Paradise Valley Residential Care Home

Type of visit: Required - 1 Year

On 10/03/2025 at approximately 09:30AM, 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, Cynthia Florada. Administrator, Edward Gadia arrived during visit at approximately at 10AM. Facility has an approved fire clearance and capacity for 6 non-ambulatory residents, of which 1 may be bedridden. The facility currently approved for capacity of 6 residents. Facility has an approved hospice waiver for 3 individuals. Upon arrival, LPA was informed that there were 2 residents in care and 2 staff members on-site. Facility is a 1 story building with 6 Resident bedrooms, 2 staff bedrooms, 2 bathrooms, and common spaces. At approximately 10AM, 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 10:45AM, 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. However, LPA discovered backyard Fire Emergency exit door lock was not working properly. Administrator agrees to repair the exit door lock and submit the proof of correction to the CCL (Technical Violation Given). 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 111.6 degrees F and 112.8 degrees F which is within regulation between 105- and 120-degrees F at faucets accessible to residents. Continued on LIC809-C page... Continued from LIC809 page... 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 cabinet next to the dining room. During the centrally stored medication record review LPA discovered some of the medications were not recorded on the facility log. Administrator agrees to update centrally stored medication log and submit CCL (See LIC809-D page). At approximately 11:35PM, LPA reviewed 2 resident records and found 2 of 2 residents have current care plans, signed admission agreements, and physician's report on file. 1 out of 2 residents did not have TB test result on file. Administrator agreed to share TB test results for R1 with the Community Care Licensing (Technical advice given). At approximately 12:05PM, LPA reviewed 2 staff records. 2 of 2 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 certification. 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 06/10/2025. Updated copies of the following documents were requested for facility file and are to be submitted to CCL by due date of 10/15/2025: LIC 308 Designation of Facility Responsibility LIC 500 Personnel Summary LIC 610 Emergency Disaster Plan LIC 9020 Register of Facility Client’s/Resident’s Copy/Proof of Updated Certificate 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(ies), 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, and Appeal Rights discussed and provided to Administrator. Signature on form confirms receipt of documents.the state’s words, verbatim · CDSS document, Oct 3, 2025

The state marks this report as 6 pages; the online copy we transcribed has 4. You can request the full file from the county licensing office.

Allegation investigated: Facility staff are not keeping the facility at a comfortable temperature for clients

Licensing Program Analyst (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 facility staff are not keeping the facility at a comfortable temperature for clients. Per anonymous complainant, facility heater is not working during winter resulting in residents to suffer. On 3/27/25 and 4/1/2025, LPA conducted visits to the facility made observations, reviewed records and conducted interviews with staff and residents. During tour of the facility, LPA made observations noticing that temperature of 70 degrees Fahrenheit as required per regulation. Based on interviews conducted with Licensee it was confirmed that the facility heater broke down on 2/25/25 and Licensee contacted immediately a contractor to fix the furnace. Although, Licensee was provided with two options to repair or replace it and Licensee choose to replace the system. During the time of replacing the system, the Licensee provided residents with space heaters that were observed by LPA during tour of the facility on 3/27/25. Continued on LIC9099-C Unsubstantiated Continued from LIC9099... LPA also conducted interviews with staff that corroborated Licensee’s statement, and residents were unable to confirm or disregard allegation, because they did not recall if they were feeling cold at any prior date. Based on records review, on 3/30/24, Licensee provided LPA with a receipt as a proof of service dated 2/25/25 with job description detailing the following: "Contractor will furnish all labor, materials, equipment, supervision and contract administration to complete in a good and workmanlike manner the purchase and installation of Split System Straight A/C, full system to home of customer located at 524 Americano Way Fairfield, Ca as described more fully below". Payment date 3/14/25 reflected the job completion. A finding that the complaint allegation occurs of facility staff are not keeping the facility at a comfortable temperature for clients 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.the state’s words, verbatim · CDSS document, May 12, 2025 · control 21-AS-20250324104134

