Raya's Paradise

Type of visit: Case Management - Health Checks

At approximately 12:30 p.m. on 04/08/26 Licensing Program Analyst (LPA) Nicholas Reed conducted an unannounced case management visit. LPA met with the assistant administrator and disclosed the reason for the visit. Today’s case management visit was conducted to ensure the health and safety of all residents. LPA toured the facility inside and out at 12:35 p.m. today, interviewed seven (07) out of eight (08) residents between 12:40 p.m. and 1:25 p.m., and requested pertinent records, including but not limited to admission agreements, medical assessments, care plans, and staff and client rosters at 3:00 p.m. No immediate health or safety concerns were observed during today’s visit. Exit interview conducted. Copy of report provided.the state’s words, verbatim · CDSS document, Apr 8, 2026

Type of visit: Case Management - Health Checks

Licensing Program Analyst (LPA) Tuesday Cabiness conducted an unannounced case management visit. LPA met with House Manager Kevin Moscoso who was also informed the reason of the visit. Executive Director Brian Rosales was also notified. During today's visit, LPA conducted physical plant inspection of the common areas: living/dining room, resident rooms, and bathrooms. LPA observed (2) additional staff and (3) additional residents, who were having a resident's council meeting. The current census at the facility is (7). No health and safety risks observed during visit.the state’s words, verbatim · CDSS document, Dec 9, 2025

Type of visit: Case Management - Health Checks

Licensing Program Analyst (LPA) Tuesday Cabiness conducted an unannounced case management visit. LPA met with Executive Director Brian Rosales and was also informed the reason of the visit. During today's visit, LPA conducted physical plant inspection of the common areas: living/dining room, resident rooms, and bathrooms. LPA also toured the kitchen and food supply. No health and safety risks observed during visit.the state’s words, verbatim · CDSS document, Nov 18, 2025

Type of visit: Case Management - Health Checks

Licensing Program Analyst (LPA) Tuesday Cabiness conducted an unannounced case management visit. LPA met with staff Maria Castellanos and informed her the reason of the visit. Executive Director Brian Rosales was notified via phone, who was also informed the reason of the visit. During today's visit, LPA conducted physical plant inspection of the common areas: living/dining room, resident rooms, and bathrooms. No health and safety risks observed during visit. Exit interview and copy of report will be given to ED.the state’s words, verbatim · CDSS document, Oct 27, 2025

Type of visit: Case Management - Health Checks

Licensing Program Analyst (LPA) Tuesday Cabiness conducted an unannounced case management visit. LPA met with staff George Tristan and informed him the reason of the visit. Executive Director Brian Rosales was notified via phone, who was also informed the reason of the visit. During today's visit, LPA conducted physical plant inspection of the common areas: living/dining room, resident rooms, and bathrooms. LPA also inspected the kitchen area for supply of food. No health and safety risks observed during visit. Exit interview and copy of report will be given to ED.the state’s words, verbatim · CDSS document, Oct 17, 2025

Type of visit: Case Management - Health Checks

Licensing Program Analyst (LPA) Tuesday Cabiness conducted an unannounced case management visit. LPA met with staff Maria Castellanos and informed her the reason of the visit. House Manager Kevin Moscoso was present during the visit and everyone was informed the reason of the visit. Executive Director Brian Rosales was notified and on his way to the facility. During today's visit, LPA conducted physical plant inspection of the common areas: living/dining room, resident rooms, and bathrooms. No health and safety risks observed during visit. Exit interview and copy of report provided to House Managerthe state’s words, verbatim · CDSS document, Oct 6, 2025

Type of visit: Case Management - Health Checks

Licensing Program Analyst (LPA) Tuesday Cabiness conducted an unannounced case management visit. LPA met with staff Maria Castellanos and informed her the reason of the visit. Staff contacted Executive Director Brian Rosales. During today's visit, LPA conducted physical plant inspection of the common areas: living/dining room, resident rooms, and bathrooms, and kitchen area. No health and safety risks observed during visit. Exit interview and copy of report provided to ED.the state’s words, verbatim · CDSS document, Sep 22, 2025

