Nora's Place 2

Type of visit: Required - 1 Year

On May 15, 2026, Licensing Program Analyst (LPA) Brandon Lopez made an unannounced visit to the facility to conduct the required annual inspection. LPA was greeted and granted entry into the facility by care giving staff after explaining the purpose for the visit. Administrator (AD) Mark Cruz was notified via telephone and later arrived to assist with the inspection. LPA observed that Mark Cruz has a valid Administrator certificate which expires on December 2, 2026. The facility is a Residential Care Facility for the Elderly (RCFE) licensed for six non-ambulatory residents, of which one may be bedridden, and has a hospice waiver for four. The facility is a single story home which consist of five resident bedrooms, one of which is shared, one staff bedroom, three bathrooms, a living room, a dining room, a kitchen, and an attached two car garage. LPA, accompanied by the AD, conducted a tour of the interior portions of the facility. On today's visit, there were six residents in care and two care giving staff present. LPA observed the See Something, Say Something poster (PUB 475) mounted on the wall by the dining room. LPA inspected the five resident bedrooms and observed them to be clear of any hazards. LPA observed resident bedrooms to have the required furnishings of a bed, a chair, a chest of drawers, and a lamp. LPA observed resident beds to have clean linens and blankets. LPA observed additional linens to be stored in a hallway closet. LPA observed the staff bedroom to be kept locked and inaccessible to residents in care. LPA inspected the two shared resident bathrooms and observed them to be clean. Resident bathrooms were equipped with grab bars and non-skid floor mats. Faucets and toilets were operational. Hot water temperature measured between 109.5 and 109.7 degrees Fahrenheit. CONTINUED ON LIC809-C LPA observed the facility has a two day perishable and a seven day non-perishable food supply in the kitchen. LPA observed kitchen knives and sharps to be stored in a locked box located in the kitchen pantry. LPA observed the facility has a three day emergency food and water supply stored in a closet located near the dining room. LPA observed fire extinguishers to be mounted on the wall in the kitchen and in the garage. LPA observed fire extinguishers to be charged and serviced as of March 9, 2026. LPA tested the wired smoke detectors/carbon monoxide detectors which tested operational. LPA observed the facility conducted their most recent emergency disaster drill on January 22, 2026. LPA observed the centrally stored medication to be kept in a locked closet located by the entryway of the facility. LPA observed there is also a first aid kit stored near the kitchen and it has all the required components. LPA inspected the attached two car garage and observed it to be inaccessible to residents in care. LPA observed the garage to be used for storage and laundry. LPA observed chemicals and toxins to be stored in the garage. LPA, accompanied by the AD, conducted a tour of the exterior portions of the facility. LPA observed the exterior to be clear of any obstructions or hazards. LPA observed a shaded outdoor seating area with furniture for resident use. LPA observed the perimeter gates of the facility to be self-latching and can be opened in an evacuation. There are no bodies of water on the premises. LPA reviewed all six resident files. All the required documentation were present and current in the resident files reviewed. LPA reviewed the residents' medication and medication administration records. LPA reviewed two staff files. All staff are background cleared and associated to the facility. Based on the observations made during today's visit, no deficiencies are being cited per Title 22 of the California Code of Regulations. An exit interview was conducted with Administrator Mark Cruz and a copy of the report was provided at time of visit.the state’s words, verbatim · CDSS document, May 15, 2026

