Remolona Family Guest Home

Type of visit: Required - 1 Year

Unannounced Annual visit made out to this facility on 05/27/2026 by Licensing Program Analyst (LPA) Charlie Yang. This LPA was met by the facility caregivers, Claudia Gonzalez and Vanessa Medina, who were briefly interviewed at this time. This LPA requested that they go ahead and contact the facility designated Administrator, Nora Remolona, to inform her that CCL was present at this time. The facility designated Administrator, Nora Remolona, arrived later to this facility and was briefly interviewed at this time. Current census was 13 residents. It was learned that there were (4) residents under the care of hospice at this time. This facility does have an approved waiver to be able to accept and retain up to (6) residents under the care of hospice at any given time. It was learned that this facility has a program to be able to accept and retain dementia residents at any given time. It was learned that there were (4) residents diagnosed with dementia at this time. It was learned that there were (5) residents receiving services through home health at this time. It was learned that this facility does not have a bedridden fire clearance to be able to accept or retain any residents deemed to be bedridden at any given time. Tour of this facility was conducted. Dining area, living area, and all other areas intended for resident use were toured. Furniture and furnishings were observed to be sufficient and able to meet the needs of the residents at this time. Linen closet, located in facility hallway closet, was reviewed and observed to contain a sufficient supply of towels, sheets, and bedding able to meet the needs of the residents at this time. Kitchen area was toured. Kitchen drawers and cabinets were opened and reviewed. Food supply for 2-day perishable and 7-day nonperishable quantities was reviewed to make sure that they were in compliance at all times. Pantry area was toured. Garage area was toured. Laundry area, located in the garage area, was toured and observed to be locked at this time. A review of the bleach, detergent, and all other cleaning supplies was conducted to make sure that they were locked and made inaccessible to the residents at this time. Administrator certificate # 7007799740 for Nora Remolona which was observed to expire on 11/01/2026 and in compliance at this time. Medication cabinet, located in the facility kitchen cabinet, was observed to be locked and made inaccessible to the residents at this time. First aid kit, located in the kitchen cabinet, was reviewed. This LPA observed that it did contain all of the required components at this time. Fire extinguisher located hanging on the wall adjacent to the kitchen was observed to have been annually inspected by the local fire extinguisher company, ARF Fire Extinguisher Services, with the inspection date of 03/11/2026 and in compliance at this time. Facility resident bedrooms were toured. Furniture and furnishings were observed to be sufficient and able to meet the needs of the residents at this time. Facility resident restrooms were toured. Grab bars and non skid mats were observed to be present and in good repair at this time. Hot water temperatures were taken to make sure that they were within the allowed range of 105-120 degrees at all times. A tour of the facility exterior grounds was conducted. A review of the facility perimeter fence, side gates, and all other exits was conducted. A review of (5) facility personnel records was conducted and noted on the following LIC 859. A review of (5) facility resident records was conducted and noted on the following LIC 858. The following forms and documents were requested to be updated and submitted into CCL for review by this LPA: LIC 308 LIC 400 LIC 500 LIC 610 The following deficiencies were observed and cited on the following LIC 809-D pursuant to Title 22 Rules and Regulations, Health and Safety Codes. Civil Penalty assessed in the amount of $500 on the following LIC 421 IM. Appeal Rights were printed and a version was given to the facility designated Administrator at this time. Exit Interviewthe state’s words, verbatim · CDSS document, May 27, 2026