Type of visit: Case Management - Health Checks

Licensing Program Analyst (LPA) Tuesday Cabiness conducted an unannounced case management visit. LPA met with staff Maria Castellanos and informed her the reason of the visit. Staff contacted Executive Director Brian Rosales, who was on the facility to facility. During today's visit, LPA conducted physical plant inspection of the common areas: living/dining room, resident rooms, and bathrooms, and kitchen area. No health and safety risks observed during visit. Exit interview and copy of report provided to ED.the state’s words, verbatim · CDSS document, Sep 8, 2025

Type of visit: Case Management - Health Checks

Licensing Program Analyst (LPA) Tuesday Cabiness conducted an unannounced health and safety case management visit. LPA was greeted by med-tech Vanessa Navarro, who allowed LPA to enter. LPA observed residents at the dining room table and observed an additional caregiver/staff Raven Matthews on duty. The current census is (6). LPA spoke to Executive Director Brian Rosales over the phone and informed him also the reason of the visit. Brian joined the visit at 1245pm. House Manager Kevin Moscoso arrived later during the visit. Everyone was informed the reason of the visit. Physical plant inspection: Facility has nine (9) resident bedrooms, and ten (10) bathrooms. All rooms were observed to be clean with appropriate furnishing. Common areas were neat and clean. Front and back entrance has key pad with code to exit. Kitchen area had sufficient perishable and non-perishable. LPA obtained the following facility information and reviewed client and staff records. 1. LIC 500 2. Resident Roster 3. POA or Conservator (Contact Information) - will be emailed See LIC809C) 6. Physician Report - will be emailed 7. Admission Agreement - will be emailed 8. Rent Payment Source - will be emailed Exit interview conducted with Executive Director Brian Rosales and a copy of this report was issued.the state’s words, verbatim · CDSS document, Aug 25, 2025

Type of visit: Required - 1 Year

On 07/21/25, 10:15 am, Licensing Program Analyst, (LPA) Raymond Comer, conducted an unannounced Annual visit to this facility. LPA met with Administrator, and reason for the visit was disclosed. Facility is licensed as a one-story residence, with kitchen area at sub-floor level, fire clearance for eleven (11) non-ambulatory, of which, eleven (11) may be bedridden. Hospice waiver for eleven (11). No residents are receiving hospice services at this time. Facility has nine (9) resident bedrooms, and ten (10) bathrooms. At 10:35 am, LPA conducted a tour of the physical plant with the Administrator and observed the following: Physical plant: Facility’s main door is the primary entry/exit access. Screening area is located upon entrance. Alarm sensors are present at all exits and require a code to deactivate. Visitor Sign-in sheet, hand sanitizer, gloves and masks are available. Hand washing, and other necessary signage are posted throughout the facility. Room temperature is comfortable; wall thermostat displays a setting of 75.0°F. within the required range. An approved Mitigation and Infection Control plan is on file. Required postings are prominently displayed and observed to be current. Disaster drills were last conducted on 4/01/2025. Fire Detection/Protection system is present in the facility. Multiple dual-carbon monoxide detector/smoke alarms are installed, hardwired, and interconnected. Fire alarms were tested and function properly. LPA observed One (1) fire extinguisher located in the kitchen area, and one extinguisher located in the main hallway. Both extinguishers show service date: 01/07/2025. [LIC 809C Continued] Kitchen: LPA observed kitchen as clean, equipped with a functional stove, multiple appliances, with adequate supply of perishables and non-perishable food. Pantry space stores emergency dry food, condiments, and can goods. Food observed as properly labeled and stored. Kitchen cabinets store dishes, plastic, paper goods and utensils. Knives and sharps are secured in a locked drawer and inaccessible to residents. Medications are stored in a secured medications cart in dining room area and are inaccessible to residents. Medications are listed on a centrally stored medication and destruction record log. A First Aid kit is complete and stored in the medication cabinet. Laundry area is located in secured room adjacent the main kitchen. Laundry soaps and other cleaning agents are stored and inaccessible to residents. Storage observed to have adequate supply of linen and towels. Commons: LPA observed all common areas of the facility, including the living room and dining areas, to be clean and organized. Furnishings are in good condition. Bedrooms are observed as clean with sufficient lighting, properly furnished with bedding, dressers, closets, linens, at least one chair, and night stand. Bathrooms were observed to be clean and sanitary, with necessary supplies and required safety features. (grab bars, anti-slip floor stripping) Hot water temperature measured at 112°F., within the required range. Outdoor area observed to have a shaded patio, with table with sufficient seating for the residents. Outdoor furniture observed to be in good condition. All trash cans observed as covered. No bodies of water in the facility. Resident records: At 12:35 pm, Resident files were reviewed for current IPP, Needs and Services plans, physician report, and admission agreements. Resident records appear as complete and current. Staff records: Staff files were reviewed. Criminal record clearances, and health screenings were present. Staff are associated to this facility. Staff records appear as complete and current. There were no immediate health and safety hazards observed at the time of this inspection. Exit interview conducted and a copy of this report was given to facility's Administrator.the state’s words, verbatim · CDSS document, Jul 21, 2025

