Olga's Care Home for the Elderly

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Manuel Monter conducted an unannounced annual inspection visit, and met with Administrator Olga Atienza-Bilan. During the visit, LPA observed 4 residents and 2 staff. LPA explained the purpose of the visit. LPA toured the facility inside out with ADM which included the Living room, kitchen, dining room, 3 restrooms and 5 residents bedrooms. The staff area of the facility was also inspected. The front yard and backyard were inspected. There was no obstruction to block the walkways. During the tour LPA observed residents participating in a group reading session in the facility dinning room table. Two-day perishable food supplies and seven day nonperishable food supplies were observed. LPA observed the medication storage area, knives storage area, and cleaning product storage area as locked and inaccessible to residents in care. Room temperature was at 75 degrees F, and hot water temperature was measured at 116 degrees F in resident bathrooms. Fire extinguisher was serviced in July 2025. The facility was equipped with smoke and carbon monoxide detectors. Smoke detectors was tested by ADM, and were functional. LPA observed facility first aid kit and facility fire/earthquake drill log. The facility's last drill was on October 1, 2025. LPA reviewed facility records for 2 staff and 3 residents. LPA reviewed 3 resident medications and centrally stored medication records. No deficiencies cited during today's visit. This report was reviewed with Administrator Olga Atienza-Bilan and a copy of the signed report was provided.the state’s words, verbatim · CDSS document, Oct 14, 2025

Type of visit: Required - 1 Year

Licensing Program Analysts (LPA) Maria (Mita) Partoza and Manuel Monter a conducted an unannounced required 1 year inspection visit and met with licensee/administrator (LIC/ADM) Olga Atienza-Bilan and stated the purpose of the visit. The facility is licensed to serve adults 60 and over of which 6 may be non-ambulatory and is subject to terms and condition of dementia waiver. LPA observed 5 out of 5 residents are present at the facility that have mild neurocognitive impairment, 1 staff was present during the visit. At 3:05 p.m. LPAs toured the facility inside and outside with LIC/ADM including but not limited to the kitchen, bathroom, dining room, living room, 5 residents rooms, garage, backyard and exterior walkways. The temperature inside the home was at 73 degrees Fahrenheit. The kitchen was observed to be sanitary and organized, knives and sharps were locked and not accessible to residents. LPA observed 2 days of perishable food and 7 days of non-perishable food. The refrigerator temperature was at 36 degree Fahrenheit and the freezer was at 22 degree Fahrenheit. LPA discussed with LIC/ADM food safety and storage. Under the sink cabinet is used to store cleaning supply kept locked and not accessible to residents. The water temperature measured at 108 to 112 degrees Fahrenheit. Resident's room (R1 to R5) have sufficient storage. The facility is equipped with a fire, smoke and carbon monoxide alert system that is in good working condition, night lights on the hallway are in good working condition. The hallway are free from obstruction. LPA observed that medications are kept locked and inaccessible to residents. The first aid kit is complete and is easily accessed by staff. page 1 of 2 - see LIC 809C The backyard, walkways, ramps and patio are free from debris and obstruction. The facility screen windows were observed to be in good repair. The washer and dryer located at garage are in good working condition. Laundry soap and cleaning supplies are locked and not accessible to residents in care. LPA reviewed 3 out of 5 resident records such as the centrally stored medication and destruction record (CSMDR), admission agreement, needs and services plan, health screening and observed records to be current and updated. LPA reviewed 2 out of 2 staff records including but not limited to required training, first aid/CPR training, health screening and background clearance. All staff have criminal record clearance/fingerprints. The facility has conducted an fire and earthquake drill on 06/1/2024. Deficiency was cited during today's visit for based on California Code of Regulations (CCR) Title 22 87555(b)(21). See LIC 809D. An exit interview was conducted during today's visit with Licensee/administrator Olga Atienza-Bilan. A copy of the report and appeal's rights was provided. end of report page 2 of 2the state’s words, verbatim · CDSS document, Oct 23, 2024

Allegation investigated: Facility staff physically abuses resident Facility staff yells at resident Facility staff deprives resident of food Unqualified Staff