Allegation investigated: Uncleared staff working in the facility

Licensing Program Analyst (LPAs) Deniz and Cuadra arrived unannounced to conduct a complaint investigation and deliver findings regarding the above allegation and met with Licensee Edgard 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, but Licensee allegedly hides the illegal employees whenever there is a state visit. On 3/28/25 additional information was received by the Department from an anonymous party that provided names of facility uncleared staff (S1 and S2) who Licensee supposedly rotates their schedules between all three facilities owned by the Licensee. On 3/27/25 and 4/1/2025, LPA conducted visits to the facility made observations, reviewed records and conducted interviews with staff and residents. During tour of the facility, LPA observed S1 and S2 providing care and supervision to residents in care. LPAs inspected a large recreational vehicle (RV) parked outside of the facility where there was no evidence of any personal belongings. Continued on LIC9099-C... Substantiated Continued from LIC9099-C... Based on interviews conducted with Licensee, RV is used as personal for leisure activities. Interviews 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 LPA with LIC500 Personnel report dated 3/6/2025 revealed that S1 was listed in the facility schedule. However, during file review, it was revealed that S1 was cleared, but they were not associated to the facility, LPA informed Licensee that S1 should never be working and providing care to residents prior to a criminal record clearance or exemption. The Licensee immediately discovered that there was a discrepancy in the name of S1, so they submitted appropriate correction request to properly associate S1 to the facility roster through Guardian system. On 3/30/2025, the Licensee submitted updated Guardian Roster confirming that after corrections made, S1 was associated to the facility as of 3/6/25. The preponderance of evidence standard has been met; therefore, the above allegation is found to be SUBSTANTIATED. California Code of Regulations, (Title 22, Division 6, Chapter 8), is cited on the attached LIC 9099D. Appeal Rights Given. Civil penalties are being assessed in the amount of $100 for allowing a person to work, reside or volunteer in the facility without a been associated to the facility. Continued from LIC9099... During tour of the facility, LPA observed a signed on R2’s room door stating the following: “Contact Isolation - standard precautions prior to entering the room: clean hands, gown and gloves – visitors see nurse before entering”. Based on records review, the facility submitted incident report dated 3/30/25 confirming to the Department, R2’s diagnosis along with staff training records dated 3/28/25. Regarding hospice resident who passed away possible due to negligence of staff. Licensee provided LPA with death report of resident (R1) who was receiving hospice services when they passed away on 12/3/24 along with death certificate #5409158 obtained from California Death Registration System indicating that R1’s immediate cause of death was senile degeneration of brain without any other significant condition that could contributed to their death. A finding that the complaint allegation occurs of personal rights 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.the state’s words, verbatim · CDSS document, May 12, 2025 · control 21-AS-20250317162541

From the deficiency page — Deficiency type: Type A · Section cited: CCR 87355(e) · Plan of correction due date: May 13, 2025

Type A - 87355 (e) All individuals subject to a criminal record review pursuant to Health and Safety Code Section 1569.17(b) shall prior to working, residing or volunteering in a licensed facility. This requirement is not met as evidenced by: Based on record review, the licensee did not comply with the section cited above in that one staff (S2) was not associated to the facility in Guardian which poses an immediate health, safety or personal rights risk to persons in care.the state’s words, verbatim · CDSS document, May 12, 2025

Plan of correction: Licensee immediately submitted documentation to associate S1 in the Guardian system and submitted proof of doing so the same day. Deficiency is cleared. Civil penalties are being assessed in the amount of $100 for allowing a person to work, reside or volunteer in the facility without a been associated to the facility.

Allegation investigated: Questionable death Facility staff does not seek timely medical treatment Licensee does not ensure staff are adequately trained Facility staff are not meeting residents nutritional needs Facility staff are not providing residents with adequate toileting supplies Staff are not taking precautions to prevent the spread of illness Staff are mismanaging resident's records

