Olive Grove Residential Care Home

Type of visit: Required - 1 Year

At 8:00am on 07/14/2026, Licensing Program Analyst (LPA) Jeffries arrived unannounced to the facility to conduct the facility annual inspection. LPA met with Administrator, Maribel Castillo, announced who he is and the reason for the visit. Administrator and LPA conducted a physical tour of the facility. LPA noted that this is a 3 bedroom, 2 bathroom, living room, dining room, laundry room and kitchen. LPA noted there is a very large back yard with gazebo and seating for outdoor activities and visitations. LPA noted that all rooms have linins and furniture meeting regulation standards. LPA noted that both bathrooms are using liquid soap and paper towels and incontinent products are store in facility closet. LPA observed at least two days of perishable foods and at least seven days of non perishable foods on hand for six residents and staff. LPA observed a working fire extinguisher primed an in the green in the kitchen. LPA observed a complete first aide kit per regulation requirements in the dining room. LPA noted that medications are located in a locked cabinet in the kitchen. LPA noted that wired smoke detectors are located in kitchen and throughout the facility and in proper working condition. LPA noted that the facility is clean and in good repair and all hallways and exits were free and clear of obstructions. LPA reviewed facility Infection Control Plan, Emergency Disaster Plan, Liability Insurance, and Centrally Stored Medication Records. LPA reviewed all staff and client files to be complete. All staff were reviewed to be properly cleared to work in this facility. Administrator and LPA conducted a full review of the annual care tools module. LPA noted that no technical, violations, or citations were noted during the annual care tools module review. LPA noted that this full facility inspection had no technical, violations, or citations. Exit interview, report read, and report providedthe state’s words, verbatim · CDSS document, Jul 14, 2026

Type of visit: Required - 1 Year

At 8:00am on 07/11/2025, Licensing Program Analyst (LPA) Jeffries arrived unannounced to the facility to conduct the facility annual inspection. LPA met with Administrator, Maribel Castillo, announced who he is and the reason for the visit. Administrator and LPA conducted a physical tour of the facility. LPA noted that this is a 3 bedroom, two bathroom, living room, dining room, laundry room and kitchen. LPA noted there is a very large back yard with gazebo and seating for outdoor activities and visitations. LPA noted that all rooms have linins and furniture meeting regulation standards. LPA noted that both bathrooms are using liquid soap and paper towels and incontinent products are store in bathroom 1. LPA observed at least two days of perishable foods and at least seven days of non perishable foods on hand for six residents and staff. LPA observed a working fire extinguisher primed an in the green in the dining room. LPA observed a complete first aide kit per regulation requirements in the dining room. LPA noted that medications are located in a locked cabinet in the kitchen. LPA noted that wired smoke detectors are located throughout the facility and in proper working condition. LPA noted that the facility is clean and in good repair and all hallways and exits were free and clear of obstructions. LPA reviewed facility Infection Control Plan, Emergency Disaster Plan, Liability Insurance, and Centrally Stored Medication Records. LPA reviewed all staff and client files to be complete. All staff were reviewed to be properly cleared to work in this facility. Administrator and LPA conducted a full review of the annual care tool modules. LPA noted that there were no violations or citation as a result of the annual care tool modules review. LPA noted that there were no violations or citations as a result of the physical inspection. LPA noted that there are no violations or citation as a result of the full facility annual inspection. Exit interview, report read, and report provided.the state’s words, verbatim · CDSS document, Jul 11, 2025

The state marks this report as 9 pages; the online copy we transcribed has 2. You can request the full file from the county licensing office.

Allegation investigated: Staff caused injury to resident. Staff does not maintain a comfortable room temperature for resident. Staff sleeping while on duty. Staff tells resident to disrupt another resident’s sleep.