Type of visit: Required - 1 Year

Unannounced Annual visit made out to this facility on 04/30/2025 by Licensing Program Analyst (LPA) Charlie Yang. This LPA was met by the facility staff persons, Maria Lourdes Vazquez and Rosalinda Wright, who were briefly interviewed at this time. This LPA requested that they go ahead and contact the facility designated Administrator, Nora Remolona, to inform her that CCL was present at this time for an annual visit. The facility designated Administrator arrived later to this facility while this LPA was conducting this visit. Current census was 15 residents. It was learned that there were (4) residents under the care of hospice at this time. This facility does have an approved waiver to be able to accept and retain up to (6) residents under the care of hospice at any given time. It was learned that there were (5) resident receiving services through home health at this time. Tour of this facility was conducted. Dining area, living area, and all other areas intended for resident use were toured. Furniture and furnishings were observed to be sufficient and able to meet the needs of the residents at this time. Linen closet, located in facility hallway, was reviewed and observed to contain a sufficient supply of towels, sheets, and bedding able to meet the needs of the residents at this time. Kitchen area was toured. Kitchen drawers and cabinets were opened and reviewed. Food supply for 2-day perishable and 7-day nonperishable quantities was reviewed to make sure that they were in compliance at all times. Pantry area was toured. Additional food storage units located in the garage area were observed to be present and functional at this time. Laundry room, located as part of the garage, was toured. Bleach, detergent, and all other cleaning supplies were observed to be locked and made inaccessible to the residents at this time. Administrator certificate, # 7007799740, for Nora Remolona was observed to have an expiration date of 11/01/2026 and in compliance at this time. Forms and documents have been completed in order to renew this Administrator certificate at this time. Medication cabinet, located in the facility kitchen cabinet, was observed to be locked and made inaccessible to the residents at this time. First aid kit, located in the medication closet, was reviewed. This LPA observed that it did contain all of the required components at this time. Fire extinguishers were located throughout this facility and observed to have been annually inspected by the local fire extinguisher company, ARF Fire Extinguisher Company, on 03/05/2025 and found to be in compliance at this time. Facility resident bedrooms were toured. Furniture and furnishings were observed to be sufficient and able to meet the needs of the residents at this time. Facility resident restrooms were toured. Grab bars and non skid mats were observed to be present and in good repair at this time. Hot water temperatures were taken to make sure that they were within the allowed range of 105-120 degrees. A tour of the facility exterior grounds was conducted. A review of the facility perimeter fence, side gates, and all other exits was conducted. A review of (4) facility personnel records was conducted on the LIC 859. A review of (5) facility resident records was conducted on the LIC 858. The following forms and documents were requested to be updated and submitted into CCL for review by this LPA: LIC 308 LIC 400 LIC 500 LIC 610 There were no deficiencies observed or cited during today's annual visit. Exit Interviewthe state’s words, verbatim · CDSS document, Apr 30, 2025

Type of visit: POC

Unannounced Plan of Correction visit made out to this facility on 04/30/2025 by Licensing Program Analyst (LPA) Charlie Yang. This LPA was met by the facility staff persons, Maria Lourdes Vazquez and Rosalinda Wright, who were briefly interviewed at this time. This LPA requested that they go ahead and contact the facility designated Administrator, Nora Remolona, to inform her that CCL was present at this time for a POC . The facility designated Administrator Nora Remolona arrived later to this facility while this LPA was conducting this visit. Current census was 15 residents. The purpose of this visit was to follow up on the deficiencies that were cited from a prior annual visit conducted on 04/23/2024 and to follow up on the Plan of Correction. The following deficiencies were observed and cited on 04/23/2024: Water supplies and plumbing fixtures shall be maintained as follows: (2) Faucets used by residents for personal care such as shaving and grooming shall deliver hot water. Hot water temperature controls shall be maintained to automatically regulate the temperature of hot water used by residents to attain a temperature of not less than 105 degree F (41 degrees C) and not more than 120 degree F (49 degrees C). Prior to accepting a resident for care and in order to evaluate his/her suitability, the facility shall, as specified in this article 8: (3) Obtain and evaluate a recent medical assessment. All window screens shall be clean and maintained in good repair. 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 facility did complete the Plan of Correction and provided all of the required forms and documents at this time. Plan of Correction clearance letters were printed and copies were provided to the facility designated Administrator at this time. There were no further deficiencies observed or cited during today's Plan of Correction visit. Exit Interviewthe state’s words, verbatim · CDSS document, Apr 30, 2025