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 anonymous complaint allegation of a questionable death. Per anonymous complainant, there was a resident (unknown name) has died a few months back, proper care is not provided. The Reporting Party could not be contacted to gather additional information regarding the "death" a few months back. Based on LPA’s records review, this allegation had been previously investigated and determined unsubstantiated under complaint# 21-AS-20250317162541, because since December 2024 there was no deceases at this facility, other than a resident (R1) who was under hospice care and their passing was due to unrelated reasons to care and supervision. Continued on LIC9099-C... Unsubstantiated Continued from LIC9099... Licensee provided LPA with death report of resident (R1) who was receiving hospice services when they passed away on 12/3/24 along with death certificate #5409158 obtained from California Death Registration System indicating that R1’s immediate cause of death was senile degeneration of brain without any other significant condition that could contributed to their death. A finding that the complaint allegation occurs of questionable death 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. Regarding the allegation of facility staff does not seek timely medical treatment. Per anonymous complainant and anonymous co-complainant, resident (R2) has a diagnosis of MRSA, R2 is isolated, but proper care is not given by staff (S1 & S2) resulting in R2 getting sick and possible all residents could eventually get sick with MRSA. Based on LPA’s records review, this allegation had been previously investigated and determined unsubstantiated under complaint# 21-AS-20250317162541 due to standards precautions observed at the facility, the incident was self-reported to the Department and staff training records dated 3/28/25 were obtained. A finding that the complaint allegation occurs of facility staff does not seek timely medical treatment 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. Another allegation was received by the Department about Licensee does not ensure staff are adequately trained. Per anonymous complainant and anonymous co-complainant, all residents at the care home are at risk due to staff providing care are not adequately trained. According to anonymous parties, Licensee rotates all caregivers to three care homes whenever there will be a state visit. The caregivers don't have day off, working 24 hours, which could lead to inappropriate care. Based on LPA’s records review, the facility provided LIC500 personnel report and training records confirming that all staff associated to the facility do have required training hours as stated per regulations. A finding that the complaint allegation occurs of Licensee does not ensure staff are adequately trained 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. Continued on LIC9099-C... Continued from LIC9099-C...There is another allegation of facility staff are not meeting residents’ nutritional needs. Per anonymous complainant, foods of the residents (unknown names) are coming from the relief food stations, residents are not fed on time (Unknown dates and times). LPA was unable to contact reporting party to gather additional information. On 4/1/25, LPA conducted 10-day visit to the facility made observations and requested food receipts for the month of March 2025. During tour of the facility, LPA/staff observed the following in the facility refrigerator: two bags of 6.5lb of chicken thighs, one bag of 5.5 lb of stir fry vegetable blend, one pound of frozen grapes, one bag of ten waffles, one packet of 1.5 lb of ham, eight oranges, one packet of 96 slices of cheddar cheese, two cucumbers, half of tomato, half of purple onion, six apples, one cabbage, five 30gr protein shakes chocolate, two 5.3 oz of zero sugar Greek yogurt, seven 20 oz of bread, 30ct of large eggs, two bottles of 20 oz of juices, 5lb of potato salad, container with eight sprinkled cookies and half gallon of milk. In the pantry there was one watermelon, four bananas, two 8 oz of ensure bottles. In the facility pantry area non-perishables observed were as follow: eight boxes of artificial drink packages, three boxes of jelly, three cans of clam chowder, two boxes of elbow pasta, twelve cans of fruit cocktails, two cans of alfredo sauce, two cans of roast vegetables, five cans of tomato sauce, one can of chicken noodle, one box of 80 oz of quaker oats, one packet of 10lb of pancake mix, six boxes of mac and cheese, two cans of tuna, one can of 16 oz of peanut butter, one box of 24 bottles of ensure and 5lb of cane sugar. Based on interviews conducted with the Licensee, LPA was told that they were expecting their food delivery for that day. On 4/2/25, LPA was provided with order #2000130-23925556 no amount showing, but dated 4/1/25 and delivered to facility address, followed by pictures of food items in the facility refrigerator and pantry area. On 4/23/25, LPA followed up with Licensee to request food receipts requested for the month of March 2025 that confirmed adequate amount of food supplies. A finding that the complaint allegation occurs of facility staff are not meeting residents’ nutritional needs 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. Regarding allegation of facility staff are not providing residents with adequate toileting supplies. The anonymous complainant reported that most of the time, all supplies are not sufficient referring to incontinence and hygiene supplies. On 4/1/25, LPA conducted 10-day visit to the facility made observations and requested admission agreements as well as pertinent documentation regarding two residents (R3 & R4) who the facility provides supplies for them and documentation about agreement to bring incontinence supplies by the other remaining residents (R5 & R6) or any other document as evidence of this agreement with other agency. Continued on LIC9099-C... Continued from LIC9099-C... Based on records review, Licensee provided resident’s admission agreements detailing incontinence supplies agreement for R3 & R4 in the amount of $370 for the month of February to March 2025 and other agencies agreements to provide incontinence care supplies. During facility tour of residents’ rooms, LPA observed adequate amount of incontinence supplies in each room. Although, there was adequate amount of incontinence care supplies observed, LPA had a conversation with the Licensee regarding not allowing to have a limited supplies of incontinence care not limited to gloves, shampoo, incontinence briefs, wipes and disposable bed pads. A finding that the complaint allegation occurs of facility staff are not providing residents with adequate toileting supplies 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. According to anonymous complainant, staff are not taking precautions to prevent the spread of illness. Anonymous complainant raised concerns about the lack of precautions that staff are taking to manage resident (R2) who was recently diagnosed with MRSA. Based on LPA’s records review, this allegation had been previously investigated and determined unsubstantiated under complaint# 21-AS-20250317162541 due to standards precautions observed at the facility, the incident was self-reported to the Department and staff training records dated 3/28/25 were obtained. A finding that the complaint allegation occurs of staff are not taking precautions to prevent the spread of illness 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. The last allegation refers to staff are mismanaging resident's records. Per anonymous complainant and co-complainant, this is in connection of R2’s case that has been reported and the safety of the elders in Americano. We hope that the State will take action to Licensee's falsification of documents and unjust treatment to the elderly in his care home. LPA has been conducting visits due to multiple complaints received by the Department on 3/27/25 and 4/1/25. Based on records review, the facility has provided pertinent documentation including doctor’s orders and follow up after visits made by residents timely. Resident’s records appeared to be updated and complete as stated per regulation. LPA was unable to contact anonymous complainant to gather specific information regarding supposedly falsification of documents. A finding that the complaint allegation occurs of staff are mismanaging resident's records 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.the state’s words, verbatim · CDSS document, May 12, 2025 · control 21-AS-20250328102443

