New Villa - Monarch

Allegation investigated: Staff did not refund the preadmission fees to the applicant or the applicant’s representative.

*This report does not supersede the previous report created on 05/26/2026 but is used to correct and clarify findings. * On 06/02/2026 at approximately 08:04 AM Licensing Program Analyst (LPA) Watson conducted a subsequent complaint visit to the facility listed above to deliver findings. LPA Watson met with Care Giver Raffy Miranda and explained the reason for the visit. LPA Watson was granted entry into the facility. The investigation consisted of the following: On 05/26/2026 between 12:30 PM – 04:50 PM, the Department requested, obtained, and reviewed the following records: Resident Roster dated 05/10/2026, Staff Roster dated 01/02/2025, Short-Term Respite Admission Agreement dated 04/20/2026, Medical Assessments dated 03/04/2026, 04/20/2026, and 05/03/2026, and the Immunization Record for R1 dated 03/16/2026. CONTINUE ON LIC9099-C Unsubstantiated The Department conducted interviews with Staff #1–#3 (S1–S3) and Residents #2–#3 (R2–R3). An attempt to interview R1 was made; however, R1 could not be reached via telephone and was not at the facility at the time of the visit. Allegation: Staff did not refund the pre-admission fees to the applicant or the applicant’s representative. It is alleged that the facility declined to issue a refund despite multiple requests for reimbursement to the applicant or the applicant’s representative based on services never rendered. On 05/26/26 between 12:30 AM and 04:50 PM, the Department conducted an interview with S1. During the interview, S1 was asked if the facility refunded the pre-admission fees to the applicant or the applicant’s representative. S1 answered that the facility does not charge pre-admission fees but instead has a respite agreement that mentions refunding 75% of the unused portion of the monthly payment and that refunds are only provided in the event of a resident’s passing. S1 was also asked to describe the payments received for the stay and explain how those payments were recorded or processed. S1 stated that upon signing the contract, the reporting party issued a check for the first week, which serves as the holding agreement for a room. S1 also stated that it is indicated in the agreement that if the resident’s responsible party decided not to use the room after paying for the first week, even if the resident did not occupy the room, they would not receive a refund unless the resident passed away. On 05/26/2026 between 12:30 AM and 04:50 PM the Department conducted interviews with Staff #1–#3 (S1–S3) and Residents #2-3 (R2-R3). Out of those interviewed 3 out of 3 staff and 2 out of 3 residents denied the above allegation. An attempt to interview Resident#1 was made but R1 was not at the facility at the time of visit. On 05/26/2026 between 12:30 AM and 04:50 PM, the Department obtained and reviewed the Short-Term Respite Admission Agreement dated 04/20/2026, and it showed on page 1 under “Purpose of Stay” that the resident was being admitted for a temporary short-term respite stay from 05/18/2026 to 06/01/2026. Further review of the Short-Term Respite Admission Agreement showed on page 2, No. 5 under “Rate and Payment Terms,” that a refund of the unused portion of 75% will be returned to the family within 14 days and that refunds are only provided for the passing of a resident prior to a respite visit. The department reviewed the Short-Term Respite Admission Agreement and observed that it was signed on 04/20/2026 by R1’s responsible person. CONTINUED ON LIC9099-C Based on the information gathered, interviews conducted, and an analysis of records reviewed, the Department found no evidence to support the allegation mentioned above. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur; therefore, the allegation is Unsubstantiated. An exit interview was conducted with Administrator Jennifer Villanueva, and a copy of this report was provided.the state’s words, verbatim · CDSS document, Jun 2, 2026 · control 11-AS-20260519082826

Allegation investigated: Staff did not refund the preadmission fees to the applicant or the applicant’s representative.