Type of visit: Case Management - Other

Unannounced Case Management visit made out to this facility on 04/30/2025 by Licensing Program Analyst (LPA) Charlie Yang. This LPA was met by the facility staff persons, Maria Lourdes Vazquez and Rosalinda Wright, who were briefly interviewed at this time. This LPA requested that they go ahead and contact the facility designated Administrator, Nora Remolona, to inform her that CCL was present at this time for a Case Management visit. The facility designated Administrator arrived later to this facility while this LPA was conducting this visit. Current census was 15 residents. The purpose of this case management visit was to go over the recent change to the facility program that was submitted into CCL by this facility Licensee. This Licensee submitted a facility program addressing advertising and accepting residents diagnosed with dementia at any given time. This LPA reviewed the facility program change for dementia care and requested that the following changes be made at this time: Cite and include rules and regulations pertaining to dementia care and supervision within the program Detail and update facility physical plant changes that will be made Detail and update visiting hours Detail and update the rules and regulations for Advertising Dementia care Upon completion and submission by this Licensee, this LPA will review and update the facility program for this facility license to reflect dementia care. There were no deficiencies observed or cited during today's case management visit. Exit Interviewthe state’s words, verbatim · CDSS document, Apr 30, 2025

Type of visit: Required - 1 Year

Unannounced annual visit made out to this facility on 04/23/2024 by Licensing Program Analyst (LPA) Charlie Yang who was met by the facility staff person, Nena De La Cruz, who was requested by this LPA for her to go ahead and contact the facility designated Administrator, Nora Remolona, to inform her that CCL was present at this time. The facility designated Administrator arrived shortly thereafter to this facility while this LPA was conducting this annual visit. A brief interview was conducted with the facility designated Administrator at this time. It was learned that there were (5) residents under the care of hospice at this time. This facility has an approved hospice waiver for (6) residents at any given time. It was learned that there were (3) other residents who were receiving services through home health as well. This facility also has, on file, a program to accept and retain residents diagnosed with dementia at this time. Current census was 15 residents. A tour of this facility was conducted. Administrator certificate was observed to be present and in compliance at this time for facility designated Administrator Nora Remolona. Kitchen area was toured. Cabinets and drawers were reviewed. Food preparation stations, dishwashing station, and other areas intended for meal preps were toured. Food supply was reviewed for adequate 2-day perishable and 7-day nonperishable quantities at this time. This LPA did observe additional food storage units which were present and functional at this time. A tour of the dining area, living area, and all other areas intended for resident use was conducted. Medication cabinet, located in kitchen hallway closet, was reviewed. Policies and procedures involving dispensing, documenting, and overall administration of resident medications were discussed with the facility designated Administrator at this time. The medication cabinet was observed to be locked and made inaccessible to the residents at this time. A tour of the resident bedrooms and restrooms was conducted. Furniture and furnishings were observed to be sufficient and able to meet the needs of the residents at this time. Grab bars and non skid mats were observed to be present and in good repair at this time. Hot water temperatures were taken and measured to make sure that they were within the allowed range of 105-120 degrees. Linen closet, located in the facility hallway cabinet, was observed to contain a sufficient supply of towels, blankets, and linens to meet the needs of the residents at this time. Fire extinguishers, located throughout this facility, were observed to have been annually inspected on 11/28/2023 by the local fire extinguisher company, Armor Fire Extinguisher Services, and in compliance at this time. First aid kit was observed to be present and contained all of the required components at this time. Exterior grounds of this facility were toured. A review of the facility perimeter fence, side gates, and exits was conducted. A review of (5) facility resident files was conducted and noted on the following LIC 858. A review of (5) facility personnel files was conducted and noted on the following LIC 859. The following forms and documents were requested to be updated and submitted into CCL: LIC 308 LIC 400 LIC 500 LIC 610 The following deficiencies were observed and cited on the following LIC 809-D pursuant to Title 22 Rules and Regulations, Health and Safety Codes. Appeal Rights were printed and a copy was given to the facility designated Administrator at this time. Exit Interviewthe state’s words, verbatim · CDSS document, Apr 23, 2024