Napa-Sonoma Quality Care Home

Type of visit: Case Management - Annual Continuation

Licensing Program Analyst (LPA) Alviso, conduct a continued annual inspection, on 10/1/25 at about 2:20pm, and met with Administrator Ryanne Tapnio. LPA observed a caregiver, Mielo, on shift upon LPA's arrival. Annual inspection began on 9/17/25, see LIC809/809D of that date. Six (6) residents are in care. LPA will be reviewing facility records during today's inspection. Facility has a required infection control plan. Facility has a required emergency disaster plan. Facility has an approved hospice waiver for two (2) residents. There is an approved plan of dementia care. Fire clearance is approved for six (6) non-ambulatory, of which one may be bedridden. LPA reviewed six (6) resident files. All files are complete. LPA reviewed three (3) staff files. All staff have first aid certification and CPR certification as required. LPA reviewed annual training. No deficiencies cited during today's inspection. LPA conducted exit interview with Administrator Ryanne Tapnio.the state’s words, verbatim · CDSS document, Oct 1, 2025

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Alviso, conduct a Required- 1 Year inspection, on 9/17/25 at about 1:50pm, and met with Administrator Ryanne Tapnio. LPA observed a caregiver,Mielo, on shift upon LPA's arrival. Five residents are in care, and one resident is currently hospitalized. Facility has a required infection control plan. Facility has a required emergency disaster plan. Facility has an approved hospice waiver for two (2) residents. There is an approved plan of dementia care. Fire clearance is approved for six (6) non-ambulatory, of which one may be bedridden. LPA is requesting the following documents be updated and submitted by 10/17/25 LIC308 - Designation of Administrator Responsibility LIC500 - Personnel Report LIC610E 9-pages-Emergency Disaster Plan (review and update as needed/required) Submit if any changes. Infection Control Plan- (review and update as needed/required) Submit if any changes. Copy of LIC400 Handling of Client Cash Resources -complete & submit (required form) Copy of Surety Bond- if handling cash Copy of Current Liability Insurance Resident Roster Copy of Administrator Certificate LPA and Administrator toured the facility. The LPA observed the following: All exits were free and clear of obstruction. Hot water was measured at 109.4 degrees Fahrenheit, which is within regulation. Continued on LIC809C... Sufficient supply of linens, cleaners/disinfectants, PPE supplies, and sufficient supply of paper products. Sufficient supply of food for residents in care. Sufficient furnishings for residents use. Sufficient lighting in facility common areas, bathrooms, and resident rooms. Cleaners/disinfectants were locked up and inaccessible to residents in care. Fire extinguishers, two (2) were serviced and tagged as required. Backyard has a large covered deck and the pathway from the ramp to the fire gate is free and clear of any obstructions. The fire gate opened freely. LPA will continue the annual inspection at a later date. LPA will review files of residents and staff, facility records, and staff training. LPA observed the following deficiencies. LPA obtained photos. LPA observed the medication cabinet had the lock on it, and it had the key inserted and hanging in the lock. Resident medications were stored in this cabinet, and all medications were not secure and inaccessible to residents in care. Deficiency cited, 87465(h)(2) Incidental Medical and Dental Care, see LIC809D. LPA observed that in a drawer in the kitchen were pre-poured medications, pm medications, for residents in care. Regulation does not allow for pre-poured medications, facility is not in compliance. Deficiency cited, 87465(h)(5) Incidental Medical and Dental Care, see LIC809D. LPA observed food not stored appropriately during the inspection; Food leftovers, cold soup in a small pot on the stove, two plates of food sitting in a cold counter-top oven, and leftover cold rice sitting in a rice cooker on the counter. Three small fruit plates uncovered on a shelf in the refrigerator, and a small uncovered bowl of sliced apple that had turned brown in the refrigerator. LPA observed that food is not being stored appropriately in order to prevent them from potential contamination. Deficiency cited, General Food Service Requirements 87555(b)(9)-see LIC809D. LPA observed the freezer in the garage to be dirty inside, with food stains, food crumbs, and in need of a deep cleaning. Deficiency will be cited, General Food Service Requirements 87555(b)(21), see LIC809D. Deficiencies cited from the California Code of Regulations, Title 22, Division 6 of California Regulation. Failure to correct the deficiency and/or repeat deficiencies within a 12 month period may result in civil penalties. Exit interview conducted with Administrator Ryanne Tapnio. Appeal rights provided to the Administrator.the state’s words, verbatim · CDSS document, Sep 17, 2025