On 05/26/26 at approximately 12:30AM LPA Licensing Program Analyst (LPA) Watson conducted an initial complaint visit to the facility listed above. LPA Watson met with the Administrator Jennifer Villanueva and explained the reason for the visit. LPA Watson was granted entry into the facility. The investigation consisted of the following: On 05/26/2026 between 12:30 PM – 04:50PM, the department requested, obtained, and reviewed the following records: Resident Roster 05/10/2026, Staff Roster 01/02/2025, Short Term Respite Admission Agreement 04/20/2026, Medical Assessment 04/20/2026, 03/04/2026, 05/03/2026. The department interviewed Staff#1-#3 (S1-S3) and Residents#2-#3(R2-3 R3) CONTINUED LIC9099-C Unsubstantiated Allegation: Staff did not refund the pre-admission fees to the applicant or the applicant’s representative It is alleged that the facility declined to issue a refund despite multiple requests for reimbursement to the applicant or the applicant’s representative based on services never rendered. On 05/26/26 between 12:30AM AND 04:50 PM the department conducted an interview with S1. During the interview S1 was asked, did the facility refund the preadmission fees to the applicant or the applicant’s representative. S1 answered we do not charge pre-admission fees but we do have instead a respite agreement that mentions returning 75% of the unused portion of their monthly payment and refunds only being provided in the event of a resident’s passing? S1 was also asked to describe the payments received from the persons responsible, party, for the stay and explain how those payments were recorded or processed. S1 said that upon signing the contract, the reporting party issued a check for the first week which is the holding agreement for a room. If she decided not to use the room after paying for that first week, even if the resident never occupied the room, they would not get a refund unless the resident passed away. On 05/26/2026 the department interviewed Staff#1-#3 (S1-S3). Out of those interviewed 3 out of 3 denied the above allegation. On 05/26/2026 the department interviewed Residents#2-#3(R2-3 R3), An attempt to interview Resident #1 was made but R1 but R1 was not present at the facility during the time of interviews. On 05/26/2026 between 12:30AM AND 04:50 PM the department obtained and reviewed the Short-Term Respite Admission Agreement dated 04/20/2026, and it showed on Pg.1 under Purpose of Stay” The Resident is being admitted for a temporary short-term respite stay from 05/18/2026 to 06/01/2026. Further review of the Short-Term Respite Admission Agreement showed on page 2 No. 5 under Rate and Payment Terms that a refund of unused portion of 75% will be returned to family within 14 days. Refunds are only provided for the passing of a resident prior to a respite visit. An exit interview was conducted with the Administrator Jennifer Villanueva, and a copy of this report was given.the state’s words, verbatim · CDSS document, May 26, 2026 · control 11-AS-20260519082826

Type of visit: Required - 1 Year

On 2/24/26, at 1:30pm, Licensing Program Analyst (LPA) Perry Scott conducted an unannounced required annual inspection visit to New Villa-Monarch. LPA met with Jennifer Villanueva, Administrator, and the purpose of today’s visit was explained. The facility is licensed to serve six (6) non- ambulatory residents (age 60 and over). Currently, the home has (0) residents. The facility has an approved hospice waiver for (5) residents. The facility’s annual fees are current. The facility is a single-story building located in a residential neighborhood. It consists of the following: three (3) bedrooms, two (2) bathrooms, living room, dining room, kitchen, laundry area, garage, and an outside patio area. At 1:55pm, LPA and staff toured the facility. There are no bodies of water or firearm/ammunition on the premises. All resident rooms were checked. Beds and bedding were in good condition, adequate lighting provided, and adequate storage for resident personal belongings was observed. Walls and floors were in good repair. Bed linens, comforters, and bath towels were adequately stocked at the time of visit. Bathrooms were found to be within Title 22 regulations. Toilets and water faucets worked properly. The shower was free of mold/mildew, there was adequate lighting, and sufficient toiletries were accessible to clients. The water temperature measured 114.8F. A comfortable temperature is maintained in the facility. Report Continued On LIC809-C LPA observed the facility to be clean, sanitary, and appropriately furnished at the time of visit. Storage areas for cleaning agents, toxins, and sharps were inaccessible to residents. The kitchen was inspected and there is enough perishable and non-perishable food available for the residents. All food items were stored properly. The water temperature measured 115.9F in the kitchen. Medications were centrally stored and properly locked, first aid kit was checked and fully stocked with manual. The fire extinguisher was charged, and the smoke/ carbon monoxide detectors were operable. The last fire/emergency drill was conducted on 03/15/2025. The facility’s administrator’s certificate (7032194740) was valid from 05/18/2025 through 05/17/2027. The facility’s liability insurance was valid from 04/30/2025 through 04/30/2026. LPA conducted a review of (4) staff records and reviewed the facility disaster plan. All staff records were complete with required documents and training. The facility disaster plan was current and in compliance with Title 22 at the time of visit. During the visit, LPA observed the facility infection control practices. LPA observed screening protocols for visitors, staff, and residents. LPA observed that sanitizing stations were in common areas and restrooms. LPA observed that the facility had the required postings, posted throughout the facility. LPA advised the facility to continuously monitor the Centers for Disease Control (CDC) website and Community Care Licensing (www.cdss.ca.gov) for Provider Informational Notices (PIN) and for any updates relating to COVID-19 guidance and other related issues. No deficiencies were cited during this inspection visit. An exit interview was held, and a copy of this Facility Evaluation Report was provided to Jennifer Villanueva, Administrator.the state’s words, verbatim · CDSS document, Feb 24, 2026

