Padua Assisted Living 2

Type of visit: Required - 1 Year

On 07/15/2026, Licensing Program Analyst (LPA) Shakaricka Hughes arrived at the facility to conduct an unannounced annual inspection. LPA Hughes met with facility administrator Angelita. The current census is 2 with 2 facility staff present. This facility is a single story building licensed to serve (6) non-ambulatory residents. LPA inspected the physical plant including but not limited to the common area, kitchen, dining area, resident bedrooms, resident bathrooms, laundry room and outside courtyards of the facility to ensure compliance with Title 22 regulations. LPA observed the facility to be free of odor, clean and in good repair. LPA observed bedrooms to be properly furnished with appropriate bedding and lighting. There are no bodies of water present. LPA toured the kitchen and observed sufficient seven-day non-perishable and two-day perishable food supplies. Hot water temperature was measured at 116.0 degrees Fahrenheit in resident bathroom sink, which is within the required regulation of 105 to 120 degrees Fahrenheit. Grab bars and non-slip mat were observed to be stable and in good repair at this time. Smoke and carbon monoxide detectors are in compliance with fire safety. The fire extinguisher is located in the kitchen area and was last serviced on 05/21/2026. LPA observed the facility has a public telephone in the common area and the facility has the required posters posted. Facility thermostat was observed at 75 degrees Fahrenheit. LPA observed toxins located in the garage area kept locked and inaccessible to residents. LPA observed sharp knives kept locked in the kitchen and inaccessible to residents. Continuation 809-C LPA checked medication storage and found medication to be locked away and inaccessible to residents. LPA reviewed 2 out of 2 residents medications and the medication administration record (MAR) was complete. The first aid kit was checked and contained the required components. LPA requested resident and staff files for review. LPA reviewed 2 out of 2 resident files and they were complete. LPA reviewed 3 staff files, and it was complete. LPA reviewed staff criminal record clearances, and a review of staff records indicates that all facility staff or other individuals who require caregiver background checks are fingerprint cleared. The following documents will be email to LPA by 07/16/2026 (1) LIC 308 Designation of Administrative Responsibility (2) Copy of Administrator Certificate (3) LIC 610 Current Emergency Disaster Plan (4) Proof of Current Liability Insurance (5) LIC 500 Current Personnel Report As a result of this annual visit, the facility is in compliance with Title 22 Regulations, the LIC 809 reports were provided to the facility.the state’s words, verbatim · CDSS document, Jul 15, 2026

Type of visit: Case Management - Deficiencies

On April 30, 2026, Licensing Program Analyst, Arvin Villanueva (LPA), arrived unannounced at this facility to conduct a case management visit. LPA initially met with staff on duty, Nahryeong Lee, and stated the purpose of the visit. The administrator, Angelita Dayoan, was notified and authorized Lee to sign this report. The purpose of the visit is to issue citation based on an office meeting with the Department of Labor (DOL) conducted on April 6, 2026. Documentation from DOL shows that Angelita Dayoan and Nicholas Padua, both responsible parties of the restitution, did not comply with the DOL restitution agreement requiring payment of back wages to former employee, S1. DOL reported that despite having S1’s correct and current address, Angelita admitted she made no attempts to pay the required restitution. Email correspondence with from DOL representative to Angelita dated April 6, 2026, indicated S1’s address was verified as current and specifying the required payment amount of $13,125.00, consisting of wages and accumulated interest. Furthermore, DOL’s communication with S1, which S1 stated that no one from the facility attempted to contact or pay S1. DOL reported that Angelita confirmed she made no payment attempts. Based on the information gathered, deficiencies are being cited today. Exit interview was conducted with Angelita and Plan of Correction (POC) was discussed. Prior to this visit, Angelita stated she mailed the payment to S1 on April 15, 2026, and that she will submit all required documents to DOL by May 4 2026. A copy of this report and appeal rights were provided.the state’s words, verbatim · CDSS document, Apr 30, 2026

From the deficiency page — Deficiency type: Type B · Section cited: CCR 87405(d)(2) · Plan of correction due date: May 1, 2026

Administrator – Qualification and Duties: The administrator shall have the qualifications… Knowledge of and ability to conform to the applicable laws, rules and regulations This requirement is not met as evidenced by: Based on interviews and record reviews, the licensee did not comply with the regulation cited above. The licensee did not meet the terms of the federal wage settlement agreement. This poses a potential health, safety, and/or personnal rights risks to residents in care.the state’s words, verbatim · CDSS document, Apr 30, 2026

Plan of correction: Corrected prior to this visit. Angelita issued the full restitution payment via mailed check to S1 on April 15, 2026 and provided the documented proof during this visit