Type of visit: Case Management - Other

On 06/11/25, at 10:45AM, Licensing Program Analyst Gina Saucedo conducted an unannounced site visit at this facility for the purpose of obtaining records. LPA met with Brian Rosales, Administrator and explained the purpose of the visit. During this visit, LPA obtained the following information: 1. Census 2. LIC 601 3. LIC 500 4. Resident Roster 5. POA or Conservator (Contact Information) 6. Physician Report 7. Admission Agreement 8. Rent Payment Source Exit interview conducted and a copy of this report was issued.the state’s words, verbatim · CDSS document, Jun 11, 2025

Allegation investigated: Staff are not meeting resident's toileting needs- Staff did not ensure resident's call button was not in disrepair- Staff left resident in the bathroom for an extended period of time-

At 10:00 am, on 12/16/2024, Licensing Program Analyst, (LPA) Raymond Comer, arrived, unannouced, to initiate a 10 day complaint visit. LPA spoke with Administrator, Brian Rosales, and reason for the visit was disclosed. At 10:20 am, LPA conducted a physical plant tour; No immediate health and safety risks were observed. To investigate the allegation(s) above, LPA reviewed relevant records at 10:25 am including, but not limited to, the facility's resident roster, personnel roster, facility maintenance repair ticket log, Resident#1 (R1)'s physician report, and care plan. LPA interviewed Staff between 10:40 am, and 11:25. LPA interviewed Residents between 11:40 am, and 12:20 pm. At 12:25 pm, LPA conducted observations of resident room#1, room#9, and room#2. [LIC 9099-C Continued]- Unsubstantiated Allegation: Staff are not meeting resident's toileting needs- LPA interview with residents revealed the following: Residents confirm they are assisted with showering and toileting tasks in a timely manner by staff. Residents (R2) and (R3) require assistance with clothes/diaper changes and confirm staff have ensured they are clean and changed since there admission. R1's responsible family member (F1) confirms they have not witnessed staff being negligent responding to R1's toileting needs. However, F1 did express a concern about staff response times occasionally taking longer than ten minutes. LPA did not observe any smell of urine, feces, nor any foul odors within the facility. Therefore, based on LPA records review, interviews and observations, the allegation of Staff not meeting resident toileting needs is deemed Unsubstantiated at this time. Allegation: Staff did not ensure resident's call button was not in disrepair- LPA interview with residents revealed the following: Residents state that, when activated, "wrist alert fob" and room call buttons function properly, and that staff respond to activated calls in a timely manner. LPA testing of R1's wrist alert fob, restroom call button, and bedroom call button, found them as working property. Staff responded to activated call buttons within five minutes of activation. LPA review of the facility's repair ticket log found no issues regarding call buttons servicing needs; no witnesses were identified to corroborate the allegation. Therefore, based on LPA records review, interviews with staff, and residents, the allegation of staff not ensuring R1's call button as not being in disrepair is deemed Unsubstantiated at this time. Allegation: Staff left resident in the bathroom for an extended period of time- LPA interview with F1 revealed the following: F1 states that R1 has health challenges which makes it difficult for R1 to accurately assess the passage of time. LPA interview with residents confirm that staff respond to activated call buttons within an average of five to ten minutes. LPA interview with staff confirm their awareness and sensitivity to R1's needs regarding timely call button response. No witnesses were identified to corroborate the allegation. Therefore, based on LPA interviews with R1's responsible family member, staff, and residents, the allegation of staff leaving resident in the bathroom for an extended period is deemed Unsubstantiated at this time.the state’s words, verbatim · CDSS document, Dec 16, 2024 · control 31-AS-20241212140953