On 08/23/2024, Licensing Program Analyst (LPA) Brian Phillips conducted a subsequent complaint investigation visit to the facility above to deliver final findings for the above allegations. During today’s visit, LPA Phillips met with Licensee/Administrator Maribel Castillo, and explained the reason for the visit. On the allegation: Staff caused injury to a resident. It is alleged that a visitor to the facility observed that the ear of Resident #1 (R1) was black and blue. Allegedly the visitor inquired about the ear of R1 and staff stated it was from cleaning R1’s ear. R1 was asked about what happened to their ear but they did not know. It is also alleged that the facility staff allow R1 to use their wheelchair as a walker. Allegedly staff were informed by the responsible party of R1 that it is unsafe to use their wheelchair as a walker. Staff interviewed by LPA on 04/17/2024 stated that relatives of R1 were complaining about the level of care, but R1 had improved while in care at the facility. Continued on 9099-C Unsubstantiated R1 stated that they were happy with the treatment in the facility and did not corroborate the statements made by complainant/Reporting Party (RP). Staff stated the facility is complying with giving R1 activities and treatment, Activities of Daily Living (ADL), as well as needs and services. On 04/17/2024, LPA conducted record review of relevant documentation of R1 to the allegation above. LPA reviewed the Resident Admissions Agreement, Medical Assessment/Physicians Reports, Appraisal Needs and Services Plan, and any relevant medical/hospital documentation that all outlined the need for R1 to have assistance from staff in ADLs such as bathing, grooming, and hygiene needs. Both staff of the facility and outside Agency representatives providing care to R1 stated that there was an attempted mediation with RP to ask what the facility can improve upon related to caring for R1, but RP did not have any specific answers. LPA received photographs that provided documentation of the redness/irritation to the top of R1’s ear. LPA observed that the ear of R1 appeared to be irritated/red but did not observe any bruising or any black or blue discoloration. According to staff interviewed by LPA, this redness on R1’s ear occurred during a cleaning of R1’s ears by staff members assisting with R1’s grooming/bathing/hygiene ADLs. All residents interviewed by LPA stated that they did not observe any mistreatment of R1 by any staff member and had never received any type of physical mistreatment by any staff member at the facility. Staff members and RP interviewed by LPA all stated that a previous meeting had been set up with the facility, in which there was anger at the fact that R1 was having trouble walking. Staff interviewed by LPA stated that R1 used a wheelchair in the correct capacity at the facility, and not as a walker. Residents interviewed by LPA stated that R1 was observed to be using a wheelchair while in the facility, but not as a walker just as a traditional wheelchair. Based on the information obtained, there was insufficient evidence that staff do not maintain a comfortable room temperature for resident(s). Therefore, the allegation is deemed Unsubstantiated at this time. On the allegation: Staff does not maintain a comfortable room temperature for resident. It is alleged that a visitor to the facility observed a blanket over the head of Resident #1 (R1) while in their bedroom. R1 allegedly told the visitor that they were cold. The visitor allegedly asked for staff to turn the facility heater on, but staff did not know how. On 04/17/2024, LPA conducted an initial 10-day complaint investigation visit to the facility above. During this visit, the LPA toured the physical plant areas inside and outside to ensure there are no health and safety hazards and the facility is in compliance with Title 22 Regulations. LPA observed that the facility maintained a comfortable temperature in all common areas and resident bedrooms inspected. Continued on 9099-C LPA observed a thermostat in the main facility living room area which was observed to be at 72 degrees Fahrenheit at the time of visit by LPA. On 08/23/2024, LPA conducted a subsequent complaint investigation visit to the facility above. During this visit, LPA observed that the facility maintained a comfortable temperature in all common areas and resident bedrooms inspected. LPA did not physically observe an uncomfortable temperature in the facility at the time of either visit, whether it be observably cold or observable hot. All residents interviewed by the LPA indicated that they had no problems with the temperature maintained by the facility and were comfortable in care. All Staff members interviewed by the LPA indicated that they had not had any residents ask to change the temperature in the facility, either to ask for air conditioning or to have a heater turned on. While at the facility on 04/17/2024, LPA asked staff to demonstrate how to use the thermostat and facility heater. Staff members were able to adequately demonstrate to LPA how to operate the facility temperature controls. No resident was observed by LPA during either visit (04/17/2024 or 08/23/2024) to be wearing blankets or sweaters/additional clothing in the facility or visibly uncomfortable due to excessive cold. No resident was observed by LPA during either visit to be sweating or visibly uncomfortable due to excessive heat. Based on the information obtained, there was insufficient evidence that staff do not maintain a comfortable room temperature for resident(s). Therefore, the allegation is deemed Unsubstantiated at this time. On the allegation: Staff sleeping while on duty. It is alleged that a visitor to the facility asked Resident #1 (R1) where a facility staff member was and was informed that the staff member was sleeping. It is alleged that R1 refuses to sleep on the bed in their bedroom and prefers to sleep on the recliner in the facility living room, while a staff member sleeps on the couch. It is alleged that R1 called their responsible party by telephone stating that they were hungry and that a staff member was sleeping. This telephone call allegedly took place at 10:00am. R1 was informed that they should wake the staff member. After the staff member allegedly woke up, they refused to speak with the responsible party of R1. Staff interviewed by LPA stated that R1 sleeps on the couch sporadically when watching television but uses their bedroom to sleep at night. Residents interviewed by LPA corroborated this statement and added that R1 was observed by other residents to go into their bedroom at night to sleep. No staff member or resident interviewed by LPA stated that they had ever observed a staff member sleeping on the couch in the common area living room of the facility while on duty. During unannounced and unscheduled visits by LPA on 04/17/2024 and 08/23/2024, no staff member was observed by LPA to be sleeping and/or laying on the couch in the living room of the facility or anywhere else in the facility. Continued on 9099-C Based on the information obtained, there was insufficient evidence that staff do not maintain a comfortable room temperature for resident(s). Therefore, the allegation is deemed Unsubstantiated at this time. On the allegation: Staff tells resident to disrupt another resident’s sleep. A visitor to the facility stated they witnessed facility staff members asking Resident #1 (R1) to wake up Resident #2 (R2) for lunch. On 04/17/2024, LPA received documentation for record review regarding the meal/food service schedule for the facility. This schedule is documented to have lunch for the facility residents in the afternoon approximately between 12pm-3pm. All facility staff members and residents interviewed by the LPA indicated that lunch is served in the afternoon and that if a resident does not know that lunch has been served, staff or other residents will let them know as a courtesy. No staff or resident interviewed by LPA indicated that any resident would be intentionally disrupted if they had requested or required privacy such as sleeping in their room. No resident interviewed by LPA stated that they had ever been forced to go wake up another resident for any reason, and no staff member interviewed by LPA stated that they had ever required or forced a resident to wake up another resident. Based on the information obtained, there was insufficient evidence that staff do not maintain a comfortable room temperature for resident(s). Therefore, the allegation is deemed Unsubstantiated at this time. Exit interview conducted. Copy of this report provided to the facility.the state’s words, verbatim · CDSS document, Aug 23, 2024 · control 29-AS-20240415163235