Type of visit: Office

An office meeting was conducted today, April 6, 2026, at 10:00am via Teams Meeting with the following individuals: Liza King, Licensing Program Manager (acting Regional Manager) Stephen Richardson, Licensing Program Manager Lisa Rios, Licensing Program Manager Arvin Villanueva, Licensing Program Analyst Patricia Canites, Department of Labor representative Kevin Navarro, Department of Labor representative Angelita Dayoan, Licensee/Administrator Nicholas Padua, Licensee The purpose of this meeting was to discuss the current status of the settlement payment with the licensees Angelita Dayoan and Nicholas Padua. This meeting followed up on a signed agreement for the licensees to repay back wages to employees via a payment plan. Angelita confirmed that several employees have received partial payments and that she is close to completing all payments. Providing proof of payment to Department of Labor (DOL) was delayed because the administrative contact, James, was unable to reach Angelita. Angelita reported having difficulties locating two employees: S1 and S2. DOL will assist in locating these individuals. Angelita was advised to attempt to contact S1 and S2. {1 of 2} Angelita was advised the final deadline to provide all proof of payment (cancelled checks) is May 4th 2026. Angelita agreed to upload all existing cancelled checks to DOL’s portal by tomorrow, April 7th 2026 no later than 5:00pm. Angelita confirmed that payments to employees are “free and clear” and that she has not requested the funds back from the employees. Due to communication issues and payment delays, licensees were advised that the Department will initiate an audit of this facility and other facilities that are under the licensees. This audit is to verify the facilities’ financial solvency and their ability to continue to operate. The licensees agreed to do the following: Upload all available cancelled checks to the DOL’s portal by April 7th 2026 no later than 5:00pm. Provide all remaining proof of payment by May 4th 2026. Licensees agreed to contact S1 and S2 first and provide back wages payment. If unable to locate or reach out to these individuals, licensees were advised to send payment to DOL. S1 and S2 will need to retrieve payments at DOL. The Department will do the following: The Department will conduct an audit to verify the facility’s financial solvency and their ability to continue to operate. No deficiencies were cited during today’s meeting. Exit interviews and licensees were informed that a copy of this report will be emailed to them and a request made by this LPA for licensees to sign the documents and send back a copy of the signed report. {2 of 2}the state’s words, verbatim · CDSS document, Apr 6, 2026

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Vincent Moleski arrived unannounced to conduct an annual inspection. LPA Moleski met with facility administrator Angelita Dayoan and explained the purpose of the visit. LPA Moleski reviewed five resident files (R1-R5) and two staff files (S1-S2). LPA Moleski toured the facility with Dayoan and inspected common areas, the kitchen, bedrooms, bathrooms, and backyard areas. Furniture and furnishings were sufficient to meet the needs of residents. The facility temperature was 75 degrees Fahrenheit, which is within the required range of 68 and 85 degrees. The facility's water temperature measured 111 degrees Fahrenheit, which is within the required range of 105 and 120 degrees. LPA Moleski observed first aid supplies, a fully-charged and up-to-date fire extinguisher, and carbon monoxide/smoke detectors. LPA Moleski observed a minimum 2-day supply of perishable food and a minimum 7-day supply of nonperishable food. LPA Moleski observed a locked cabinet for the storage of medication. LPA Moleski observed locked cabinets for the storage of cleaning solutions and knives. LPA Moleski interviewed two staff members (S1-S2) and one resident (R5). No deficiencies were cited during this visit. An exit interview was conducted and a copy of this report was left with Dayoan.the state’s words, verbatim · CDSS document, Jul 24, 2025

The state marks this report as 5 pages; the online copy we transcribed has 2. You can request the full file from the county licensing office.

Type of visit: Case Management - Other

Licensing Program Analyst (LPA) Vincent Moleski arrived unannounced to conduct a case management visit. LPA Moleski met with facility administrator Angelita Dayoan and explained the purpose of the visit. Prior to this visit, LPA Moleski observed a resident of this facility (R1) in the community unsupervised. LPA Moleski was familiar with this resident's history due to previous incidents at this facility, including elopement incidents and multiple complaint investigations. On 08/10/2023, LPA Moleski substantiated an allegation that facility staff were not properly supervising residents in care, resulting in residents wandering from the facility. During this visit, Dayoan said that R1 was sent out to their work program this morning around 8 a.m. LPA Moleski called the work program's program coordinator, who confirmed that R1 was scheduled to work today. LPA Moleski left a voicemail message to follow up with R1's Alta California Regional Center Service Coordinator. If necessary, LPA Moleski will follow up with the work program as needed. No deficiencies were cited during this visit. An exit interview was held and a copy of this report was left with Dayoan.the state’s words, verbatim · CDSS document, Mar 27, 2025

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Vincent Moleski arrived unannounced to conduct an annual inspection. LPA Moleski met with facility administrator Angelita Dayoan and explained the purpose of the visit. LPA Moleski reviewed five resident files (R1-R5) and three staff files (S1-S3). LPA Moleski observed in R5's file an after-visit summary which stated R5 went to the hospital on 6/25/24 due to abdominal pain, and received a CT scan while there. LPA Moleski observed a handwritten incident report in R5's file regarding the hospital visit, but which was not completed, and did not indicate that it was sent to CCLD. LPA Moleski reviewed email and fax records and observed that no report had been received regarding this incident. LPA Moleski toured the facility with Dayoan and inspected common areas, the kitchen, bedrooms, bathrooms, and backyard areas. Furniture and furnishings were sufficient to meet the needs of residents. The facility temperature was 75 degrees Fahrenheit, which is within the required range of 68 and 85 degrees. The facility's water temperature measured 106 degrees Fahrenheit, which is within the required range of 105 and 120 degrees. LPA Moleski observed first aid supplies, a fully-charged and up-to-date fire extinguisher, and working carbon monoxide/smoke detectors. LPA Moleski observed a minimum 2-day supply of perishable food and a minimum 7-day supply of nonperishable food. LPA Moleski observed a locked cabinet for the storage of medication. LPA Moleski observed locked cabinets for the storage of cleaning solutions and knives. LPA Moleski interviewed two staff members (S1-S2) and one resident (R1). This facility is hereby cited per 22 CCR Section 87211(a)(1). An exit interview was held with Dayoan. Appeal rights and a copy of this report were left with Dayoan.the state’s words, verbatim · CDSS document, Aug 6, 2024