Type of visit: Required - 1 Year

On 06/11/24, 8:45 AM Licensing Program Analyst, (LPA) Raymond Comer, conducted an unannounced Annual visit to this facility. LPA met with caregiver who contacted the Facility Administrator, Brian Rosales, and reason for the visit was disclosed. Facility is licensed as a one story residence, with kitchen area at sub-floor level, fire clearance for eleven (11) non-ambulatory, of which, eleven (11) may be bedridden. Hospice waiver for eleven (11). At the time of this inspection, Facility has two (2) residents receiving hospice services. Facility has nine (9) resident bedrooms and ten (10) bathrooms. At 9:25 AM, LPA conducted a tour of the physical plant with the Administrator and observed the following: Physical plant was inspected for cleanliness and condition. Facility’s main door is the primary entry/exit access. Screening area is located immediately upon entrance. Auditory alarm sensors are present on all exits and require a code for access. Visitor Sign-in sheet, hand sanitizer, gloves and masks are available. Covid 19 prevention protocols are posted. Hand washing, coughing etiquette, and other necessary signage are posted in the bathrooms, hallway, and throughout the facility. Room temperature is comfortable; wall thermostat displays a setting of 76.0°F. within the required range. An approved Mitigation and Infection Control plan is on file. Required postings are prominently displayed and observed to be current. Disaster drills were last conducted on 3/15/2024. [LIC809C Continued] Fire Detection/Protection system is present in the facility. Multiple dual-carbon monoxide detector/smoke alarms are installed, hardwired, and interconnected. Fire alarms were tested and function properly. LPA observed One (1) fire extinguisher located in the kitchen area, and one extinguisher located in the main hallway. Both extinguishers show service date: 02/12/2024. Kitchen: At 10:05AM, LPA observed kitchen as clean, equipped with a functional stove, multiple appliances, with adequate supply of perishables and non-perishable food. Open pantry space stores emergency dry food, condiments, and can goods. Food observed as properly labeled and stored. Kitchen cabinets store dishes, plastic, paper goods and utensils. Knives and sharps are secured in a locked drawer and inaccessible to residents. Medications are stored in a secured medications cart in dining room area and are inaccessible to residents. Medications are listed on a centrally stored medication and destruction record log. A First Aid kit is complete and stored in the medication cabinet. Laundry area is located and secured in hallway storage compartment near the kitchen. Laundry soaps and other cleaning agents are stored and inaccessible to residents. Storage observed to have adequate supply of linen and towels. Commons: LPA observed all common areas of the facility, including the living room and dining areas, adjacent to the kitchen, to be clean and organized. Furnishings are in good condition. Bedrooms are observed as clean with sufficient lighting, properly furnished with bedding, dressers, closets, linens, at least one chair, and night stand. Bathrooms were observed to be clean and sanitary, with necessary supplies and required safety features. (grab bars, anti-slip floor stripping) Hot water temperature measured at 114.8°F. Within the required range. [LIC809C Continued] Outdoor (backyard) area observed to have a shaded patio, with table with sufficient seating for the residents. Outdoor furniture observed to be in good condition. All trash cans were observed to be covered. There are no bodies of water in the facility. Resident records: At 12:35 PM, Resident files were reviewed for current IPP and/or Needs and Services plans, physician report, and admission agreements. Resident records appeared to be complete and current. Staff records: Staff files were reviewed. Criminal record clearances, Health Screening, Employee Rights Records were present and Staff are associated to this facility. Staff records appear to be complete and current. There were no immediate health and safety hazards observed at the time of this inspection. Exit interview conducted and a copy of this report was given to facility representative, Administrator Brain Rosales.the state’s words, verbatim · CDSS document, Jun 11, 2024