Type of visit: Required - 1 Year

On this day, Licensing Program Analyst (LPA) Kevin Saborit-Guasch made an unannounced visit to the facility to conduct the required annual inspection. LPA was greeted and granted entry by facility caregiving staff after after introducing himself and stating the purpose of the visit. Administrator Mark Ryan Cruz was notified of the visit via telephone and arrived later to assist. There are currently six residents in care, six of which are receiving hospice care at this time. LPA observed residents relaxing in the facility's common living areas or in their respective bedrooms. LPA accompanied by facility staff toured the physical plant. The facility is a one-story house with an attached garage. The facility has four private and one shared bedrooms along with one staff room that is normally kept locked. Door was however not locked at the time of the present visit. There are two shared bathrooms throughout the facility. Bedrooms appear clean and sanitary. All residents are using half rails or full rails for postural supports. Adequate orders present in all hospice plans of care reviewed. All resident bedrooms have the required furnishings. Bathrooms appear clean and sanitary. Hot water temperature measured at 110F in two bathrooms with faucets used for personal grooming. LPA observed the kitchen has a minimum two (2) day perishable and seven (7) day non-perishable food supply. Sharp items and the medication central storage verified to be secured. Cleaning supplies and chemicals are observed in an unlocked cabinet off of the dining room and are moved to a secure storage during the visit. Type B citation issued and cleared during the visit. CONTINUED ON FORM LIC809-C CONTINUED FROM LIC809 The mounted fire extinguisher is charged, with up-to-date maintenance tag attached. LPA tested the smoke and carbon monoxide detectors which were found to be operational. The attached garage is inaccessible to residents and used for laundry as well as additional storage of food and supplies. LPA and facility staff toured the outside of the facility. LPA observed an shaded outdoor seating area with furniture for resident use. There are self-latching gates on both sides of the property and the routes of egress are free of clutter and obstructions. There are no bodies of water on the premises. Facility does not utilize locked perimeters or delayed egress. LPA reviewed six resident records which included all necessary components. LPA reviewed resident medication records and prescription orders for all residents with no discrepancies observed. Oxygen is currently in use with adequate signs posted. There are no residents currently assessed as being bedridden at the time of the visit. Six resident interviews were attempted or conducted during the visit along with two staff interviews. LPA reviewed staff records for the two relieving caregivers present along with the two regular caregivers on time off during the visit. All staff are background cleared and associated to the licensed location accurately, with current CPR certificates on file. 2025 annual training provided. Disaster drills are conducted quarterly with proof of the attendance provided. Based on the observations made during today’s visit, one type B deficiency is being cited per Title 22 Division 6 of the California Code of Regulations. An exit interview was conducted and a copy of this report along with appeal rights was provided to a facility representative.the state’s words, verbatim · CDSS document, May 7, 2025

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Alvaro Ramirez, Jr. conducted an unannounced visit for the Required 1 Year Inspection. LPA explained the purpose of today’s visit, and was greeted and granted entry by caregiver Rebecca Ladignon. Administrator (AD) Mark Cruz arrived shortly after. For today’s visit, LPA observed a total of six residents in care and two staff members on duty. LPA Ramirez toured the interior and exterior portions of the facility with AD Cruz. The facility is a single level structure and is licensed for six non-ambulatory residents, of which four may be on hospice and one bedridden. There are a total of six bedrooms, of which five are resident bedrooms and one staff bedroom. LPA Ramirez toured each bedroom in the facility and observed that bedrooms were provided with furniture in good repair, clean linens, adequate storage space, and kept free of tripping hazards. Smoke and carbon monoxide detector and auditory exit alarms were tested and operational. There are a total of three restrooms of which one is for staff and two are for residents. Restrooms were observed to be in good repair, toilets were operational, and grab bars and non-skid floor mats were provided. Water temperature tested between 107.7-108.8 degrees Fahrenheit. Facility met the minimum two-day perishable and seven-day non-perishable food supplies. Sharp items and knives were locked and inaccessible to residents in care. Fire extinguisher was charged, mounted and located by the kitchen. During today's visit LPA observed as the residents were participating in their morning exercise/stretching. CONTINUED ON LIC809-C.. LPA Ramirez observed the emergency disaster and evacuation plan, which is located by the dining room/kitchen hallway. Facility had back-up emergency food and water supply. LPA observed that the First Aid Kit had all the required components. LPA observed that medications and toxins were locked and inaccessible to residents in care. For the exterior portion, LPA Ramirez observed a shaded area, patio furniture, and the grounds were free of any hazards. There are two gates in the backyard, which both are self-closing and self-latching. No bodies of water were observed. LPA reviewed four resident files and two staff files. LPA interviewed residents and staff present. For today's visit no deficiencies were issued per Title 22 Division 6 of the California Code of Regulations. An exit interview was conducted with AD Cruz. A copy of this report was provided at the time of exitthe state’s words, verbatim · CDSS document, Jun 20, 2024

Allegation investigated: Staff is failing to prevent an insect infestation. Staff does not maintain the facility in a clean condition.

