Pleasant Villa

Type of visit: Required - 1 Year

On 04/22/26, at 10:10am, Licensing Program Analyst (LPA) Perry Scott conducted an unannounced annually required inspection visit to Pleasant Villa, INC. LPA was met by Melonie Joy Suarez, Director, Arleen Lumba, Administrator, Mariel Ventura, Administrator, and the purpose of today’s visit was explained. The facility is licensed to serve six (6) non-ambulatory individuals (age 60and over); of which one (1) may be bedridden in bedroom #4. Waiver granted for hospice care of two (2) residents. Currently, the home has (5) residents. The residents are South Central Los Angeles Regional Center (SCLARC) residents. None of the residents have Restricted Health Care Conditions and none utilizes postural supports or protective devices. The facility’s annual fees were due on 04/15/2026 for $495.00. The facility has a past due balance. The facility is a single-story structure located in a residential neighborhood. It consists of the following: (4) bedrooms, (2) bathrooms, dining room, living room, kitchen, laundry room and an attached garage. At 10:30am, LPA and staff toured the facility. There are no bodies of water or firearm/ammunition on the premises. All resident rooms were checked. Beds and bedding were in good condition, adequate lighting provided, and adequate storage for resident personal belongings was observed. Walls and floors were in good repair. Bed linens, comforters, and bath towels were adequately stocked at the time of visit. Bathrooms were found to be within Title 22 regulations. Toilets and water faucets worked properly. The shower was free of mold/mildew, there was adequate lighting, and sufficient toiletries were accessible to clients. The water temperature measured 112.2F degrees in the bathroom. A comfortable temperature is maintained in the facility. LPA observed the facility to be clean, sanitary, and appropriately furnished at the time of visit. Storage areas for cleaning agents, toxins, and sharps were inaccessible to residents. Report Continued On LIC809-C The kitchen was inspected and there is enough perishable and non-perishable food available for the residents. All food items were stored properly. The water temperature measured 116.5F degrees in the kitchen. Medications were centrally stored and properly locked, first aid kit was checked and fully stocked with manual. The fire extinguisher was charged and last inspected on 03/25/2026. The smoke/ carbon monoxide detectors were operable. The last fire/emergency drill was conducted on 04/07/2026. The facility’s administrator’s certificate (7034156740) was valid from 1/27/2025 through 1/26/2027. The facility’s liability insurance was valid from 05/21/2025 through 05/21/2026. The facility’s surety bond was in effect at the time of the visit. LPA conducted a review of (5) resident records, (5) staff records, and reviewed the facility disaster plan. LPA observed that residents had the following current reports in their file: Physician’s report, Admission Agreements, Behavioral Assessments, Quarterly Reports, and Regional Center Individual Program Plan (IPP). Staff records were complete with required documents and training. The facility disaster plan was current and in compliance with Title 22 at the time of visit. LPA reviewed (5) resident medication administration records, and medication, and did not observe any discrepancies at the time of visit. During the visit, LPA observed the facility infection control practices. LPA observed screening protocols for visitors, staff, and clients. LPA observed that sanitizing stations were in common areas and restrooms. LPA observed that the facility had the required postings, posted throughout the facility. LPA advised the facility to continuously monitor the Centers for Disease Control (CDC) website and Community Care Licensing (www.cdss.ca.gov) for Provider Informational Notices (PIN) and for any updates relating to COVID-19 guidance and other related issues. No deficiencies were cited during this inspection visit. An exit interview was held, and a copy of this Facility Evaluation Report was provided to Arleen Lumba, Administrator.the state’s words, verbatim · CDSS document, Apr 22, 2026

