Paradise Manor

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Steve Chang conducted an unannounced annual inspection visit, and met with Designated Administrator (ADM) Melanie Gavina. 2 staff were observed in the facility. 4 Residents went to day program. LPA checked 2 resident files and 2 staff files. LPA toured the facility inside out with ADM. Living room, family room, kitchen, dinning room and 4 restrooms were inspected. 4 single resident rooms, and laundry area were inspected. One staff live-in room was observed in the facility. Two day perishable food supplies and seven day nonperishable food supplies were observed sufficient. Medication closet, knives closet and cleaning product closet were observed locked. Room temperature was at 69 degree F, and hot water temperature was at 106 degree F in facility. Fire extinguisher was serviced on 6/8/2025. The temperature of freezer was observed at 0 degree F. The temperature of refrigerator was observed at 30 degree F. First aid box, night lights, and flash lights were observed in the facility. The last time the facility conducted the earth quake drill was on 1/3/26 and the fire alarm drill was on 1/4/26. The facility was equipped with fire alarm system, smoke and carbon monoxide detectors. Smoke detectors and carbon monoxide detectors were tested by ADM, and they were working fine. Front yard and backyard were inspected. There was no obstruction to block the walkways. One storage room was observed in the backyard. No citation noted today. Exit interview was conducted with ADM. This report was provided to ADM for signature. A copy of the report was provided to ADM.the state’s words, verbatim · CDSS document, Feb 3, 2026

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Marcela Yanez conducted an unannounced Required 1 Year visit and met with Melanie Gavina Designated Administrator. During visit, LPA toured the facility inside and out. LPA toured the garage area and observed food storage areas and locked cabinets for cleaning supplies. LPA observed the kitchen area and observed locked cabinets for medications, sharp objects, and cleaning supplies. LPA observed perishable food supply of at least two days and a non-perishable food supply of at least seven days. Refrigerator temperature measured at 20 degrees F and freezer measured at -7 degrees F LPA toured four resident bedrooms. Each bedroom had available bedding and clothing storage areas as well as functioning lights. While touring resident bedroom R1 LPA observed medication belonging to R1 accessible to residents in care. R1 is not allowed to administer their own medication. Medication was removed and placed in locked cabinet. LPA toured 3 resident bathrooms. Each bathroom had available soap and paper towels and functioning lights. The water temperatures in the bathroom sinks measured with thermometer at 109 degrees F. LPA toured the outside area and found the exits to be clear of obstructions. LPA observed fire extinguisher was last serviced on 04/25/24. LPA reviewed Fire and Earthquake log was last disaster drill was last conducted on 01/04/25 and 01/05/25. LPA reviewed resident records for 2 resident. LPA reviewed 2 staff records and found them to be complete. ADM tested the smoke detectors in the hallway smoke detector to function properly when tested. Deficiencies were cited as per California Code of Regulations Title 22. This report was reviewed with Melanie Gavina Designated Administrator and a copy of this report and appeal rights were provided.the state’s words, verbatim · CDSS document, Feb 21, 2025

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Manuel Monter conducted an unannounced annual inspection visit, and met with Lead staff Melanie Gavina (S1). During the visit, LPA observed 4 residents and 2 staff. S1 called Administrator (ADM) Lynda Miguel and ADM stated S1 could give LPA tour and sign on her behalf. LPA toured the facility inside out with S1 which included the Living room, kitchen, dining room, 4 restrooms and 4 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. While touring resident bedroom #3, LPA observed 7 containers of dish washing detergent on the ground. While touring the bathroom #2, which is located across from bedroom #3, LPA observed a bottle of dish washing detergent. (Photographs were taken.) 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 70 degrees F, and hot water temperature was measured at 118 degrees F in resident bathrooms. Fire extinguisher was serviced in May 10, 2023. The facility was equipped with smoke and carbon monoxide detectors. Smoke detectors was tested by S1, and were functional. LPA observed facility first aid kit and facility fire/earthquake drill log. The facility's last drill was on January 7, 2024. Page 1 out of 2. LPA reviewed facility records for 2 staff and 2 residents. While reviewing resident records, LPA discovered that residents R1, R2 and R3 are under the age of 60. LPA reviewed 2 resident medications and centrally stored medication records. LPA reviewed 2 residents P&I records. LPA conducted interviews with 2 staff (S1 to S2) and 2 residents (R1-R2). Deficiencies are being cited during today's visit, see LIC809-D. This report was reviewed with Lead staff Melanie Gavina and a copy of the signed report was provided. Page 2 out of 2.the state’s words, verbatim · CDSS document, Feb 15, 2024

Allegation investigated: The facility bathroom has mold.