Allegation investigated: Facility staff did not allow resident to have visitors. Facility staff did not ensure that resident was fed. Facility staff did not ensure that resident was taking their medications. Staff did not attend the residents as required.

At 12:30 p.m. on 02/01/2024, Licensing Program Analyst (LPA) Nicholas Reed conducted an unannounced complaint visit. LPA met with Administrator and disclosed the reason for the visit. To investigate the allegations above, LPA conducted an initial visit on 02/14/2023 and reviewed pertinent records at 3:40 p.m. including but not limited to the resident list, staff list, admission agreement, and care notes, and interviewed the administrator at 4:00 p.m. LPA interviewed Staff #1 (S1) at 1:00 p.m. on 11/16/23, Staff #2 (S2) at 4:15 p.m. on 01/23/24, and Staff #3 (S3) at 2:30 p.m. on 01/29/24. LPA conducted a subsequent visit today and toured the facility at 12:45 p.m. Regarding the allegation ”Facility staff did not allow resident to have visitors” it was alleged that S1 told the family of Resident #1 (R1) they were not allowed to visit. Interview with S1 revealed they informed family of R1’s health status but never told visitors they could not come to the facility. Unsubstantiated S1 further stated that R1’s family visited several times, but they did not follow the facility’s safety protocols. The Administrator also confirmed that the facility followed the Centers for Disease Control (CDC) guidance and the mitigation plan regarding facility visitation. Visitation was allowed but limited to protect the health of all facility residents. Record review revealed the facility’s mitigation plan had a visitation policy in place. Additionally, visitors could call ahead for “visiting tips”. Care notes revealed R1 did have a visitor on 11/26/2022. Staff interviewed confirmed the facility followed the visitation policy listed on the mitigation plan and were not aware of any issues with visitation. Based on interviews and record review, the facility staff allowed R1 to have visitors. Therefore, the allegation is deemed UNSUBSTANTIATED at this time. Regarding the allegation ”Facility staff did not ensure that resident was fed” it was alleged facility staff did not encourage R1 to eat despite their deteriorating health. Review of care notes revealed R1 ate 50% - 100% of their meals in November 2022. Staff supplemented R1’s diet with snacks and nutritional shakes. R1 ate less than 50% of their meals in December 2022. Interview with the administrator revealed staff encouraged R1 to eat, but R1 would store food in their mouth and spit it out when staff were not looking. S1 confirmed R1 would store food instead of eating it. S2 and S3 stated R1 ate all their food. Based on interviews and record review, the facility provided R1 with meals and supplemental shakes to ensure they were fed. Therefore, the allegation is deemed UNSUBSTANTIATED at this time. Regarding the allegation ”Facility staff did not ensure that resident was taking their medications” it was alleged that R1 was not taking their medications. Interview with the administrator revealed that R1 took all of their regular medications, however R1’s hospice agency frequently changed R1’s medications. S1 noted R1 had difficulty swallowing but took all of their medications. S2 and S3 could not recall any missed or refused medications. Record review did not reveal any information regarding missed or refused medications either. Based on interviews and record review, the facility ensured R1 was able to take all medications. Therefore, the allegation is deemed UNSUBSTANTIATED at this time. Regarding the allegation ”Staff did not attend the residents as required” it was alleged staff left R1 unsupervised for fear of contracting R1’s illness. Interview with S2 and S3 revealed they attended to R1 regularly during R1’s admission. S3 “took good care of” R1. Record review of care notes revealed staff regularly provided meals, supervision, and assistance with grooming, and S2 checked on R1 every 2 hours. Other staff were noted to check on R1 every hour. Interview with the administrator revealed staff assisted with changing, grooming, and medications regularly. S1 noted staff wore protective gear and attended trainings to provide increased supervision for R1. Based on interviews and record review, the facility attended R1 as required. Therefore, the allegation is deemed UNSUBSTANTIATED at this time. No immediate health and safety hazards were observed during this visit. Exit interview conducted. Appeal rights discussed. Copy of report provided.the state’s words, verbatim · CDSS document, Feb 1, 2024 · control 31-AS-20230213085222