Type of visit: Required - 1 Year

On 07/15/2024, Licensing Program Analyst (LPA) Brian Phillips arrived at the facility unannounced to conduct a required annual site inspection at the facility above. When the LPA arrived, they were greeted by Licensee Reymar Castillo as the Administrator was not available and informed them of the reason for the visit. The LPA toured the physical plant areas inside and outside to ensure there are no health and safety hazards and facility is in compliance with Title 22 Regulations. This is a Residential Care For the Elderly (RCFE) facility, with an approved fire clearance for six (6) residents. The age range at this facility is 60 years old and over. The facility is approved for six (6) non-ambulatory residents with a hospice waiver approved for two (2) residents. KITCHEN: The LPA inspected the kitchen/food service area and observed that knives/sharp instruments are stored in a locked storage container in the kitchen. Kitchen appliances were in operable condition. The LPA observed perishable items in good condition, with proper expiration dates precluding the perishable items from expiring. The facility has a sufficient supply of perishable and non-perishable food. Additional perishable food items were purchased prior to the visit and stored in the garage area on a shelf and/or an extra freezer. The hot water temperature was measured in the kitchen at an appropriate temperature as per the regulation. The Kitchen/food service and preparation area was very clean and everything appeared to be in good/operating condition. COMMON AREAS: At the time of the visit, living room and dining room furniture was observed to be in good condition. There is a fireplace in the living room, which is covered and inaccessible. The facility maintained a comfortable temperature. Smoke detector(s) and carbon monoxide detector were tested and operational at the time of the visit. The fire extinguishers were fully charged and are serviced annually. All exits from the facility either have delayed egress or locks which were all operational at the time of the visit. The LPA observed required postings throughout the common space. Continued on 809-C There were two linen closets in the hallway with extra towels and fresh linens for residents. OUTDOOR/BACKYARD: The backyard has an outdoor area equipped with furniture for resident use. There is a side gate which is delayed egress self-closing. All exits from the interior of the facility into the backyard area have accessibility ramps for residents. There were no bodies of water noted. There is a separate laundry room where cleaning products are stored, which is kept locked. The laundry room is accessible through the garage. There was emergency food and water in the garage which was observed to be in good condition. Cleaning supplies and disinfectants are kept in locked cabinets in the garage. In the front of the facility, the LPA noted that the facility had a delayed egress front gate outside into the driveway area, and the entire facility was gated. There is a locked storage shed in which extra accessibility/medical items are maintained for potential clients. This facility shares a common wall with an individual tenant not associated with the facility. This tenant maintains an apartment with no access to the interior of the facility, and no way to interact with residents of the facility. BEDROOMS: The LPA observed the resident bedrooms, which were furnished appropriately with clean linens, appropriate furnishings and sufficient lighting. There are three designated resident rooms. One of the resident rooms has two beds and an attached bathroom. The other two resident bedrooms have individual beds, and the residents share a bathroom in the hallway. At the time of the visit, the facility has a designated staff room which also serves as an office for the licensee. Each closet in all of the resident rooms has extra pillows, clean/fresh linens, and appropriate incontinence materials if applicable for future residents. RESTROOMS: The two resident restrooms were clean and sanitary and in operating condition with grab bars and non-skid surfaces. The bathrooms were sufficiently stocked with supplies and paper towels; towels and washcloths are not shared. The hot water temperature was measured in both of the restrooms at the appropriate degrees Fahrenheit as per the regulations. RECORDS: The facility keeps resident records on-site at the facility while Staff records were not stored on-site in the facility, but electronically by the Administrator/Licensee. Staff records were reviewed for Health Screening Report/Tuberculosis (TB) Clearance for facility personnel, Personnel