Pleasant Valley Care Home

Type of visit: Required - 1 Year

03/12/2026, Licensing Program Analyst (LPA) Loera conducted an unannounced Annual Required – 1 yr. inspection visit for this facility. Facility has a dementia program. There are currently five residents in care with three residents currently on hospice. Facility is approved for six non-ambulatory and hospice waiver for three. LPA was greeted by staff member. Administrator, Bella Nachor arrived shortly after. LPA and staff toured the building and grounds. The facility was found to be at a comfortable temperature. LPA observed a 2 day supply of perishable and 7 day supply of non-perishable food. Facility has a food menu posted. All rooms were furnished and in good repair. Extra hygiene products and linens were available. Water temperature in sinks accessible to residents in care were measured within the range of 105 to 120 degrees F. Fire extinguishers were last inspected October 2025. Smoke/Carbon Monoxide detectors located throughout the facility were tested and operational. Chemicals were located in the garage. Sharps are located in a locked drawer in the kitchen. Medications were found to be centrally stored. LPA conducted spot medication count and found all prescription medication to be properly recorded on the Centrally Stored Medication Record. Facilities last emergency drill was conducted 03/04/2026. LPA conducted a review of four resident records. All records had the required documentation. LPA conducted review of three staff records/training. Upon a review of staff records, LPA found all staff to have required annual and initial training as well as current 1st Aid & CPR certification on file. continued on LIC809C No deficiencies cited during today's inspection. Updated copies of the following documents were requested for facility file and are to be submitted to CCL by 04/12/2026: LIC500- Personnel Report LIC308- Designation of Responsibility LIC610D- Emergency Disaster Plan (updated) Updated Liability Insurance Exit interview conducted with Administrator and a copy of this report was provided.the state’s words, verbatim · CDSS document, Mar 12, 2026

Type of visit: Required - 1 Year

04/22/2025, Licensing Program Analyst (LPA) Loera conducted an unannounced Annual Required – 1 yr. inspection visit for this facility. Facility has an emergency disaster plan as required. Facility has an infection control plan as required. There are currently 5 residents in care. Facility approved/cleared for 6 non-ambulatory, and hospice waiver for 2. LPA was greeted by staff. Administrator arrived shortly after. At approximately 12:40 PM, LPA and Administrator toured the building and grounds. The facility was found to be at a comfortable temperature with all exits free from obstruction. LPA observed a 2 day supply of perishable and 7 day supply of non-perishable food. Refrigerated food was found to be stored in a safe manner being labeled and dated. LPA observed an activities calendar and as well as a food menu. All rooms were furnished per regulation. All rooms were in good repair. Extra hygiene products and linens were available. Water temperature in sinks accessible to residents in care were measured at 110.2 and 111.9 degrees F which is within the range of 105 to 120 degrees F. Fire extinguishers were last inspected 05/2024. Smoke/Carbon Monoxide detectors located throughout the facility were tested and operational. Facilities last fire/disaster drill was conducted 3/3/2025. Toxins, sharps and other items that could pose threat if available to residents were located in the garage and under the kitchen sink and found to be secured. Medications were found to be centrally stored. LPA conducted spot medication count and found all prescription medication to be properly recorded on the Centrally Stored Medication Record. continued on LIC809-C LPA conducted a review of 3 resident records. All records had the required documentation. LPA conducted review of 3 staff records/training. Upon a review of staff records, LPA found all staff to have required annual and initial training as well as current 1st Aid & CPR certification on file. No deficiencies cited during today's inspection. Updated copies of the following documents were requested for facility file and are to be submitted to CCL by 05/23/2025: LIC500- Personnel Report LIC308- Designation of Responsibility LIC402- Surety Bond Liability Insurance Exit interview conducted with Administrator and a copy of this report was provided.the state’s words, verbatim · CDSS document, Apr 22, 2025

Type of visit: Prelicensing

At approximately 9:00AM, Licensing Program Analyst (LPA) Felias arrived announced to conduct a Pre-Licensing Inspection and met with Applicants, Anabelle Bautista and Brian Bautista. Upon arrival, LPA was informed that there are currently no residents in care. Facility received an approved fire clearance dated 01/04/2024 that allows for six non-ambulatory clients. Facility also has a hospice waiver for 2 individuals. LPA conducted a walk-though of facility with Applicants and observed the following: Facility is a one story residence with five resident bedrooms, two bathrooms and common areas. Facility was found to be clean and at a comfortable temperature with all exits free from obstruction. Facility had emergency lighting. Facility has an Infection Control plan on file. 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. Mattress pads were in place or available for Resident use. Toxins were observed to be stored inaccessible to residents. Bathrooms were equipped with necessary grab bars, and non-slip floors/mats were present. All resident rooms were furnished per regulation with a bed, lamp, dresser, chair and bedside table. Facility has sufficient items for cooking and eating. Facility has a locked cabinet in the hallway used for centrally stored medications and files. Cleaning supplies and toxins will be locked in a cabinet in the garage. Facility has indoor/outdoor areas for visiting and activities. Facility has emergency lighting in hallways. LPA confirmed that contents of the facility First Aid Kit were sufficient. LPA confirmed that Applicants is familiar with Guardian. Component III was reviewed. No Deficiencies or Advisories given during visit. Pre-Licensing completed. Facility is ready to be Licensed as a Residential Care Facility for the Elderly. LPA will submit Pre-Licensing Application Report to the Application Unit Analyst in Sacramento. Application Unit Analyst will notify Applicant of Status. Exit interview conducted. Copy of report discussed and provided. Signature on form confirms receipt of documents.the state’s words, verbatim · CDSS document, May 7, 2024