Qcare Residential Facility III

Type of visit: Required - 1 Year

On 09/11/2026 at 11:45AM, Licensing Program Analyst (LPA) Andrew Christy arrived unannounced to conduct the 1-Year Annual Required inspection. LPA met with Administrator, Flores Blanca, and explained the purpose of the visit. The facility currently houses four (4) residents with a max capacity of six (6) residents. LPA toured facility including but not limited to bedrooms, bathrooms, kitchen, common area, and backyard. All outdoor and indoor passageways are kept free of obstruction. No bodies of water were observed. A comfortable indoor temperature is maintained at 70.0 degrees Fahrenheit. The hot water temperature in the residents’ shared bathroom was measured at 111.4 degrees Fahrenheit. LPA observed lighting in all rooms are adequate for the comfort and safety of the residents. Residents’ bathrooms are equipped with grab bars and non-skid mats. There is a minimum of one week supply of non-perishable and 2 day of perishable foods. Centrally stored medication and sharps were locked and inaccessible to residents. Smoke detectors and carbon monoxide detectors were in operating condition during visit. Fire extinguisher was last serviced on 05/14/2026. At 12:45PM, LPA reviewed four (4) resident files and four (4) staff files, all found to be complete. The emergency disaster plan was last reviewed 09/11/2026. Quarterly emergency drills were last conducted 06/15/2026. A review of resident medications and the Medication Administration Record (MAR) found no outstanding errors. No deficiencies cited during visit. Exit interview conducted and a copy of this report was provided to the administrator.the state’s words, verbatim · CDSS document, Sep 11, 2026

Type of visit: Case Management - Other

On 01/22/2026 at 2:25 PM, Licensing Program Analysts (LPAs) P.Manalo and A. Christy arrived unannounced to conduct a Case Management inspection of Qcare Residential Facility III. LPAs met with Assistant Administrator (ADM), Gladys Cuevas Villa, to ensure the facility is in compliance with applicable statues and regulations. During the visit, LPAs conducted interviews with residents and staff. Based on interviews, 2 of 3 residents stated that the facility is comfortable. Interviews with staff revealed that there are no live-in staff in this facility and that staff are receiving their paychecks on time and with no issues. LPAs observed the California Minimum Wage and Industrial Welfare Commission Wage Orders poster but is not the updated year. LPAs conducted a tour of the physical plant and observed the following deficiencies: At 2:30 PM, interview with S1 and Assistant ADM revealed that there is only one staff per shift. At 2:45 PM, LPAs observed the facility does not have sufficient food for all the residents in care. At 2:50 PM, LPAs observed Lysol Wipes unlocked in R1’s room and the tool shed with chemicals. Continue to LIC809-C... Continue from LIC809... At 3:00 PM, LPAs observed the the kitchen cabinets loose and the smoke alarm missing in the hallway. The following deficiencies were observed (see LIC 809D) and cited from the California Code of Regulations, Title 22 and/or Health and Safety Code Failure to correct deficiencies by POC date may result in additional Civil Penalties. Therefore, the facility appears to be not in compliance. An exit interview was conducted and a copy of the report was provided.the state’s words, verbatim · CDSS document, Jan 22, 2026

From the deficiency page — Deficiency type: Type A · Section cited: CCR 87309(a) · Plan of correction due date: Jan 23, 2026

(a) Except as specified in subsection (b), the licensee shall ensure that disinfectants, cleaning solutions, poisonous substances, knives, matches, tools, sharp objects, and other similar items which could pose a danger to residents are in locked... This requirement is not met as evidenced by: Based on observation, the licensee did not comply with the section cited above by having Lysol Wipes unlocked in R1’s room and the tool shed with chemicals which poses an immediate safety risk to persons in care.the state’s words, verbatim · CDSS document, Jan 22, 2026

Plan of correction: Administrator agrees to lock the items and send proof to CCLD by POC date.