Type of visit: Case Management - Annual Continuation

Licensing Program Analyst (LPA) Alviso conduct a continued annual inspection, and met with Licensee/Administrator Ryanne Tapnio. Annual was started on 11/5/24. Facility has a required infection control plan. Facility has a required emergency disaster plan. Facility has an approved hospice waiver for two (2) residents. There is an approved plan of dementia care. Fire clearance is approved for six (6) non-ambulatory, of which one may be bedridden. Per facility record reviews, emergency disaster drills are being conducted as required. Facility was observed by the LPA to be clean and orderly during the inspection. Food supply was sufficient. Medications were locked and inaccessible to residents in care. Cleaners and disinfectants were locked and inaccessible to residents in care. Sufficient supply of paper products, linens, furnishings, and personal protective equipment (PPE). Facility has a carbon monoxide detector and required smoke alarms. All exits were free and clear of obstruction. All common areas, hallways, bathrooms, and resident rooms had sufficient lighting for residents in care. Facility was at a comfortable temperature. LPA reviewed five (5) resident files, including medications/medication records. LPA reviewed three (3) staff files, including staff required training. LPA is requesting the following documents be updated and submitted by 1/4/2025: LIC308 - Designation of Administrator Responsibility LIC500 - Personnel Report LIC610E-Emergency Disaster Plan (ensure to review and update as needed/required) Infection Control Plan (ensure to review and update as needed/required) Copy of LIC400 Handling of Client Cash Resources (include copy of surety bond if handling cash) Copy of Current Liability Insurance Resident Roster Copy of current Administrator Certificate There were no deficiencies cited during today's inspection. Exit interview held with the Administrator.the state’s words, verbatim · CDSS document, Dec 4, 2024

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Alviso, conduct a Required- 1 Year inspection and met with caregiver Rhodora Parino. Caregiver contacted Administrator Ryanne Tapnio to notify them of LPA's arrival to the facility. Administrator arrived to meet with the LPA. Facility has a required infection control plan. Facility has a required emergency disaster plan. Facility has an approved hospice waiver for two (2) residents. There is an approved plan of dementia care. Fire clearance is approved for six (6) non-ambulatory, of which one may be bedridden. LPA toured the facility with the Administrator. Facility was observed by the LPA to be clean and orderly during the inspection. The annual will be completed at a later date. The following deficiency was observed during today's inspection: LPA observed a resident room that had some facility items stored in it, these are not the resident's personal belongings. LPA obtained pictures. LPA observed a compact refrigerator for facility resident medications. LPA observed facility linens stored in the cabinets that are in the residents room. Per interviews with staff these are linens that belong to the facility. There are other facility items stored in the glass cabinets that are facility belongings. The LPA has discussed this with the Administrator in the past, including during prelicensing inspection, which was a change of ownership. Administrator stated their understanding of the above. This deficiency will be cited, 87307(a) Personal Accommodations and Services- Living accommodations and grounds shall be related to the facility's function. The facility shall be large enough to provide comfortable living accommodations and privacy for the residents, who reside in the facility, see LIC809D. Deficiencies cited from the California Code of Regulations, Title 22, Division 6 of California Regulation. Failure to correct the deficiency and/or repeat deficiencies within a 12 month period may result in civil penalties. Exit interview conducted with Administrator Ryanne Tapnio. Appeal Rights Provided to the Administrator.the state’s words, verbatim · CDSS document, Nov 5, 2024

From the deficiency page — Deficiency type: Type B · Plan of correction due date: Nov 18, 2024

87307(a) Personal Accommodations and Services- Living accommodations and grounds shall be related to the facility's function. The facility shall be large enough to provide comfortable living accommodations and privacy for the residents, who reside in the facility. This requirement was not met as evidenced by: LPA observed a resident room that had some facility items stored in it, these are not the resident's personal belongings. LPA obtained pictures. LPA observed a compact refrigerator for facility resident medications. LPA observed facility linens stored in the cabinets that are in the residents room. Per interviews with staff these are linens that belong to the facility. There are other facility items stored in the glass cabinets that are facility belongings. This is a risk to resident's personal rights.the state’s words, verbatim · CDSS document, Nov 5, 2024

Plan of correction: Submit photos of resident's R1's room cleared of all facility items, and the refrigerator. Include a written self certification letter of understanding that R1's room and no other resident room is to be used for facility storage. POC due 11/18/24.