Record (employment application), verification of age over 18 years old, education/experience, verification of first aid training, Criminal Record Statement, Criminal Record Clearance/Exemption, Verification of Staff training, Employee Rights, and Abuse Reporting Requirements. Continued on 809-C. The administrator of the facility has an active RCFE Administrator Certificate that expires 10/06/2025. LPA observed that one (1) Staff member has no documentation of fingerprinting prior to beginning employment in the facility and no documentation of either a criminal record clearance or a criminal record exemption. All individuals subject to criminal record review do not have documentation of criminal record clearance or criminal record exemption in their individual personnel files. Resident records were reviewed for, but not limited to Pre-Admission/Placement appraisals, Resident Appraisals, Appraisal Needs and Services Plan (ANS), Physicians’ Reports, Identification and Emergency Information, Current Admission Agreement with signatures, Personal Rights for Residents, Record of Residents safeguarded cash resources, Record of Resident personal property/valuables, Responsible Person or Conservator of Resident, Self-management of medications if applicable, Medication Orders, and Medication Logs. All resident files reviewed by the LPA had the appropriate documentation included. MEDICATIONS: Medications were reviewed for residents at the facility. Medications are stored in a centrally stored and locked closet in the hallway. The LPA observed the Licensee demonstrate the locking and unlocking of the centrally stored medication cabinet in the hallway. LPA observed the MARS and centrally stored medication logs for each resident and did not observe any deficiencies. INFECTION CONTROL: Upon entry, the facility has a central entry point for symptom screening and a sanitation station. The staff members will keep up signs that promote good hand hygiene and symptoms of COVID. The facility has an adequate supply of Personal Protection Equipment (PPE) and the facility is able to obtain additional supplies as needed. The facility’s cleaning protocol is sufficient. If needed, the facility has the capacity to designate a single isolation room if the facility has a confirmed case of COVID-19. The facility’s policies and procedures as it pertains to infection control are adequate. FACILITY DOCUMENTATION: The facility keeps hard copies of the Application for an RCFE, Affidavit Regarding Client/Resident Cash Resources, Surety Bond, LIC 500 Personnel Report, LIC 501 Personnel Record, LIC 503 Health Screening Report, LIC 610E Emergency Disaster Plan for Residential Care Facilities For the Elderly, LIC 9282 Residential Infection Control Plan, LIC 999 Facility Sketch, and the Rental Agreement signed and dated 04/01/2023 with a copy of Cashier’s Check. The facility additionally has a Plan of Operation, Control of Property, Facility Program Description, Rules of Discipline/Personal Rights, Admission Agreement for Residents, Sample Food Menu, and the Theft & Loss Policy. Continued on 809-C The facility has on file a Dementia Care Plan document as well as Hospice Care Waiver. The Hospice Care Waiver states the maximum number of Hospice residents which the facility is requesting at any one time is two (2). Deficiencies were cited for the facility having one (1) employee required to be fingerprinted pursuant to Section 87355, having no documentation of fingerprinting with no documentation of either a criminal record clearance or a criminal record exemption as required by Section 87355(e). All personnel records are not maintained at the facility and not available physically at the facility for LPA to to inspect, audit, and copy. However, personnel records were available to LPA electronically as the Administrator/Licensee had to scan the Personnel Records from a separate location after a delay. Technical violations were issued to the facility as all individuals subject to criminal record review pursuant to Health and Safety Code Section 1569.17(b) shall prior to working in a licensed facility request transfer of criminal record clearance as specified in Section 87355 or request and be approved for transfer of criminal record exemption as specified in section 87356(r). Licensee shall receive Criminal Record Clearances/Criminal Record Exemptions for all Staff at facility. Exit interview conducted. A copy of the report was issued/provided to the facility.the state’s words, verbatim · CDSS document, Jul 15, 2024

The state marks this report as 9 pages; the online copy we transcribed has 6. You can request the full file from the county licensing office.