Allegation investigated: -Resident sustained unexplained injury (s).

Licensing Program Analysts (LPAs) Cuadra and Magdaleno arrived unannounced to conduct a complaint investigation and deliver findings regarding the above allegations and met with Licensee, Edward Gadia. The Department received an allegation of resident sustained unexplained injury (s). Per SOC341 received from the reporting party, on 10/4/24 resident (R1) was complaining of wrist pain, they were observed with small purple bruises on their wrist and hand that did not indicate nothing unusual was happening to them, but the following week, R1 was complaining of pain, bruising was now yellowing, so the reporting party contacted R1’s physician, the doctor referred R1 to have x-rays done that revealed an acute fracture distal ulna diagnosis on 10/17/24 that it was suspected from any source of force. Based on confidential interviews conducted by LPA with staff (S1 and S2) indicates that about two to three weeks prior to the diagnosis of R1’s injury, R1 was complaining of pain, but it was within “normal” that R1 was complaining, but the following week upon concerns raised by an outside individual, staff notified the Licensee who instructed them to contact R1’s physician. Continued on LIC9099C... Unsubstantiated Continued from LIC9099... According to staff, R1 tends to hit the walls with their hands, developed combative behavior, refuses to drink enough water and have been recently diagnosed with urinary tract infection (UTI). Interviews conducted with residents (R2 & R2) did not reveal any witnessed incident of abuse. Based on records review, R1’s physician report dated 9/6/24 indicates that R1 has a diagnosis of hypertension and did not have a history of self-abuse or aggressive behavior condition prior to this incident. The facility provided daily progress notes indicating that on 3/19/24, staff have noticed a tendency of R1 to be slightly aggressive to them, R1 swing their arms at them, but neither R1’s physician’s report nor their care plan was updated on 9/4/24 reflecting how the facility will be handling any of these behaviors. Although, LPA is unable to determine the reason of R1’s fracture on their wrist. LPA have reviewed incident report logs from the facility that did not indicate the facility made a report to the Department about any incident and no further details were documented regarding any investigation been conducted by the facility. LPA will address reporting requirements and medical attention in a case management due to facility did not seek any further medical attention. A finding that the complaint allegation occurs of resident sustained unexplained injury while in care 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.the state’s words, verbatim · CDSS document, Jan 21, 2025 · control 21-AS-20241021110127