On this day, Licensing Program Analyst (LPA) Kevin Saborit-Guasch made an unannounced visit to the facility for the purpose of conducting the initial investigation into the four allegations listed above. LPA was greeted and granted entry by caregiving staff after introducing himself and stating the purpose of the visit. Administrators Mark Cruz and Eleonor Avendano were notified of the visit by telephone and arrived later to assist. Administrators were provided with the allegations upon their arrival. LPA requested, obtained and reviewed resident records for the six individuals currently in care at the facility. LPA accompanied by administrators then conducted a tour of the physical plant and inspected two bathrooms used to provide toileting care to residents in addition to an additional bathroom in use by staff. LPA also toured the outside perimeter of the facility and verified the operation of multiple appliances throughout the facility. CONTINUED ON FORM LIC9099 Unfounded Regarding the allegation that Facility staff are recording the residents and visitors without adequate authorization, the following has been concluded: There are three video cameras observed in the facility's living room during the tour of the physical plant. Two of these are demonstrated to be a built-in system put in place by the facility's landlord, routed to a central console in a cupboard, and not currently in operation. A third camera is a remotely operated camera connected to the Internet. Footage received by the camera is accessible through an application on the licensee's phone. A review of the resident's admission agreements found the presence of a signed Permission to Photograph issued to every resident and/or their authorized representative upon admission. The consent form however only states that "The facility will be photographing residents for the following reasons: - New Resident File Photo - Parties and Holidays Events - Accident or injury to resident. These photos will be considered confidential and will not be used for public use". Consent obtained to photograph residents does not extend to video footage obtained by the camera placed in the living room of the facility. As a result, the allegation is found to be Substantiated, meaning that the preponderance of evidence standard has been met. A corresponding Type B citation was issued on the attached form LIC9099-D. An exit interview was conducted and a copy of this report along with appeal rights were provided to a facility representative. CONTINUED FROM FORM LIC9099 Regarding the allegation that Staff is failing to prevent an insect infestation, the following has been concluded: Based on observation of the facility's physical plant conducted during today's visit, no evidence of an excessive accumulation of moisture was found in spite of the occurrence of a rain event less than 24 hours prior to the visit. Additionally, no evidence of an infestation of any kind was found during the visit. Facility staff was able to provide evidence of a pest control intervention occurring on February 27, 2024 at the facility's address. Regarding the allegation that Staff does not maintain the facility in a clean condition, the following has been concluded: Based on observation of the facility's physical plant conducted during today's visit, all five bedrooms is use by current residents along with three bathrooms and common areas reviewed were all found to be clean and free of obstructions. No evidence of a failure to maintain adequate cleanliness was found around the physical plant. The two allegations are therefore found to be Unfounded, meaning that the allegations are false, could not have happened and/or are without a reasonable basis. An exit interview was conducted and a copy of the report was provided to a facility representative. CONTINUED FROM FORM LIC9099 Regarding the allegation that Facility bathrooms have rust, the following has been concluded: Based on observation of the facility's physical plant conducted during today's visit, the two bathrooms in use to provide toileting care to residents in care are found to be equipped with all necessary items and are observed to be clean and in good repair. There is presence of rust near the shower head of a third bathroom, however that shower is not in use for the benefits of the residents due to the presence of an excessive threshold barring mobility-impaired residents from accessing the shower. Per interviews conducted, the bathroom is only in use for the current live-in caregivers. As a result, the allegation is found to be Unsubstantiated, meaning that although the allegation may have happened or is valid, there is no preponderance of evidence to prove the alleged violation did or did not occur. An exit interview was conducted and a copy of this report was provided to a facility representative.the state’s words, verbatim · CDSS document, Mar 7, 2024 · control 22-AS-20240229132238

From the deficiency page — Deficiency type: Type B · Section cited: CCR 87468.2(a)(1) · Plan of correction due date: Apr 5, 2024

Per CCR Section 87468.2(a)(1) "residents in privately operated residential care facilities for the elderly shall have all of the following personal rights: To have a reasonable level of personal privacy in accommodations(...)". This requirement is not met as evidenced by: Based on observation, one videosurveillance system was found to be in use in the facility's common area. Consent was not found to have been documented for the use of the camera. This constitutes a potential risk to the health, safety or personal rights of individuals in care.the state’s words, verbatim · CDSS document, Mar 7, 2024

Plan of correction: Licensee removed the camera from the premises during the visit. Additionally, a consultation was provided to the licensee that operating the system can be permitted once adequate consent has been obtained from all the residents and/or their respective authorized representatives. Deficiency cleared during the initial visit.