Palo Alto Senior Care Home

Type of visit: Required - 1 Year

On 11/06/25 Licensing Program Analyst (LPA) M. Yang arrived unannounced to conduct an annual visit. LPA introduce self, stated the purpose of the visit and met with staff Archimedes Crisologo. Licensee/Administrator Marisela De La Torre Vizcarra was called and arrived shortly. All five residents were present during inspection. LPA toured facility with Licensee. The facility was observed to be at a comfortable temperature, clean, in good repair, and no passageway obstructions or fire hazards were observed inside or outside. All residents’ bedroom were toured and observed to have the required furnishings and with adequate lighting. An adequate supply of perishable and non-perishable food was observed. Fire extinguisher was observed with a service date: 10/22/25. Last fire drill was completed on 10/10/25.Medications were observed locked in kitchen cabinet. Medications were checked and MARs were reviewed and observed administered as prescribed. Kitchen was toured and observed cleaning chemicals under kitchen sink. Knives were observed locked in lockbox under kitchen counter. The bathrooms were toured. Non-skid mats and grabbed bars were observed. Hot water temperature was tested at 115.3 and 113.5 degree F in the bathroom 1 and maintained at 114.2 and 116.2 degree F in master bathroom. Extra linens and towels were observed. Outside of facility toured and observed to be free of debris. Side exit observed self-closing and self-latching. Adequate outdoor seating is available for residents. All residents’ and sample of staff files were reviewed to have required records. Carbon monoxide and smoke detector operational during visit. No deficiencies issued during this inspection. Exit Interview conducted. The following documents requested to be updated and submitted to Fresno CCL by 11/12/25: Lic 308, Lic 309, Lic 500, Lic 610E, current Administrator certificate, and current liability insurance. A copy of this report was provided to Licensee, whose signature on this form confirms receipt of this report.the state’s words, verbatim · CDSS document, Nov 6, 2025

Type of visit: Required - 1 Year

On 10/28/2024, Licensing Program Analyst (LPA) Walton arrived unannounced to conduct an annual inspection. LPA introduced self, stated the purpose of the visit and requested to meet with the Administrator. LPA met with Administrator, Marisela Vizcarra. LPA reviewed facility records and observed the following: LPA found that 3 out of 4 client records were observed to be current and complete. LPA did not observe hospice binder for S1. Administrator stated that hospice nurse completed a binder and requested for another agency "drop off" the binder to the facility. Personnel records reviewed. LPA found personnel records to be complete, however staff did not have documentation of annual training on file. Medications reviewed and observed to be administered as prescribed. Emergency disaster plan reviewed. Last fire drill conducted on 09/14/2024. LPA conducted a tour of the facility. Facility appeared clean and at a comfortable temperature. Common areas were furnished with adequate seating and lighting. Fire extinguisher observed to be last serviced on 10/16/2023. LPA toured the facility kitchen. Kitchen appeared clean and safe for food preparation. LPA observed an adequate food supply. Medications observed to be locked and inaccessible in a cabinet in the kitchen. LPA observed the facility bathroom to be operational. Bathroom was equipped with securely fastened grab bars. Hot water measured at 116.4 degrees F. Cleaning supplies observed to be locked an inaccessible in a closet. LPA toured resident bedrooms and observed the bedrooms to have required furnishings. LPA observed an adequate supply of linens. Smoke detector and carbon monoxide detector observed to be operational during today's inspection. Exterior tour conducted. All exits and passage ways were free from obstructions during today's inspection. Deficiencies are being cited in accordance to California Code of Regulations, Title 22, Division 6 on the attached 809D. Exit interview conducted and a plan of correction was reviewed and developed with Administrator. A copy of this report and appeal rights were discussed and provided to Administrator, Marisela Vizcarra, whose signature on this form confirms receipt of this document. LPA is requesting the following documents be submitted to the Fresno CCL office via fax or mail by 11/11/2024: Current copy of Administrator Certificate, Designation of Facility Responsibility (LIC308), Administrator Organization (LIC 309), Affidavit regarding Client/Resident Cash Resources (LIC 400), Liability Insurance, Emergency and Disaster Plan (LIC 610E) Personnel Report (LIC500), Register of Facility Clients/Residents for (LIC9020A), Surety Bond.the state’s words, verbatim · CDSS document, Oct 28, 2024

The state marks this report as 5 pages; the online copy we transcribed has 3. You can request the full file from the county licensing office.

Allegation investigated: Resident sustained unexplained fractures while in care

On 11/29/2023, Licensing Program Analyst (LPA) Walton arrived unannounced to deliver findings on the above allegation. LPA introduced self and disclosed the purpose of the visit to the Administrator. LPA met with Administrator, Marisela Vizcarra. The Department investigated the allegation: Resident sustained unexplained fractures while in care, and found that the allegation is UNSUBSTANTIATED. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur. No deficiencies issued during this inspection. An exit interview was conducted with Administrator. A copy of this report was discussed and provived to Administrator, Marisela Vizcarra, whose signature on this form confirms receipt of this document. Unsubstantiatedthe state’s words, verbatim · CDSS document, Nov 29, 2023 · control 24-AS-20230831103153

The state marks this report as 3 pages; the online copy we transcribed has 1. You can request the full file from the county licensing office.

Type of visit: Required - 1 Year

On 11/29/2023, Licensing Program Analyst (LPA) Walton arrived unannounced to conduct an annual inspection. LPA introduced self, stated the purpose of the visit and requested to meet with the Administrator. LPA was granted entry to the facility, facility staff contacted Administrator via telephone, and Administrator arrived a short time later. LPA met with Administrator, Marisela Vizcarra. LPA conducted a tour inside and outside of facility. Facility observed to be clean, odor free and at a comfortable temperature. Common areas were furnished well with adequate seating and lighting available. Resident bedrooms appeared clean and had required furnishings. LPA observed an adequate supply of linen. Resident bathrooms were equipped grab bars in toilet and tub/shower areas, non-skid mats were observed. Hot water measured at 128.7 degrees F. Kitchen toured, appeared clean, observed a 7-day supply of non-perishable and 2-day supply of perishable food. Exterior tour conducted, all exits open and free of obstructions. Side gate was observed to be self-latching. Fire extinguisher serviced on 10/16/2023. Smoke detectors and carbon monoxide detectors observed operational during today’s inspection. Last fire drill conducted on 07/20/2023. All cleaning supplies are locked in secured closet in the hallway. LPA reviewed staff and client records. Medications reviewed and observed to have original labels and be administered as prescribed. A deficiency is being issued in accordance to California Code of Regulations, Title 22, Division 6 on the attached 809D. Exit interview conducted and a plan of correction was reviewed and developed with the Administrator. A copy of this report and appeal rights were discussed and provided to Administrator, Marisela Vizcarra, whose signature on this form confirms receipt of this document. LPA is requesting the following documents be submitted to the Fresno CCL office by 12/13/2023: Current copy of Administrator Certificate, Designation of Facility Responsibility (LIC308), Administrator Organization (LIC 309), Affidavit regarding Client/Resident Cash Resources (LIC 400), Liability Insurance, Emergency and Disaster Plan (LIC 610E) Personnel Report (LIC500), Register of Facility Clients/Residents for (LIC9020A), Surety Bond.the state’s words, verbatim · CDSS document, Nov 29, 2023

The state marks this report as 6 pages; the online copy we transcribed has 2. You can request the full file from the county licensing office.