Type of visit: Case Management - Deficiencies

Licensing Program Analysts (LPAs) Cuadra and Magdaleno conducted a case management visit to cite deficiencies discovered during a complaint investigation and met with Licensee, Edward Gadia. LPA learned through records review and interviews that on 10/4/2024 facility staff did not seek any medical attention from resident’s (R1) physician after staff (S1 & S2) were notified by an outside agency that R1 was complaining of pain and bruising was noted on their wrist. Per S1 and S2, they notified the Licensee about R1’s condition, but it was until 10/17/24 when an outside agency came to the facility who noticed bruising was not yellowing, then they contacted R1’s physician who referred them to have x-rays done and a diagnosis revealed an acute fracture distal ulna. According to facility progress notes, on 3/19/24 R1 initiated to experience aggressive behaviors towards the staff, and swing their arms at them, but it wasn’t timely addressed by facility staff. Deficiencies cited from the California Code of Regulations, Title 22, Division 6 of California Regulation. Appeal rights given. Failure to seek medical care resulted in violation causing injury to person in care $500 immediate civil penalty issued. The licensee was informed that additional civil penalties are under review by the Department per Health and Safety Code 1569.49 (f).the state’s words, verbatim · CDSS document, Jan 21, 2025

From the deficiency page — Deficiency type: Type A · Section cited: CCR 87465 · Plan of correction due date: Jan 22, 2025

87466 Observation of the Resident The licensee shall ensure that residents are regularly observed for changes in physical, mental, emotional & social functioning & that appropriate assistance is provided when such observation reveals unmet needs...& brought to the attention of the resident's physician and the resident's responsible person, if any. This requirement has not been met as evidence by: Based on interviews and record review the licensee failed to update R1’s care plan and medical assessment addressing mental and behavioral changes noticed since 3/19/24. Also, the facility staff did not seek medical attention after observing R1’s bruising and complaints of pain, which poses an immediate risk to the health and safety of the residents in care.the state’s words, verbatim · CDSS document, Jan 21, 2025

Plan of correction: Licensee to ensure resident’s physician and their responsible parties are always informed of any changes in resident’s condition and care needs. Licensee will develop a procedure that it will be attached to the facility plan of operation indicating how the facility will ensure that resident’s physician and their responsible parties will be informed of any changes in resident’s condition and care needs by POC due date. Failure to seek medical care resulted in violation causing injury to person in care $500 immediate civil penalty issued.

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Cuadra arrived unannounced to conduct an annual required – 1 yr. inspection visit for this facility and was greeted by House Supervisor, Erminda Rivera. Annual fees are current. Required postings were observed. Contact information was reviewed. LPA/House Supervisor initiated a tour of the facility approximate at 9:45am and observed the following: facility was found to be clean and at a comfortable temperature with all exits free from obstruction. Water measured 109.2 and 108.5 degrees F which is within regulation. Auditory alarms were found operational. Resident’s bedrooms were furnished per regulation. Fire Extinguisher was found to be last charged on 7/17/24. Smoke detectors and carbon monoxide detectors throughout the facility were tested and found to be in operational. There was not sufficient supply of perishable food, LPA/House Supervisor observed three grapefruit, 1 cauliflower, half of cucumber, bag of celery, one lettuce and one cabbage in the refrigerator (photos taken). According to house manager, tomorrow is grocery shopping day. LPA had a discussion with staff about the importance to ensure at all times that residents have supplies for three snacks between meals. There was adequate supplies of nonperishable foods handled and stored per regulation. Toxins, sharps and other items that could pose threat were inaccessible to residents. There was a supply of hygiene products, continence products, paper products and clean linens available for residents. Disaster drill has not been conducted and documented within the last quarter. LPA initiated file review at 10:15am of six residents and three staff files. All resident's files have current medical assessments and care plans. All staff have current CPR/1st aid certificates and training hours complete. Medications and medication records were reviewed. Edward Gadia's Administrator Certificate 6022588740 expires on 11/20/2024. LPA was provided with the following documents: LIC 308 Designated Facility Responsibility, LIC 500 Personnel Summary. House Supervisor agreed to submit the following by 11/8/24: Copy of liability Insurance and control of property. Deficiencies are cited from the California Code of Regulations, Title 22, Division 6 of California Regulation. Appeal rights given. Failure to correct the deficiency and/or repeat deficiencies within a 12-month period may result in civil penalties. Exit interview conducted with House Supervisor and a copy of this report was given.the state’s words, verbatim · CDSS document, Oct 29, 2024