Licensing Program Analyst (LPA) Manuel Monter conducted an unannounced visit to deliver findings regarding the allegation listed above. LPA met with facility Administrator (ADM) Atienza-Bilan. On December 21, 2022, the department received a complaint alleging facility staff yells/physically abuses resident R1. It has also been alleged facility staff deprive resident R1 of food. On December 26, 2023, the department interviewed ADM Olga Atienza-Bilan. ADM denied the allegations and stated he/she does not hit/yell at the residents. ADM stated he/she does not deprive residents’ food. ADM stated R1 has mental disorder and makes up stories. On January 13, 2024, LPA Manuel Monter interviewed 5 residents. (R1-R5). 5 Out of 5 residents denied the allegations and stated the staff don’t hit or yell at residents. 5 Out of 5 residents stated facility staff don’t deprive residents of food. Page 1 Out of 3. Unfounded On January 13, 2024, LPA Monter interviewed S1. S1 denied the allegations and stated staff don’t hit/yell at residents. S1 stated the staff don’t deprive residents’ food. Based on a review of R1’s physician’s report dated October 29, 2022, R1 has a mental disorder. Based on a review of R1’s Appraisal Needs & Services Plan, dated February 2, 2023, R1 has a mental disorder. The Department has completed the investigation of the above allegations. Based on interviews conducted and record review, the department has found that the above allegations were UNFOUNDED, meaning that the allegations were false, could not have happened and/or are without a reasonable basis. No deficiencies cited, Exit interview conducted with Administrator, Atienza-Bilan and a copy of the report was provided. Unqualified Staff On December 21, 2022 the department received a complaint alleging staff is unqualified. On December 26, 2023, the department requested staff training documents from ADM. The department reviewed staff training records for Olga’s Care Home For the Elderly. Staff S1-S4 had 10-12 training certificate forms. Staff S1-S4 completed training in the following, but not limited to; ADL's personal care of residents, food prep, medication, resident's rights, bladder/bowel incontinence, dementia, & abuse reporting. The department also reviewed the ADM's training records. The ADM had training on the following, but not limited to; Dementia training, medication training, fall prevention, infection control, DSS laws regulations & polices, Nutrition and working with Hospice. Page 2 Out of 3 Based on interviews conducted, the preponderance of evidence standard has been met therefore the above allegation is found to be SUBSTANTIATED. Deficiencies were cited from California Code of Regulations, Title 22 during today’s visit, see LIC 9099-D. This report was reviewed with Administrator Atienza-Bilan and a copy of the report was provided. Appeal Rights was provided. Page 2 out of 2. The Department has completed the investigation of the above allegations. Based on record review, the department has found that the above allegations were UNFOUNDED, meaning that the allegations were false, could not have happened and/or are without a reasonable basis. No deficiencies cited, Exit interview conducted with Administrator, Atienza-Bilan and a copy of the report was provided. Page 3 Out of 3.the state’s words, verbatim · CDSS document, Jan 19, 2024 · control 26-AS-20221221131344

From the deficiency page — Deficiency type: Type B · Section cited: CCR 87211(a)(1)(D) · Plan of correction due date: Jan 26, 2024

87211(a)(1)(D) Any incident which threatens the welfare, safety or health of any resident, such as psychological abuse of a resident by staff or other residents, or unexplained absence of any resident. This requirement was not met as evidenced by; Based on interview with ADM. ADM stated he/she did not report when R1 told ADM about the alleged abuse. ADM stated he/she did not report to licensing. This poses a potential health, safety or personal rights risk to persons in care.the state’s words, verbatim · CDSS document, Jan 19, 2024

Plan of correction: LPA discussed Reporting requirements and SOC341 with ADM. ADM stated she would send letter of understanding regarding regulation. ADM stated she would send letter by POC date, January 26, 2024.

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Manuel Monter conducted an unannounced annual inspection visit, and met with Administrator (ADM) Olga Atienza-Bilan. During visit, LPA observed 5 residents and 2 staff. LPA toured the facility inside out with ADM which included; the Living room, kitchen, dining room, restrooms and residents bedrooms. The staff area of the facility was also inspected. Front yard and backyard were inspected. There was no obstruction to block the walkways. Two day perishable food supplies and seven day nonperishable food supplies were observed. LPA observed the medication cabinet, knives storage area, and cleaning product storage area as locked and inaccessible to residents in care. Room temperature was at 75 degrees F, and hot water temperature was measured at 108 degrees F in resident bathrooms. While touring the kitchen, LPA requested to see the inside of the garage. LPA observed the door to the garage gets jammed and is difficult to close. ADM stated she has called repairman to address the door. While touring the backyard, LPA observed, bedroom #3's sliding door, does not have a screen. ADM stated it was removed because it was broken. (Photographs were taken.) Fire extinguisher was serviced in January 2024. The facility was equipped with smoke and carbon monoxide detectors. Smoke detectors was tested by ADM, and were functional. LPA observed facility first aid kit and facility fire/earthquake drill log. ADM stated the last fire drill conducted was on December 2023, but doesn't have a log. Page 1 out of 2. LPA reviewed facility records for 3 staff and 3 residents. LPA reviewed 3 resident medications and centrally stored medication records. LPA conducted interviews with 2 staff (S1 & ADM) and 3 residents (R1-R3). Deficiencies are being cited per California Code of Regulations, Title 22. See LIC809-D. Exit interview was conducted with Administrator Olga Atienza-Bilan and a copy of the signed report & appeal rights were provided. Page 2 out of 2.the state’s words, verbatim · CDSS document, Jan 13, 2024