Prime Villa Skye

Type of visit: Required - 1 Year

On June 12, 2026, Licensing Program Analyst (LPA) Jenifer Tirre conducted an unannounced required visit using the CARE Inspection Tool. LPA was greeted by staff and granted entry after stating the purpose of the visit. Administrator John Paul Atencio arrived shortly after to assist with the facility inspection. The facility is licensed for six (6) non-ambulatory residents with approved hospice waiver for six (6) residents. Currently, there is one (1) Hospice residents present during today’s visit. This is a single story home with a detached garage unit. The facility has four resident bedrooms (two shared and two private) and four bathrooms. LPA conducted a tour of the physical plant accompanied by Administrator John Paul Atencio, and the following was observed: There were no bodies of water on the premises. All rooms were inspected. Beds and bedding supplies were in operational condition, lighting was provided, and storage for the client's personal belongings was observed. Bathrooms were operational with water temperature measured between 109.9 to 116.9 degrees F. LPA observed the facility to be furnished at the time of the visit. Storage areas for cleaning supplies and sharps objects were stored and not accessible to residents. The kitchen was inspected, and sufficient two day perishable and seven day non-perishable food was maintained adequately. Facility has a fire extinguisher which was fully charged and mounted on wall. CONTINUED ON 809C During the visit, LPA observed screening protocols for visitors and sanitizing stations in common areas & restrooms. LPA observed the facility has supply of Personal Protective Equipment (PPE). All mandated inspection control posters were posted. LPA observed First Aid Kit was maintained. The last fire drill was conducted on April 1, 2026 and facility had tested operational smoke and carbon monoxide detectors in bedrooms and common areas. The facility has current liability insurance on file effective 6/28/2025 – 6/28/2026. A review of Six residents (R1-R6) service files and four staff (S1-S4) personnel files revealed to be complete. The facility has the current administrator's certification on file for John Paul Atencio # 7020749740 - Expiration 12/04/2027. No deficiencies during this inspection visit. An exit interview was conducted with Administrator Atencio, and a copy of the report was provided.the state’s words, verbatim · CDSS document, Jun 12, 2026

Type of visit: Required - 1 Year

On May 16, 2025, Licensing Program Analyst (LPA) Jenifer Tirre conducted an unannounced required visit using the CARE Inspection Tool. LPA was greeted by staff and granted entry after stating the purpose of the visit. Administrator (Admin) John Paul Atencio was present to assist with the facility inspection on today's date. The facility is licensed for six (6) non-ambulatory residents, one (1) bedridden with approved hospice waiver for six (6) residents. Currently, there is one (1) Hospice resident present during today’s visit. This is a single story home with a back storage unit no garage facility. The facility has four (4) resident bedrooms ( two shared and two private) and four bathrooms. At around 12:50PM, LPA conducted a tour of the physical plant accompanied by Caregiver, and the following was observed: There were no bodies of water on the premises. All rooms were inspected. Beds and bedding supplies were in operational condition, lighting was provided, and storage for the client's personal belongings was observed. Bed linens, comforters, and bath towels were available during the visit. Bathrooms were operational with water temperature measured between 106.3 to 115.7 degrees F. A comfortable temperature of 72 degrees F. was maintained in the facility. LPA observed the facility to be furnished at the time of the visit. Storage areas for personal hygiene, cleaning supplies and sharps objects were stored and not accessible to residents. The kitchen was inspected, and sufficient perishable and non-perishable food was maintained adequately. Facility has a supply of emergency food and water. A fire extinguisher was charged and mounted. A review of the Medication Records Administration (MAR) was conducted, and LPA observed the records are in compliance. CONTINUED ON 809C During the visit, LPA observed the facility's infection control practices. LPA observed screening protocols for visitors, staff, and residents, and sanitizing stations in common areas and restrooms. LPA observed the facility has a supply of Personal Protective Equipment (PPE). All mandated inspection control posters were posted. LPA observed First Aid Kit was maintained. Facility has audible alarms for exits and resident rooms. The last fire drill was conducted on 4/30/2025. The facility had operational smoke and carbon monoxide detectors in bedrooms and common areas. The facility has current liability insurance on file effective 6/28/24 – 6/28/25. A review of four residents (R1-R4) service files and four staff (S1-S4) personnel files revealed to be complete. The facility has the current administrator's certification on file for John Paul Atencio # 7020749740 - Expiration 12/4/2025. No deficiencies during this inspection visit. An exit interview was conducted with Administrator John Paul Atencio, and a copy of the report was provided.the state’s words, verbatim · CDSS document, May 16, 2025

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Alvaro Ramirez, Jr. conducted an unannounced visit for the Required 1 Year Inspection. LPA explained the purpose of today’s visit, and was greeted and granted entry by Caregiver Samuel Salarza. Administrator (AD) John Paul Atencio arrived shortly after. For today’s visit, LPA observed a total of five residents in care and two staff members on duty. LPA observed the Administrator's Certificate for facility AD John Paul Atencio which expires on December 4, 2025. LPA Ramirez toured the interior and exterior portions of the facility with caregiver Salarza. The facility is a single level structure and is licensed for six non-ambulatory residents, of which six may be on hospice and one bedridden. Bedroom #4 approved for bedridden. There are a total of four bedrooms, of which four are private resident bedrooms. LPA Ramirez toured each bedroom in the facility and observed that bedrooms were provided with furniture in good repair, clean linens, adequate storage space, and kept free of tripping hazards. Smoke and carbon monoxide detector and auditory exit alarms were tested and operational. There are a total of four restrooms of which one is for staff and three are for residents. Restrooms were observed to be in good repair, toilets were operational, and grab bars and non-skid floor mats were provided. Water temperature tested between 109.0-113.1 degrees Fahrenheit. Facility met the minimum two-day perishable and seven-day non-perishable food supplies. Sharp items and knives were locked and inaccessible to residents in care. Fire extinguisher was charged, mounted and located by the kitchen. CONTINUED ON LIC809-C.. LPA Ramirez observed the emergency disaster and evacuation plan, which is posted by the main entrance. Facility had back-up emergency food and water supply. LPA observed that the First Aid Kit had all the required components. LPA observed that medications and toxins were locked and inaccessible to residents in care. For the exterior portion, LPA Ramirez observed a shaded area, patio furniture, and the grounds were free of any hazards. There is one gate in the backyard, which both is self-closing and self-latching. No bodies of water were observed. LPA reviewed five resident files and two staff files. LPA interviewed residents and staff present. For today's visit no deficiencies were issued per Title 22 Division 6 of the California Code of Regulations. An exit interview was conducted with AD Atencio. A copy of this report was provided at the time of exit.the state’s words, verbatim · CDSS document, May 17, 2024