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Sparkle Day conducted an unannounced visit to the above facility. The purpose of today’s visit was to conduct the one-year inspection. LPA met with Jennifer Villanueva, Administrator and the purpose of the visit was discussed. Facility is licensed to serve (6) ambulatory residents age 60 and over . The facility has an approved hospice waiver for (5) residents. Two (2) of the residents are diagnosed with dementia . One (1) resident is receiving hospice care services. The facility does not handle any of the residents’ money. This home is a single story home consisting of: (3) resident bedrooms, (1) staff bathroom (1) resident restroom, living room, kitchen with dining area, laundry room is located in the attached garage and an outdoor shaded patio area. LPA toured the Resident bedrooms that had the required furniture, bed linens and closet/drawer space to accommodate each resident comfortably. Resident bathrooms were checked. Toilets and water faucets worked properly, grab bars were secure, shower was free of mold/mildew and a non-skid mat was in place, water temperature measured between 114F. Resident bath towels, toiletries and personal hygiene supplies were adequately stocked. Common areas were clean and clear of hazards; doorways were free of obstructions. Kitchen was checked and observed to be within Title 22 regulations. Perishable and non-perishable food supply was checked. All cleaning solutions, hazardous items, and medications were securely locked and inaccessible to residents. Smoke detectors were working properly and fire extinguisher was fully charged. Carbon monoxide detector was operational. First Aid kit was available. Outside grounds were toured and no bodies of water were observed. Walkways around the home were clear of hazards. There are no security bars or weapons on the premises. During todays visit LPA did not observe any deficiencies. Exit interview conducted with Administrator, Jennifer Villanuevathe state’s words, verbatim · CDSS document, Apr 11, 2025

