Natasha's Home

Type of visit: Required - 1 Year

At approximately 11:50 AM, Licensing Program Analyst (LPA) Robert Frank arrived unannounced to conduct a Required 1 Year visit. House Manager (HM) Nancy Vargas and Licensee Leonardo Dela Cruz arrived at 12:00 PM. Natasha's Home is Licensed as a Residential Care Facility for the Elderly (RCFE). The facility is a single story ranch house. The facility has an approved fire clearance for three (3) non-ambulatory residents. LPA was informed that there were three (3) residents in care. All three (3) residents were at day programs during the inspection. At approximately 12:15 PM, LPA reviewed the Facility's Staff Roster and found that all staff on-site were background cleared and associated to the facility per regulation. At approximately 12:20 PM, LPA toured the facility with Licensee Dela Cruz. All exits were clear and unobstructed. All three (3) fire extinguishers were last serviced and tagged on 4/26/2026. The facility was sufficiently lighted. LPA inspected three (3) resident bedrooms and found all to have sufficient lighting and furnishings as required per Title 22 Regulations. There was a sufficient supply of both perishable and nonperishable foods as required by Title 22 Regulations. There was an appropriate supply of cleaning products, linens, hygiene products and paper products available for residents. Toxins were observed to be stored inaccessible to residents. The Facility has an infection control plan as required. The facility has a required emergency disaster plan. The facility is conducting fire and emergency drills quarterly. The facility does have emergency food and supplies to meet the "72 hour shelter in place" requirements. Hot water temperatures for all sinks in facility were found to be within Title 22 regulations of 105 to 120 degrees Fahrenheit. Facility smoke detectors and carbon monoxide detectors were tested and observed to be operational. Continued on 809-C... ...Continued from 809 At approximately 1:00 PM, LPA reviewed three (3) resident files. Three (3) of three (3) resident files were observed to be well organized and thorough with all required documentation. LPA reviewed five (5) staff files. Five (5) of five (5) staff files were observed to be well organized with all required documentation including First Aid and CPR certification and proper training documentation. LPA audited Medication for three (3) residents. LPA observed all medications to be centrally stored, secure and with proper documentation. Residents' monies for personal and incidental (P&I) items were audited and observed to match P&I logs. Glenn Vargas’s Administrator Certification 7008202740 is current with an expiration date of 8/17/2027. LPA requested the following documents be submitted to Community Care Licensing by 7/30/2026: LIC 500 Personnel Report LIC 308 Designation of Responsibility LIC 610E Emergency Disaster Plan No deficiencies cited during today's visit. The facility is in compliance. Exit interview conducted. Copy of report discussed and provided to Licensee Dela Cruz. Signature on form confirms receipt of documents.the state’s words, verbatim · CDSS document, Jul 2, 2026

The state marks this report as 4 pages; the online copy we transcribed has 3. You can request the full file from the county licensing office.

Type of visit: Required - 1 Year

At approximately 8:30 AM, Licensing Program Analyst (LPA) Robert Frank arrived unannounced to conduct a Required 1 Year visit. House Manager (HM) Nancy Vargas arrived at 9:00 AM. Licensee Leonardo Dela Cruz arrived at 9:10 AM. Natasha's Home is Licensed as a Residential Care Facility for the Elderly (RCFE). The facility is a single story ranch house. The facility has an approved fire clearance for three (3) non-ambulatory residents. LPA was informed that there were three (3) residents in care. All three (3) residents were at day programs during the inspection. At approximately 9:20 AM, LPA reviewed the Facility's Staff Roster and found that all staff on-site were background cleared and associated to the facility per regulation. At approximately 9:45 AM, LPA toured the facility with Licensee Dela Cruz and HM Vargas. All exits were clear and unobstructed. All three (3) fire extinguishers were last serviced and tagged on 5/15/2025. The facility was sufficiently lighted. LPA inspected three (3) resident bedrooms and found all to have sufficient lighting and furnishings as required per Title 22 Regulations. There was a sufficient supply of both perishable and nonperishable foods as required by Title 22 Regulations. There was an appropriate supply of cleaning products, linens, hygiene products and paper products available for residents. Toxins were observed to be stored inaccessible to residents. Facility has an infection control plan as required. The facility has a required emergency disaster plan. The facility is conducting fire and emergency drills quarterly. The last disaster drill was conducted on 7/21/2025. The facility does have emergency food and supplies to meet the "72 hour shelter in place" requirements. Hot water temperatures for all sinks in facility were found to be within Title 22 regulations of 105 to 120 degrees Fahrenheit. Facility smoke detectors and carbon monoxide detectors were tested and observed to be operational. Continued on 809-C... ...Continued from 809 At approximately 10:35 AM, LPA reviewed three (3) resident files. Three (3) of three (3) resident files were observed to be well organized and thorough with all required documentation. LPA reviewed four (4) staff files. All staff files were observed to be well organized with all required documentation including First Aid and CPR certification and proper training documentation. LPA spot checked Medication for three (3) residents. LPA observed all medications to be centrally stored, secure and with proper documentation. Residents’s monies for personal and incidental (P&I) items were spot checked and observed to match P&I logs. Glenn Vargas’s Administrator Certification 7008202740 expired on 8/17/2025. A renewal application is pending. LPA requested the following documents be submitted to Community Care Licensing by 9/22/2025: LIC 500 Personnel Report LIC 308 Designation of Responsibility LIC 610E Emergency Disaster Plan Proof of Liability Insurance No deficiencies cited during today's visit. Exit interview conducted. Copy of report discussed and provided to Licensee Dela Cruz. Signature on form confirms receipt of documents.the state’s words, verbatim · CDSS document, Aug 22, 2025