Allegation investigated: Staff do not ensure resident is adequately fed Staff do not dispense residents’ medication as prescribed Staff do not treat residents with dignity or respect

*** This page was amended to fix a typographical error *** - 02/01/2024 - LPA Reed At 3:00 p.m. on 01/30/2024, Licensing Program Analyst (LPA) Nicholas Reed conducted an unannounced complaint visit. LPA met with Administrator and disclosed the reason for the visit. To investigate the allegation above, LPA conducted an initial visit on 08/24/2023 and toured the facility at 12:30 p.m. and reviewed pertinent records at 1:00 p.m. including but not limited to the resident list, staff list, admission agreements, physician reports, care notes, and care plans. LPA interviewed Staff #1 (S1) at 12:30 p.m. on 11/16/23, Staff #2 (S2) at 1:00 p.m. on 11/16/23, Staff #3 (S3) at 4:00 p.m. on 01/23/24, Staff #4 (S4) at 4:15 p.m. on 01/23/24, and Staff #5 (S5) at 2:30 p.m. on 01/29/24. LPA conducted a subsequent visit today and toured the facility at 3:00 p.m. and interviewed Resident #1 (R1) at 3:15 p.m. Unsubstantiated Regarding the allegation ”Staff do not ensure resident is adequately fed” it was alleged Resident #2 (R2) was not fed enough. Review of care notes showed that R2 did not finish their meals at times. Staff interviews revealed R2 refused food that was offered. Staff documented the percentage of the meal R2 ate and supplemented their diet with a nutritional shake. S1 and S2 confirmed that R2 had difficulty with solid foods and staff needed to supplement R2’s diet with nutritional shakes. S3 and S4 mentioned R2’s health declined and enrolled in hospice services. Based on record review and interviews, the facility properly provided food and nutritional shakes to R2, but R2 had difficulty with eating. Therefore, the allegation is deemed UNSUBSTANTIATED at this time. Regarding the allegation ”Staff do not dispense residents’ medication as prescribed” it was alleged R2 did not receive their medication because it was crushed and mixed into a puree or shake which they did not finish. S3 and S4 stated R2 received their medications in a nutritional shake which was always finished to completion. S5 mentioned they assisted R2 with medications in apple sauce. S5 could not recall R2 ever refusing medication or not taking medication. No medication refusals were noted in R2’s care notes. Based on interviews and record review, the facility properly assisted with R2 taking their medications. Therefore, the allegation is deemed UNSUBSTANTIATED at this time. Regarding the allegation ”Staff do not treat residents with dignity or respect” it was alleged staff were rude to R1. Interview with R1 revealed they have a good and respectful relationship with staff. R1 said staff were never mean to them. S3, S4, and S5 mentioned R1 was physically and verbally aggressive with staff, but no staff were ever rude or mean to R1. S5 also mentioned staff relationships got better with R1 as R1 got to know staff better. Based on interviews, staff have been courteous to R1 and treated R1 respectfully. Therefore, the allegation is deemed UNSUBSTANTIATED at this time. No immediate health and safety hazards were observed during this visit. Exit interview conducted. Appeal rights discussed. Copy of report provided.the state’s words, verbatim · CDSS document, Jan 30, 2024 · control 31-AS-20230816103721