From the deficiency page — Deficiency type: Type B · Section cited: CCR 87303(a) · Plan of correction due date: Jan 30, 2026

(a) The facility shall be clean, safe, sanitary and in good repair at all times. Maintenance shall include provision of maintenance services and procedures for the safety and well-being of residents, employees and visitors. This requirement is not met as evidenced by: Based on observations, the licensee did not comply with the section cited above by having one of the kitchen cabinets loose and the smoke alarm missing in the hallway which poses a potential safety risk to persons in care.the state’s words, verbatim · CDSS document, Jan 22, 2026

Plan of correction: The Assistant Administrator agrees to repair the items and send proof to CCLD by POC date.

From the deficiency page — Deficiency type: Type B · Section cited: CCR87555(b)(26) · Plan of correction due date: Jan 25, 2026

(26) Supplies of nonperishable foods for a minimum of one week and perishable foods for a minimum of two days shall be maintained on the premises. This requirement is not met as evidenced by: Based on observation, the licensee did not comply with the section cited above by not having sufficient food and snacks for the residents in care which poses a potential safety risk to persons in care.the state’s words, verbatim · CDSS document, Jan 22, 2026

Plan of correction: The Assistant Administrator will purchase more food and send proof of corrections by POC date.

From the deficiency page — Deficiency type: Type B · Section cited: CCR 87411(a) · Plan of correction due date: Jan 30, 2026

(a) Facility personnel shall at all times be sufficient in numbers, and competent to provide the services necessary to meet resident needs… This requirement is not met as evidenced by: Based on observation and interview, the licensee did not comply with the section cited above by only having one staff per shift which poses a potential safety risk to persons in care.the state’s words, verbatim · CDSS document, Jan 22, 2026

Plan of correction: The Assistant Administrator agrees to obtain more staffing to cover staff during break and update the LIC500. Proof of correction will be sent to CCLD by POC date.

Type of visit: POC

On 09/25/2025 at 9:45AM, Licensing Program Analysts (LPAs) Andrew Christy and Grace Luk arrived unannounced to conduct a Proof Of Correction (POC) visit. LPAs met with caregiver Hillary Limiac and explained the purpose of the visit. Administrator Joaquin Cunanan arrived at XXX. The facility currently houses four (4) residents. The following deficiencies cited during the annual visit on 09/11/2025 were cleared during this visit: 87355(e)(3) - The employee that was not associated to the facility has officially been fingerprint cleared and associated with the facility. 87303(e)(3) - The hot water temperature was measured today in the resident's bathroom at 106.5 degrees Fahrenheit. 87309(a) - There were no hazardous materials in any unlocked cabinets found during this visit. 87303(a) - The hole in the wall next to the front door was fixed, and there was no debris or furniture on the side pathways of the facility. 87468.2(a) - There are no cameras present that are pointed at any resident rooms or bathrooms. In addition, the locks on the fridge and cabinet were removed. Exit interview conducted and a copy of this report, along with the POC Letters, was provided to the administrator.the state’s words, verbatim · CDSS document, Sep 25, 2025