Type of visit: Prelicensing

On 4/04/25, at 12:30pm, Licensing Program Analyst (LPA) Perry Scott conducted an announced visit to Pleasant Villa, Inc. LPA was greeted by applicant, Maria Quan. LPA explained the purpose of today’s Pre-licensing inspection visit. An application was submitted to Community Care Licensing Division (CCLD) on 03/20/23 in the initial license application for a Residential Care Facility for the Elderly aged 60 and over. The applicant requested a capacity of six (6) non-ambulatory individuals; of which one (1) may be bedridden. Bedrooms #1 and #2 are approved for two (2) non-ambulatory residents. Bedroom #3 is approved for one (1) non-ambulatory resident and bedroom #4 is approved for one (1) bedridden resident. Garage is not approved as a living area. A waiver was granted for hospice care of two (2) residents. Structure: The home is a four (4) bedroom, two (2) bathroom, single-story home with an attached garage situated in a residential neighborhood. The home includes a living room, family room, kitchen, and laundry area. The living area included couches, love seat, table, chairs, and a television. The kitchen has a refrigerator, stove, toaster oven, crock pot, and medication fridge. The rear exterior is fenced throughout with a patio that includes a table and six (6) chairs. The passageways, walkways, and steps are free from obstructions. The front and back entrances are wheelchair accessible. Page 1 of 4 LIC9099 Bedrooms for Residents: The facility has four (4) bedrooms. Bedrooms #1 and #2 are approved for two (2) non-ambulatory residents. Bedroom #3 is approved for one (1) non-ambulatory resident and bedroom #4 is approved for one (1) bedridden resident. All rooms include two (2) twin-size beds, two (2) chairs, two (2) night-stands, and table lamps. All bedrooms are equipped with a ceiling lighting, and a dresser. All rooms had closets for ample storage. Bedrooms for Staff: There is no bedroom designated for live-in staff. Bathrooms: The home has two (2) bathrooms. Both bathrooms have a working toilet, washbasin, shower with grab bars, and non-skid mats. Linens & Hygiene Supplies: Beds have the required linen supplies which include, pillowcases, mattress pads, fitted sheets, blankets, and bedspreads. An adequate supply of linen is stored in the hall storage area. Emergency Phone Numbers, Exit Plan & Menu: The emergency disaster plan is posted along with the exit plan in the kitchen. There is one (1) fire extinguisher located in the kitchen area. The facility has a land line telephone located in the kitchen and activity area. The applicant has submitted a mitigation plan. Food Service: Dishes, cups, and flatware are stored in the kitchen cabinets, inspected, and in good repair. Knives, cutlery, and other sharp kitchen utensils are stored in a locked cabinet. Food supply is adequately stored in kitchen cabinets and consists of can and other dry goods. The facility has nonperishable foods for a minimum of one week and fresh perishable foods for a minimum of two days that were observed. Page 2 of 4 LIC9099-C Smoke Detectors: Smoke and carbon monoxide detectors throughout the interior space are operable. Toxins & Kitchen: All toxins are locked and stored under the kitchen sink. Stove burners, oven, washer and dryer are working. There is one (1) refrigerator in the kitchen. The refrigerator measured a temperature of at least 45 degrees Fahrenheit for appropriate food storage. The home is equipped with heaters, air conditioning, and a fire alarm system. Water Temperature: The hot water temperature measured 115.1F degrees in the kitchen and 111.6F degrees on average in both bathrooms. Medications, First-Aid Kit & Book: A first aid kit and manual are stored in the medication station cabinet, which has at least the following: thermometer, tweezers, scissors, antiseptic, bandages, and gauze that is locked and inaccessible to residents. The client's medications will be stored in the same medication station cabinet locked in the kitchen area and inaccessible. The facility also has a medication refrigerator that can store perishable medication that needs to be refrigerated. Resident & Staff Files: The applicant will be handling the cash resources for residents and maintain the cash in locked safe. Records of staff and residents will be stored in a locked cabinet in the activity room. Reading Material, Games, Night lights: The facility has board games, books, magazines, and other recreational materials for the resident's use, stored in the activity room. A night light was observed in the hallway leading from the bedroom to the bathroom. 3 of 4 LIC9099-C Pool/Jacuzzi & Pets: There are no pets, jacuzzi, or pools on the premises. Fire clearance: A Fire Clearance inspection was conducted on 02/18/2025 and approved for a capacity of six (6) non-ambulatory residents; of which one (1) may be bedridden in room #4 only. A waiver was granted for hospice care of two (2). LPA did not observe pad locks or other mechanisms which may be obstructions for safe and quick egress during an emergency on front and back exits. Component III: LPA and the applicant completed the Component III PowerPoint presentation, which gives an overview of what to expect while running a Residential Care Facility for the Elderly. During the pre-licensing inspection no items were observed which do not comply with applicable laws and regulations; no items require a follow up inspection for verification of correction. Pre-Licensing is complete, and this facility has no deficiencies. The department will submit a copy of this Facility Evaluation Report to the Central Applications Unit (CAU) for review. If the applicant has questions regarding the status of the application, they have been instructed to communicate with the CAU Analyst assigned to their application. An exit interview was conducted, and a hard copy of this Facility Evaluation Report has been furnished to the applicant, Maria Quan. Page 4 of 4 LIC9099-Cthe state’s words, verbatim · CDSS document, Apr 4, 2025

Type of visit: Office

Component II completion: Successful Facility Type: RCFE Application Type: Initial Capacity: 5 Census (if any clients in care): 0 COMP II Participants: Melonie Joy Suarez (administrator); Maria Quan (applicant/licensee), Hai Nguyen (facility manager) Interview Method: Teams Video On 01/03/2025, applicant/administrator participated in COMP II. Identification of the applicant and administrator was verified through interview questions based on photo ID and other identifying personal information. During COMP II, applicant and administrator confirmed that they have read and understand community care facility licensing laws included in the Health and Safety Codes and the California Code of Regulations Title 22. Signed LIC 809 with copy of photo ID have been obtained. During COMP II, CAB analyst confirmed Applicant/Administrator’s understanding of following areas: 1. Facility operation: License type, client/resident populations, and program 2. Admission Policies 3. Staffing requirements & Training 4. Restrictive/Prohibited Health Conditions 5. General provisions 6. Emergency Preparedness 7. Complaints & Reporting 8. Pre-licensing readinessthe state’s words, verbatim · CDSS document, Jan 3, 2025