Type of visit: Prelicensing

On 1/11/24 Licensing Program Analysts (LPA) Alfonso Iniguez conducted a pre-licensing evaluation for an RCFE facility type. Today’s pre-licensing evaluation was conducted with authorized administrator: Jennifer Villanueva. The licensee has applied for a license to serve (6) elderly residents ages 59 and older. The fire clearance is approved for (6) ambulatory only residents. Bedrooms (1), (2) and (3) are approved for (2) ambulatory residents only. A tour of the Kitchen, Dining Room, Living Room, (3) Bedrooms, (2) Bathrooms, Garage, Storage for all supplies, Back Yard with shade was conducted. The following was observed during this visit: MEDICATIONS There is a locked centralized storage area for Resident medications. PHYSICAL PLANT Facility is clean, sanitary, and in good repair. Protective devices are in place. Indoor and outdoor passageways, stairways, open porches, and other areas of potential hazard are free of obstructions. All window screens are clean and in good repair. Facility temperature is between 68°F. degrees and 73°F. degrees. Open porches, and areas of potential hazard are well-lit. Smoke alarms operate properly. Carbon monoxide detectors operate properly. Report continues LIC 809C. BEDROOMS There is a bed for each client with a mattress, mattress pad, bedsprings, and pillow(s) which are clean and in good repair. Mattresses and pillows are flame-retardant. There is dresser and closet space for each client that includes at least two (2) drawers or eight (8) cubic feet of dresser space per client. There is a chair and lamp for each client and at least one (1) night stand per two (2) clients. BATHROOMS There is at least one (2) toilet and washbasin per six (6) clients, family, and personnel. There is at least one (2) shower or bathtub per ten (10) clients, family, and personnel. Hot water temperature is 113° Fahrenheit. Bathroom is located near client bedrooms. There are night-lights in the hallways outside non-private bathrooms. SUPPLIES There are client personal hygiene supplies to include soap, toothpaste, toilet paper, and combination. There is a sufficient supply of clean linens to permit weekly changing or more of client top sheets, bottom sheets, bedspreads, blankets, pillowcases, mattress covers, bath towels, hand towels, and washcloths. FOOD SERVICE Dining room is near kitchen. Refrigerator(s) and freezer(s) are clean and large enough for the storage of at least two (2) days of perishable foods. Freezer is 0° Fahrenheit. Refrigerator is a maximum of 45° Fahrenheit. A seven (7) day supply of non-perishable food is present. There are enough tableware, tables, dishes, and utensils. There is enough equipment for the storage, preparation, and service of food. All equipment, dishes, and utensils are clean and well maintained. All kitchen, food storage, and preparation areas are clean. Report continues LIC 809C. RECORDS There is confidential storage of personnel records at the facility. There is confidential storage of client records at the facility. ADMINISTRATION The emergency exiting plan and emergency phone numbers are posted. Client Personal Rights are posted. Posting both sides of the Personal Rights form LIC 613 meets this requirement. Facility Visiting Policy is posted. Licensing Complaint Poster is posted. There is space available for resident council meetings and resident council postings. ACTIVITIES There is an outdoor activity space with a shaded area and furnished for outdoor use. There is at least one common room available to clients for visitors. MISCELLANEOUS There are first-aid supplies to include sterile first-aid dressings, bandages, adhesive tapes, scissors, tweezers, thermometer, antiseptic solution, and a current first-aid manual. There is space and equipment for laundry. There is a space for clean linen storage and a separate space for soiled linen. There is an operating telephone available to clients. Emergency lighting and supplies to include flashlights with batteries. During this pre-licensing inspection, LPA did not find corrections are needed. LPA conducted the Component III Orientation with the Licensee and copy of this report was provided. A copy of the facility evaluation report will be available to the Central Applications Unit (CAU) for review. If the applicant has questions regarding the status of the application, they have been instructed to communicate with their assigned (CAU) Analyst. Exit interview conducted with Jennifer Villanueva/Administratorthe state’s words, verbatim · CDSS document, Jan 11, 2024

Type of visit: Office

Component II completion: Successful Facility Type: RCFE Application Type: Initial Capacity: 6 Census (if any clients in care): 0 COMP II Participants: Jennifer Villanueva (administrator); Neilson Villanueva (applicant/licensee) Interview Method: Microsoft Teams On 10/27/23, applicant/administrator participated in COMP II. Identification of the applicant and administrator was verified through interview questions based on photo ID and other identifying personal information. During COMP II, applicant and administrator confirmed that they have read and understand community care facility licensing laws included in the Health and Safety Codes and the California Code of Regulations Title 22. Signed LIC 809 with copy of photo ID have been obtained. During COMP II, CAB analyst confirmed Applicant/Administrator’s understanding of following areas: 1. Facility operation: License type, client/resident populations, and program 2. Admission Policies 3. Staffing requirements & Training 4. Restrictive/Prohibited Health Conditions 5. General provisions 6. Emergency Preparedness 7. Complaints & Reporting 8. Pre-licensing readinessthe state’s words, verbatim · CDSS document, Oct 27, 2023