Type of visit: Required - 1 Year

On 09/11/2025 at 2:00PM, Licensing Program Analysts (LPAs) Andrew Christy and Grace Luk arrived unannounced to conduct 1-Year Annual Required inspection. LPA met with Administrator, Joaquin Cunanan and explained the purpose of the visit. The facility currently houses four residents. LPA toured facility including but not limited to bedrooms, bathrooms, kitchen, common area and backyard. All outdoor and indoor passageways are kept free of obstruction. A comfortable temperature is maintained at 70 degrees Fahrenheit. LPA observed lighting in all rooms are adequate for the comfort and safety of the residents. Residents’ bathrooms are equipped with grab bars and non-skid mats. There is a minimum of one week supply of non-perishable and 2 day of perishable foods. Centrally stored medication and sharps were locked and inaccessible to residents. Smoke detectors and carbon monoxide detectors were in operating condition during visit. Fire extinguisher was last serviced on 05/08/2025. Emergency Disaster Plan was last reviewed 09/11/2025. First aid kit was observed to be complete. At 11:25 AM, LPA reviewed 4 residents records and 4 staff records. LPAs also requested a copy of the Infection Control Plan. Continued on LIC809C..... Continued from LIC809..... The following deficiencies were found during the inspection: At 2:10PM, LPAs noticed bleach and bathroom cleaner under the bathroom sink. At 2:15PM, the hot water in the resident bathroom measured to 128.0 degrees Fahrenheit. At 2:00PM, a hole in wall near the front door was spotted. At 2:10PM, a jar of dirt above the mirror in the bathroom was found. At 2:45, the backyard was inspected and found to have junk and debris blocking one of the pathways to the side gate. In addition, random furniture and medical equipment was found in various spots in the backyard. There is also a wooden bench that is partially rotted away and poses a safety risk to anyone sitting on it. At 3:45PM, LPAs noticed video surveillance cameras pointed to resident rooms. There was also locks found on the fridge and pantry to prevent access to food. Deficiencies are cited per Title 22 California Code of Regulations and listed on LIC809D. Failure to submit proof of corrections (POC) by plan of correction due date and/or any repeat deficiencies within a 12-month period may result in civil penalties. Exit interview conducted and a copy of this report, along with appeal rights, was provided to the administrator.the state’s words, verbatim · CDSS document, Sep 11, 2025

Type of visit: Required - 1 Year

On 09/04/2024 at 9:55 AM, Licensing Program Analyst (LPA) Ardalan Gharachorloo arrived unannounced to conduct 1-Year Annual Required inspection. LPA met with Administrator, Joaquin Cunanan at 10:45 AM and explained the purpose of the visit. LPA toured facility including but not limited to bedrooms, bathrooms, kitchen, common area and backyard. All outdoor and indoor passageways are kept free of obstruction. A comfortable temperature is maintained at 70 degrees Fahrenheit. LPA observed lighting in all rooms are adequate for the comfort and safety of the residents. The hot water temperature in the residents’ shared bathroom was measured at 117.5 degrees Fahrenheit. Residents’ bathrooms are equipped with grab bars and non-skid mats. There is a minimum of one week supply of non-perishable and 2 day of perishable foods. Centrally stored medication and sharps were locked and inaccessible to residents. Smoke detectors and carbon monoxide detectors were in operating condition during visit. Fire extinguisher was last serviced on 05/04/2024. Emergency Disaster Plan was observed to be posted. First aid kit was observed to be complete. Emergency disaster drill was last conducted on 06/01/2024 . At 11:25 AM, LPA reviewed 4 residents records and 5 staff records; all were complete. At 1:10 PM, LPA also reviewed resident’s medications. Joaquin Cuanan's Administrator's certificate was reviewed. The certificate expires on 02/07/2026. Updated copies of the following document was requested for facility file and are to be submitted to CCL by 09/12/2024. Updated Fire Drill Schedule Updated Liability Insurance No deficiencies cited during visit. Exit interview conducted and a copy of this report provided.the state’s words, verbatim · CDSS document, Sep 4, 2024

Allegation investigated: Due to staff adding an additional lock on the front door, residents are locked in at night.

At 11:30 a.m., Licensing Program Analyst (LPA) Delmundo arrived unannounced to investigate the above allegation. LPA was granted entry by staff, Celia Manansala, and informed the reason for visit. LPA called and spoke over the phone with Joaquin Cunanan, administrator, who stated he can not come to the facility and authorized Marilyn 'Lyn' Ramirez to sign and receive this report. LPA checked the inside of the front door and observed a lock located close to the top of the door. The lock was observed with a key hole. LPA inteviewed the administrator and staff (S1 and S2) who all stated that the lock was installed to prevent resident from leaving the facility at night. Based on observation and interviews, the preponderance of evidence is met, therefore, the allegation is substantiated. .....continued on 9099C Substantiated Deficiency is cited from Title 22 California Code of Regulations and listed on 9099D. A $500.00 civil penalty is assessed for fire safety violation and will continue for $100.00/day until corrected. Deficiency, plan and proof of correction, and civil penalty were discussed with the administrator over the phone. Exit interview conducted. Appeal Rights, LIC421IM Civil Penalty Assessment, LIC9098 Proof of Correction form and copy of this report provided.the state’s words, verbatim · CDSS document, Apr 18, 2024 · control 15-AS-20240410121644