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Alviso, conduct a Required- 1 Year inspection and met with Lead caregiver Joy Montes. LPA observed another caregiver working, Paul Montes. Administrator Ryanne Tapnio was not available to meet with the LPA. Facility has a required infection control plan. Facility has a required emergency disaster plan. Facility has an approved hospice waiver for two (2) residents. There is an approved plan of dementia care. Fire clearance is approved for six (6) non-ambulatory. The LPA reviewed five (5) client files. The LPA reviewed six (6) staff files. All staff had criminal record clearance as required. LPA toured the facility with caregiver Joy. Hot water was checked at 108.5 Fahrenheit. Fire extinguishers (two) were serviced and tagged as required-expires 10/30/23. The facility was clean and orderly. Carbon monoxide detector was working properly. Exit alarms were working properly. Food supply was sufficient. Sufficient supply of cleaners, paper products, and hygiene products. Sufficient supply of personal protective equipment (PPE). Bathrooms were clean and orderly: Bathrooms had grab bars and non-slip mats/flooring for resident use. Licensee/Administrator to submit the following documents by 11/17/23: LIC 308 Designation of Administrative Responsibility LIC 500 Personnel Report LIC 9020 Register of Residents LIC 610 E Emergency Disaster Plan for RCFE -reviewed & updated as needed Copy of current Liability Insurance Infection Control Plan-reviewed & updated as needed LIC400 Handling of Client Cash Resources, include copy of surety bond. LPA observed the following deficiencies: LPA observed vegetables in the refrigerator that were no longer fresh, and of good quality, some were old and rotting. LPA obtained pictures. Continued on LIC809C... This deficiency will be cited, General Food Service Requirements 87555(b)(8)- All food shall be of good quality. Commercial foods shall be approved by appropriate federal, state and local authorities. Food in damaged containers shall not be accepted, used or retained, see LIC809D. LPA observed the large cabinet with all resident medications to not be locked, and a metal box in the refrigerator with medications that was unlocked, making all medications accessible to residents, and to staff/individuals that should not have access to the medications. This deficiency will be cited, Incidental Medical and Dental 87465(h)(2) Centrally stored medicines shall be kept in a safe and locked place that is not accessible to persons other than employees responsible for the supervision of the centrally stored medication, see LIC809D. Based on LPA's record review, staff #3 lacks first aid certification. This deficiency will be cited,Personnel Requirements-General 87411(c)(1) Staff providing care shall receive appropriate training in first aid from persons qualified by such agencies as the American Red Cross, see LIC809D. LPA observed a resident room and bathroom with garbage cans without tight fitting lids, one of the garbage cans had a dirty diaper and other items used in cleaning and changing the resident. This deficiency will be cited, Maintenance and Operation 87303(a)The facility shall be clean, safe, sanitary and in good repair at all times. Maintenance shall include provision of maintenance services and procedures for the safety and well-being of residents, employees and visitors, see LIC809D. Per LPA's record review, staff #2 and #3 lack initial training hours, This deficiency will be cited, as required by H&S Code 1569.625(b)(1)This training shall consist of 40 hours of training. A staff member shall complete 20 hours, including six hours specific to dementia care, as required by subdivision (a) of Section 1569.626 and four hours specific to postural supports, restricted health conditions, and hospice care, as required by subdivision (a) of Section 1569.696, before working independently with residents. The remaining 20 hours shall include six hours specific to dementia care and shall be completed within the first four weeks of employment. The training coursework may utilize various methods of instruction, including, but not limited to, lectures, instructional videos, and interactive online courses. The additional 16 hours shall be hands-on training, see LIC809D. Continued on LIC809C... Based on review of records, Staff #2 & #3 lack a health screening report, including TB test and results87411(f)Personnel Requirements – General All personnel, including the licensee and administrator, shall be in good health, and physically and mentally capable of performing assigned tasks. Good physical health shall be verified by a health screening, including a chest x-ray or an intradermal test, performed by a physician not more than six (6) months prior to or seven (7) days after employment or licensure. Per file review and observations, the facility has retained a bedridden resident, R1, but does not have the proper fire clearance as required. This deficiency will be cited, (c) To accept or retain a bedridden person, other than for a temporary illness or recovery from surgery, a facility shall obtain and maintain an appropriate fire clearance as specified in Section 87202(a), see LIC809D. Deficiencies cited from the California Code of Regulations, Title 22, Division 6 of California Regulation. Failure to correct the deficiency and/or repeat deficiencies within a 12 month period may result in civil penalties. Appeal rights provided to lead caregiver Joy Montes. Exit interview conducted with caregiver Joy Montes All documents left with Caregiver JM for Administrator Ryanne Tapnio.the state’s words, verbatim · CDSS document, Oct 17, 2023