher level of care, and R1 was not receiving Hospice Services while residing at the listed facility. Information obtained from interview with additional Witness advised there were no concerns with R1’s medical needs being met. It was stated R1 was receiving the care and services agreed to at the time of admissions. Based on interviews, record review, observations, and the inability to interview relevant Parties, the allegation Facility is not meeting resident's medical needs has been determined as Unsubstantiated. Although the allegation may have occurred there is not enough evidence to support the listed allegation. An exit interview was conducted, and a copy of this report was explained and given to Licensee, Elizabeth Pelayo.the state’s words, verbatim · CDSS document, Jul 31, 2025 · control 18-AS-20221114171517

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Yolanda Delgado arrived unannounced to conduct an annual inspection. Upon arrival LPA was greeted by facility Administrator and granted entry. LPA began inspection with introduction, visit purpose and provided the facility Administrator with LPA identification. Resident record review began- Five (5) records were reviewed. LPA reviewed for admission agreement, medical assessment and TB test results, consent forms, identification and emergency information, appraisal needs and service plans, centrally stored medication/destruction records, safeguard for personal property/valuables, and personal rights notification. This facility is meeting documentation requirements. Physical Plant and Safety of Environment/Operational Requirements- LPA toured the facility inside and outside. The home is maintained at a comfortable temperature for the clients. Lighting is sufficient for safety and comfort. Water temperature measured 109.0 degrees F. Laundry facilities and a locked cabinet is present for storing laundry soap and other chemicals in the garage. All outdoor and indoor passageways are free of obstruction. A locked area is provided for medications and sharp objects. LPA verified there is a telephone working at this location. Food Service- Food supply meets the requirement of one week supply of nonperishable and 2 day supply of perishables food on hand. A menu is posted, foods are dated to assure safety. Food prep areas are clean and organized. (Continued on next page) (Continued on from Page 1) LPA began review of employee records- Four (4) records were reviewed. LPA reviewed employee record for first aid certification, fingerprint clearance, personnel/job application, health screening and TB test results, criminal record statement, employee rights, training verification, and current administrator certification. CPR and requirements have been met. The facility employs enough staff to maintain cleanliness and meet the needs of the clients in care. Administrator certification is present and current. LPA made observation throughout the inspection process to assess if the facility remains in conformity with the State Fire Marshall regulations. The facility has not exceeded its capacity limitation and the structure remains unchanged according to the approved floor plan. Smoke detectors and carbon monoxide detectors were tested and found to be operational. Fire extinguishers are tested or replaced annually and were last done so on 06/03/2024. The facility is conducting emergency disaster drills. The last disaster drill was conducted on 06/24/2024. LPA allocated time to prepare this report for delivery. Based on the information received during this visit today, one (1) deficiency is being cited per Title 22, Division 6 of The California Code of Regulations. This report, LIC809D, Appeal Rights was reviewed with and a copy provided to the facility representative at the time of the exit interview.the state’s words, verbatim · CDSS document, Jul 24, 2024