From the deficiency page — Deficiency type: Type A · Section cited: CCR 87203 · Plan of correction due date: Apr 19, 2024

87203 Fire Safety All facilities shall be maintained in conformity with the regulations adopted by the State Fire Marshal for the protection of life and property against fire and panic. -This requirement is not met as evidenced by: -Based on observation and interviews, the licensee did not comply with the section above in installing lock on the front door which poses an immediate safety and/or personal rights risks to persons in care. Civil penalty is assessed.the state’s words, verbatim · CDSS document, Apr 18, 2024

Plan of correction: Administrator to do the following, and submit proof by 4/19/24: 1. Remove the lock and submit picture. 2. Ensure there's an awake/night staff and submit LIC500 Personnel Report. 3. In-service the staff and submit copy of in-service training with attendees signatures, A $500.00 civil penalty is assessed.

Type of visit: Case Management - Deficiencies

On this day, April 18, 2024, while at the facility investigating a complaint (Complaint Control # 15-AS-20240410121644), Licensing Program Analyst (LPA) Delmundo learned that staff (S1) who is fingerprint cleared and associated to licensee's other facility is not associated to this facility, QCare Residential Facility III. LPA also observed resident's (R1) record is not complete. There's no LIC602A Physician's Report and Pre-placement Appraisal on file. This was discussed over the phone with Joaquin Cunanan, administrator, who stated the documents were at licensee's other facility. The administrator asked Marilyn Ramirez, staff, to locate the documents but was unsuccessful. LPA also discussed about S1 not associated to this facility. Deficiencies are cited from Title 22 California Code of Regulations and listed on 809D. Failure to submit proof of corrections by plan of correction due dates, and any repeat violation within 12 month period may result in civil penalty. Deficiencies and plan and proof of corrections were discussed with the administrator over the phone. Administrator stated he can not come to the facility, and authorized Marilyn Ramirez to sign and receive this report. Exit interview conducted. Appeal Rights, LIC9098 Proof of Correction form and copy of this report provided.the state’s words, verbatim · CDSS document, Apr 18, 2024

From the deficiency page — Deficiency type: Type B · Section cited: CCR 87355(e)(2) · Plan of correction due date: May 2, 2024

87355 Criminal Record Clearance (e) All individuals subject to a criminal record review.... shall prior to working, residing or volunteering in a licensed facility: (2) Request a transfer of a criminal record clearance as specified in Section 87355(c). -This requirement is not met as evidenced by: -Based on record review and Guardian Portal look-up, the licensee did not comply with the section above for not having S1 associated to this facility which poses a potential safety and/or personal right risks to persons in care.the state’s words, verbatim · CDSS document, Apr 18, 2024

Plan of correction: Administrator to have the staff associated, and submit proof by 5/02/24.

From the deficiency page — Deficiency type: Type B · Section cited: CCR87506(a) · Plan of correction due date: May 2, 2024

87506 Resident Records (a) The licensee shall ensure that a separate, complete, and current record is maintained for each resident in the facility or in a central administrative location readily available to facility staff and to licensing agency staff. -This requirement is not met as evidenced by: -Based on record review and interview, the licensee did not comply with the section above for not having R1's documents readily avalable for review.the state’s words, verbatim · CDSS document, Apr 18, 2024

Plan of correction: Administrator to complete the resident's file, and submit self-certification by 5/02/24.