The state marks this report as 4 pages; the online copy we transcribed has 3. You can request the full file from the county licensing office.

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA), Alviso is conducting an Required-1 Year inspection, on 8/13/24 at approximately 1:00pm, and met with Administrator Leonardo Dela Cruz. LPA observed two caregivers, Rolando and Josephine, on duty. The facility's nurse arrived during the LPA's inspection. Currently three (3) residents in care. Facility has an approved fire clearance for three (3) non-ambulatory residents. All resident rooms are private. The facility does have a required infection control plan. The facility does have a required emergency disaster plan. Facility had a fire drill on 6/10/24 and an earthquake drill on 6/21/24, per record review. LPA reviewed three (3) resident files. Files were complete. P&I monies were intact, not stored with any other facility funds/not commingled. All records of P&I were complete and maintained accurately. LPA reviewed five staff files. All staff have first aid and CPR as required. All staff have criminal record clearance as required. Staff have required training. Facility had a sufficient food supply. Medications were locked up and inaccessible to residents in care. Sufficient cleaners/disinfectants, paper products, hygiene products, and linens. Cleaners/disinfectants were locked up and inaccessible to residents in care. Facility had a sufficient supply of furnishings for resident use. All resident rooms, bathrooms, hallways, and common areas had sufficient lighting for resident use. The facility was observed to be at a comfortable temperature; Facility does have a heater system, and air conditioner unit for use as needed. There were emergency supplies, including food and water. The fire extinguishers were fully charged,two (2) in the facility. All exits and walkways were clear of obstruction. Sufficient personal protective equipment (PPE) supply for use as needed. The backyard was clean and orderly, and had patio furnishings, and shade cover for resident use. Continued on LIC809C... LPA is requesting the following documents be updated and submitted by 9/13/24. LIC308 - Designation of Administrator Responsibility LIC500 - Personnel Report LIC610E-Emergency Disaster Plan (ensure to review and update as needed and/or required) Infection Control Plan (ensure to review and update as needed and/or required) Copy of LIC400 Handling of Client Cash Resources (must complete, include copy of surety bond if handling cash) Copy of Current Liability Insurance Resident Roster Copy of current Administrator Certificate. The following deficiency was observed and will be cited, see LIC809D. Hot water was checked at 134.9 degrees Fahrenheit which is not in compliance with regulation, hot water to be no higher than 120. degrees Fahrenheit and no lower than 105. degrees Fahrenheit. Administrator turned down the water heater during the inspection. Deficiency citation, 87303(e)(2) Maintenance and Operation- Water supplies and plumbing fixtures shall be maintained as follows: Faucets used by residents for personal care such as shaving and grooming shall deliver hot water. Hot water temperature controls shall be maintained to automatically regulate the temperature of hot water used by residents to attain a temperature of not less than 105 degree F (41 degree C) and not more than 120 degree F (49 degree C), 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. Appeal Rights provided to the Administrator.the state’s words, verbatim · CDSS document, Aug 13, 2024