North County Villa

Type of visit: Required - 1 Year

On 7/31/26, Licensing Program Analyst (LPA) Kyle Wellington arrived unannounced to conduct an annual inspection. LPA was greeted and granted entry by Caregiver, Jason Bautista, who was informed of the purpose of the visit. LPA met with Facility Manager (FM), Mary Jane Estiller, who arrived shortly thereafter and was also informed of the purpose of the visit. The census at the facility is six (6) residents. LPA received a resident roster from FM. LPA toured the inside and outside of the facility with FM. LPA conducted an observation and record review for the inspection. Facility Overview: Facility is a one story house with five (5) resident bedrooms, one (1) resident bathroom, staff room, staff bathroom, kitchen, dining room, living room, and attached garage. There are no pools, bodies of water or firearms at the facility. Facility has a fire clearance for six (6) non-ambulatory adults of which six (6) may be bedridden. Facility was granted a hospice waiver for six (6) residents.. Infection Control: LPA observed hand sanitizers and soap dispensers throughout the facility. Cleaning equipment and cleaning supplies were kept in the locked garage and available for regular facility maintenance. LPA reviewed the facility’s infection control plan which met the department’s requirements. Physical Plant: LPA observed the inside and outside of the facility to be clean, safe and well kept. The floors, windows and doors were clean and well maintained. The living room and dining room furniture was in good repair. The residents’ bedrooms were neat, organized and contained the required bedding, lighting and furniture. Bathroom was clean, tidy and had paper towels, soap, grab bars and non-slip floors in the showers. Extra linen and towels were kept in a closet in the hall. Laundry equipment appeared to be in good working condition. Laundry supplies were kept in the locked garage. Three (3) fire extinguishers were charged and ready for use. LPA tested one (1) of the smoke and carbon monoxide detectors and found them to be hard-wired and operational. The backyard was free of hazards and contained outdoor furniture and shaded area for the residents. Kitchen/Food Service: LPA observed the kitchen to be sanitary, organized, and well maintained. The kitchen had the ability to prepare and store food in a safe and clean environment. Kitchen appliances appeared to be in good working condition. All sharp objects were kept in a locked drawer in the kitchen inaccessible to residents. Cleaning supplies were kept in a locked cabinet under the kitchen sink inaccessible to residents. Facility has over a two day supply of perishable foods and over a seven day supply of non-perishable foods. Care & Supervision: LPA observed two (2) staff and six (6) residents at the facility during the inspection. Facility has sufficient staff to supervise the residents. Administration: LPA observed facility sketch, personal rights, resident bill of rights, emergency phone numbers, complaint procedures and long-term care ombudsman information posted near the front door. Admin holds a current Administrator Certificate, CPR/First Aid Certificate and a Criminal Record Clearance. Record Review and Resident/Staff Files: LPA reviewed the records of three (3) resident files and two (2) staff files. Staff have a a CPR/first aid certificate, criminal record clearance and are associated with the facility. The files contained all the required documentation and paperwork. The staff and client files were kept in a locked cabinet in the kitchen inaccessible to unauthorized individuals. Health Related Services/Incidental Medical Services: LPA observed clients' medications were centrally stored in a locked cabinet in the kitchen inaccessible to residents. First aid kit was kept in a locked cabinet in the kitchen and it contained all the required items. LPA reviewed three (3) residents' medications to the facility’s medication log to make sure all medication was accounted for and dispensed correctly. Disaster Preparedness: LPA reviewed the facility’s emergency and disaster plan. It is current and up to date. Fire drills are done quarterly and last done 7/13/26. Facility's property and liability insurance is current and expires on 4/1/27. All facility exits had signage and were clear of obstructions. No deficiencies were cited during this visit. An exit interview was conducted with Facility Manager, Mary Jane Estiller, and a copy of this report was given to Facility Manager, Mary Jane Estiller.the state’s words, verbatim · CDSS document, Jul 31, 2026

Type of visit: Prelicensing

On 7/17/2024, Licensing Program Analysts (LPAs), Janette Romero and Jaqueline Shaw Ross made an announced visit to conduct a pre-licensing evaluation and met with Applicant, Sandra Cid. The home is currently licensed as a Congregate Living Health Facility licensed by the Department of Public Health and looking into transitioning into a Residential Care Facility for the Elderly (RCFE). An initial application to operate an RCFE was received by the Central Applications Bureau (CAB) on 10/23/2023. Fire clearance was granted on 2/15/2024 for total capacity of six (6) non-ambulatory or bedridden residents. LPA toured the facility with Applicant Cid. During the tour, LPA observed the facility is made up of a one (1) story home with five (5) resident bedrooms, one (1) staff room, two (2) bathrooms, a kitchen, dining room, living room, and attached garage. The facility has a central heating and air conditioning system installed with a central panel located in the hallway to control entire house. Applicant Cid tested one (1) of the smoke alarm/carbon monoxide detectors and LPA observed it to be operational. Resident bedrooms are each furnished with a bed, chair, and night stand. Bathrooms have a working toilet, wash basin and have paper towels, toilet paper, and soap readily available. LPA toured the kitchen and observed the stove to be operational and refrigerator/freezer in working condition. The facility has a 2-day supply of perishable foods and 7-day supply of non-perishable foods along with adequate seating for meals for all residents. Medications and confidential files are secured in a kitchen cabinet. Additional clean linens and towels are stored in a hallway closet. A commercial washer, dryer and cleaning solutions are secured in the locked garage. The backyard is gated and there are no bodies of water observed on the premises. Indoor and outdoor pathways are free of obstructions. Let-Us-No poster, emergency phone numbers, current license, and exit route/maps are visibly posted near the entrance. During today's visit, LPA did not observe any issues or concerns. Applicant is scheduled to attend COMP III at the Riverside Regional Office on 7/25/2024. Final approval of licensure will be determined by CAB.the state’s words, verbatim · CDSS document, Jul 17, 2024

Type of visit: Office

Facility Type: RCFE Application Type: Initial Capacity: 6 Census (if any clients in care): 4 (converting from CHLF to RCFE) COMP II Participants: Mari Dee Sandra Cid (goes by Sandra) Interview Method: Telephone interview On April 25, 2024, 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. Staff/training/medications 3. Pre-licensing readiness 4. Conversion to RCFE/documents 5. General provisionsthe state’s words, verbatim · CDSS document, Apr 25, 2024