Paradise Valley Residential Care Home #2

Type of visit: Required - 1 Year

On 02/27/2026 at approximately 09:25AM, Licensing Program Analyst (LPA) Ali Deniz arrived unannounced to conduct 1-Year Required visit of this licensed Residential Care Facility for The Elderly (RCFE). LPA was greeted by Staff Member, Danilo Rivera. Administrator, Edward Gadia arrived during visit at approximately at 09:40AM. Facility has an approved fire clearance and capacity for six (6) non-ambulatory residents. Facility has an approved hospice waiver for 3 individuals. Upon arrival, LPA was informed that there were two (2) residents in care and two (2) staff members on-site. Facility is a 1 story building with 6 Resident bedrooms, 2 bathrooms, and common spaces. At approximately 09:45AM, LPA reviewed the Facility's Staff Roster and found that all staff on-site were background cleared and associated to the facility per regulation. At approximately 10:35AM, LPA and Licensee toured the building and grounds which was found to be clean and in good repair. LPA observed all walkways and exits to be unobstructed. All notices that are required to be posted have been posted and are in a highly visible area. LPA observed activity supplies for resident use. The amount of fresh and nonperishable foods is within regulation. Facility kitchen, refrigerators and freezers were clean, and food was stored properly. Staff were in the process of cleaning up kitchen at the time of this inspection. Toxins are stored in a locked housekeeping closet. Water temperature measured 110.6 degrees F and 112.4 degrees F which is within regulation between 105- and 120-degrees F at faucets accessible to residents. Fire Extinguishers found to be last charged on 07/30/2025 at the time of visit. Carbon Monoxide and smoke detectors were present and in order. There was enough lighting in all common areas, resident rooms, and hallways. Medication is centrally stored and secure in a medication cabinet next to the dining table. At approximately 11:30AM, LPA reviewed 2 resident records and found 2 of 2 residents have current care plans, signed admission agreements, and physician's report on file. Medication records are thorough and contained physician's orders for each resident. Continued on LIC809-C page... Continued from LIC-809 page... At approximately 11:30AM, LPA reviewed 3 staff records. 3 of 3 records did contain documentation of completed training records as required. Evidence of current first aid and CPR training were current. LPA was presented with proof of current CPR & 1st Aid certifications for the staff. Administrator Certificate is for Edward Gadia #7006929740 expires 11/20/2026. LPA reviewed the facility emergency disaster plan. Facility has supplies enough to operate for more than 72 hours in an emergency. Facility conducted and documented a disaster drill on 01/15/2026. Updated copies of the following documents were requested for facility file and are to be submitted to CCL by due date of 03/15/2026: LIC 308 Designation of Facility Responsibility No deficiencies were observed in the areas inspected, No citations were issued during today’s visit. Exit interview conducted. Copy of report provided to Licensee. Signature on form confirms receipt of documents.the state’s words, verbatim · CDSS document, Feb 27, 2026

Allegation investigated: Uncleared staff working in the facility

Licensing Program Analysts (LPAs) Deniz and Cuadra arrived unannounced to conduct a complaint investigation and deliver findings regarding the above allegations and met with Licensee, Edward Gadia. The Department received an anonymous complaint allegation of uncleared staff working in the facility. Per anonymous complainant, uncleared staff (unknown names) are illegally working as caregivers and they are not trained and holding illegal status, but Licensee allegedly reshuffles staff between their three care homes whenever there is a state visit. On 3/27/25, LPAs conducted 10-day visit to the facility made observations, reviewed records and conducted interviews with staff and residents. During tour of the facility, LPAs made observations and observed S1 and S2 providing care and supervision to residents in care. Based on interviews conducted with staff (S1 and S2) indicates that they are live-in staff who resides in caregiver’s room #8 as indicated in their fire clearance. Based on records review, the facility provided LPAs with LIC500 Personnel report dated 12/31/2024 confirmed that staff listed are associated to the facility through Guardian system. Continued on LIC9099-C... Unsubstantiated Continued from LIC9099... Interviews conducted with staff and residents in care did not reveal any leading evidence that could indicate the presence of any uncleared staff at this facility. Therefore, LPAs was unable to determine if allegation could happen at a prior date of any uncleared staff who could been present providing care and supervision during the time of the alleged incident. A finding that the complaint allegation occurs of uncleared staff working in the facility is unsubstantiated meaning that although the allegations may have happened or is valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur, therefore the allegation is UNSUBSTANTIATED. Exit interview conducted and copy of report given to Licensee.the state’s words, verbatim · CDSS document, May 12, 2025 · control 21-AS-20250324121040