LIcensing Program ANalyst (LPA) Steve Chang conducted an unannounced investigation visit to deliver the invstigation finding and met with House Manager (HM) Melanie Gavina. On 12/21/2021, the Department received a complaint with the allegation that the facility bathroom has mold. On 12/27/2021, LPA conducted an initial investigation visit, toured the facility, inspected the food supplies, and interviewed ADM, 3 staff (S1 - S3), and 6 residents (R1 - R6). Continue on LIC9099-C. Page 1 of 2. Substantiated The facility bathroom has mold: On 12/27/2021, LPA interviewed 6 residents (R1 - R6). 5 out of 6 stated the staff cleaned the bedrooms and restrooms every day. 2 out of 6 residents stated there was mold on the top of the restroom. LPA interviewed Administrator (ADM) Lynda Miguel. ADM stated the facility staff cleaned all the residents' bedrooms and bathrooms every day. LPA toured the facility with S1 and ADM including the common area, 4 resident bedrooms and 3 restrooms. LPA found mold on the ceiling of one of the resident restrooms. LPA showed the mold on the ceiling of the restroom to S1. S1 agreed that it was mold. LPA showed the mold on the ceiling of the resident restroom, ADM admitted it was mold and stated the mold would be cleaned up by end of the day. Based on the observation and interviews, mold was found on the ceiling of one of the resident restrooms, and S1 and ADM admitted it was mold. The Department has investigated the above allegation. Based on observation, and interviews conducted, the preponderance of evidence standard has been met. Therefore, the Department found the above allegation to be SUBSTANTIATED. Deficiencies are being cited. See LIC 9099-D. Exit interview conducted with ADM. The report was provided to HM for signature. A copy of this report was provided to HM. Page 2 of 2 The facility does not serve food in good quality: On 12/27/2021, LPA interviewed Administrator (ADM). ADM stated the facility provided the meals to residents based on the food menu. ADM stated he/she did the grocery shopping for the facility and he/she tried to shop for different food supplies to make the food meals with changes and varieties. ADM stated it was hard to make each resident fully satisfied. ADM denied the facility provided raw food, expired food or spoiled food to residents. On the same day, LPA interviewed 3 staff. 3 out of 3 staff stated they all took turns to cook breakfast, lunch and dinner based on the menu. 3 out of 3 staff denied they provided raw food or expired food to residents. They all agreed that they provided sandwich for lunch. LPA interviewed 6 residents (R1 - R6), 4 out of 6 residents (R1 - R4) stated the facility food is good. 1 out of 6 residents(R6) was unable to answer the question. 1 out of 6 residents (R5) stated the facility provided the chicken with blood inside and pink inside, he/she stated he/she can cook better than staff but was not allowed to cook. 2 out of 6 residents (R3. R4) stated the sandwich for lunch is fine but they prefer to have hot food for lunch. LPA toured the facility with S1 to check the milk, perishable food and nonperishable food. LPA did not find expired milk or expired food. 2 day perishable food and 7 day nonperishable food were observed sufficient. Based on reviewing the food menu, all the weekday lunches were sandwich and many meals were supplied with "low fat", "low calorie" food. The Department has investigated the above allegation. Based on interview, record review, and observation the department has found the above allegation is unsubstantiated. An unsubstantiated finding indicates that although the allegation may have happened and/or is valid there is not a preponderance of evidence to show the alleged violations did or did not occur. No deficiencies were cited per California Code of Regulations, Title 22. This report was reviewed with HM and a copy of the report was provided. Page 2 of 2.the state’s words, verbatim · CDSS document, Oct 18, 2023 · control 26-AS-20211221115941

From the deficiency page — Deficiency type: Type A · Section cited: CCR 87303(a) · Plan of correction due date: Oct 19, 2023

87303 Maintenance and Operation (a) The facility shall be clean, safe, sanitary and in good repair at all times. Maintenance shall include provision of maintenance services and procedures for the safety and well-being of residents, employees and visitors. This requirement was not met as evidenced by: Based on the observvation, mold was observed on the ceiling of one of the restroom which posed a immediate health and safety risk to residents in care.the state’s words, verbatim · CDSS document, Oct 18, 2023

Plan of correction: Administrator stated he/she will submit a plan of correction by the POC due date to prevent the similar incident to occur again. LPA checked the bathroom today and there is no mold observed in the bathroom.