Type of visit: Required - 1 Year

At approximately 1:00 PM, Licensing Program Analyst (LPA) Robert Frank arrived unannounced to conduct a Required 1 Year visit and was greeted by Caregiver Danilo Rivera. Administrator Edward Gadia arrived at 1:10 PM. Paradise Valley Residential Care Home #2 is Licensed as a Residential Care Facility for the Elderly (RCFE). The facility is a single story ranch house. The facility has an approved fire clearance for six (6) residents. Five (5) of the residents may be non-ambulatory The facility has a Hospice Waiver for three (3) residents. The facility has a Dementia Program on file. Upon arrival, LPA was informed that there were five (5) residents in care and three (3) staff members, including the Administrator on-site. At approximately 1:15 PM, LPA reviewed the Facility's Staff Roster and found that all staff on-site were background cleared and associated to the facility per regulation. At approximately 1:20 PM, LPA toured the facility with Administrator Gadia. All exits were clear and unobstructed. Facility had one (1) fire extinguishers which was last serviced and tagged on 7/5/2024. Food supply was sufficient. The facility was sufficiently lighted. LPA inspected five (5) resident bedrooms and found all to have sufficient lighting and furnishings as required per Title 22 Regulations. There was a sufficient supply of both perishable and nonperishable foods as required by Title 22 Regulations. There was an appropriate supply of cleaning products, linens, hygiene products and paper products available for residents. Toxins were observed to be stored inaccessible to residents. Facility has an infection control plan as required. The facility has a required emergency disaster plan. The facility is conducting fire and emergency drills quarterly. The last disaster drill was conducted on 3/10/2025. The facility does have emergency food and supplies to meet the "72 hour shelter in place" requirements. Hot water temperatures for all sinks in facility were found to be within Title 22 regulations of 105 to 120 degrees Fahrenheit. Facility smoke detectors and carbon monoxide detectors were tested and observed to be operational. Continued on 809-C ...Continued from 809 At approximately 2:00 PM, LPA reviewed four (4) resident files. Four (4) of four (4) resident files were found to be well organized and thorough with all required documentation. LPA reviewed three (3) staff files. All staff files had First Aid and CPR certification and proper training documentation. LPA observed that two (2) staff files, for S1 & S2, they did not have proof of a negative Tuberculosis test on file. One (1) staff file, for S3, did not have Tuberculosis test on file. In addition LPA observed that for S3, the medical assessment was not signed by an authorized health care representative. This deficiency will be cited. LPA spot checked Medication for four (4) residents. LPA observed all medications to be centrally stored, secure and with proper documentation. The facility does not handle resident’s monies for personal and incidental items. Edward Gadia’s Administrator Certification 7006929740 is current with an expiration date of 11/20/2026. Lourdes Gadia's Administrator Certification 7006158740 is current with an expiration date of 10/20/2026. LPA requested the following documents be submitted to Community Care Licensing by 4/14/2025: LIC 500 Personnel Report LIC 308 Designation of Responsibility LIC 610E Emergency Disaster Plan Proof of Liability Insurance Deficiencies are cited from the California Code of Regulations (CCRs), and/or the Health and Safety Code. Failure to correct the cited deficiency, on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment. Exit interview conducted. Copy of report, LIC-809D, Plan of Corrections, 811 Confidential Names and Appeal Rights discussed and provided to Administrator Gadia. Signature on form confirms receipt of documents.the state’s words, verbatim · CDSS document, Mar 14, 2025

Type of visit: Required - 1 Year

LPA Hiratsuka conducted this unannounced annual visit. LPA toured with Administrator Edward Gadia. This facility has six private resident rooms and two caregiver rooms. The backyard has a wood desk that is well maintained. There is an ample supply of perishable and nonperishable food supply. There is a locked cabinet for medications. Several topics were discussed. Today LPA obtained the following: -LIC 200 application for a community care facility or residential care facility for the elderly license to change the fire clearance from five non-ambulatory to six non-ambulatory residents as well as an updated facility sketch. LPA shall submit a new fire clearance to the fire department. -The LIC 200 also has the updated licensee mailing address to this address. The following shall be updated and submitted to Community Care Licensing Division by April 17, 2024: -LIC 308 designation of administrative responsibility -current liability insurance -LIC 500 facility personnel or staff schedule No deficiencies cited.the state’s words, verbatim · CDSS document, Mar 28, 2024