Restpadd Care

Type of visit: Required - 1 Year

On August 7, 2026, at approximately 10:20am, Licensing Program Analyst, Arvin Villanueva (LPA), arrived at this facility unannounced to conduct the annual inspection visit. LPA initially met with staff on duty, Mila Capacete (S1), and stated the purpose of the visit. The admistrator Iheoma Nwangburkuka (AD), was notified and arrived shortly after. Overview: Facility is a one-story home located in a residential neighborhood. Facility is licensed to serve up to 6 elderly residents, up to 6 may be non-ambulatory. Facility does not have clearance for bedridden, delayed egress, and locked exterior/interior. Facility has 2 fire doors. Upon arrival: LPA observed the room temperature to be at 79 degrees Fahrenheit. Present were 6 residents in care with 1 staff on duty. Physical Inspection: Areas inspected include, but not limited to, the kitchen, resident units, resident bathrooms, dining room and outdoor areas. LPA and AD inspected 4 of 5 resident bedrooms and 2 of 3 bathrooms. Hot water temperature was measured in the hallway bathroom was at 98.8 degrees Fahrenheit. Advisory provided to ensure the two fire doors remain closed at all times. In the kitchen area, LPAs observed at least 7-day nonperishable and 2-day perishable food supplies. Knives/sharps and cleaning solutions were locked. Fire extinguishers observed and last serviced on 9/3/2025. Smoke detectors were observed throughout and at least one carbon monoxide detector was observed. Advisory provided to install additional carbon monoxide in the resident hallways due to the fire doors. Medication cabinet was observed to be locked and not accessible to residents. During inspection of the medication cabinet, LPA observed a couple of days’ worth of medications pre-poured in a plastic pill case for each residents taking medication. Pre-pouring of medication more than 24 hours in advance is a violation of Title 22 regulations. {1 of 2} The outdoor area was inspected. Regarding the fence, located at the garage side, part of it was observed to be leaning and advisory as provided to address this as soon as possible. Exit gate was observed to be in good repair. No bodies of water were present. The LPA observed a shaded area with furniture available for outdoor activities. An advisory was provided to the facility to ensure all staff are familiar with the location and operation of shut-off valves in case of an emergency. An additional advisory was issued regarding trimming or clearing vegetation along the side walkways to maintain safe access. Record Reviews: Review of 4 of 6 resident files was conducted, including but not limited to, review of Admission Agreement, Physician Reports, and Ambulatory Status. Advisory provided to ensure all residents have doctor’s assessment regarding their capacity to determine or communicate their need for PRN medication. Review of 2 staff files included but not limited to background clearance, first aid/CPR certification, and training. Per review, staff on duty during this visit did not have a current First Aid certificate, only CPR certificate. Per AD, it is her oversight. Facility do not have proper documentation for quarterly disaster drill. The documentation that was reviewed did not have the proper documentation. However, per AD, they conduct quarterly drills. Advisory provided to develop a drill log specific to disaster drills. Interviews: 1 staff member and 1 resident in care. Documents Requested: LPA requested a copy of updated Liability Insurance, Personnel Records (LIC500), and Designation of Facility Responsibility LIC308 to be emailed to arvin.villanueva@dss.ca.gov Per the California Code of Regulations, Title 22, Division 6, Chapter 6 and Health and Safety Code deficiencies were cited. Advisories were provided. Plan of Correction and Appeal Rights were discussed during exit interview with AD. A copy of the report and appeal rights were provided. {2 of 2}the state’s words, verbatim · CDSS document, Aug 7, 2026

The state marks this report as 14 pages; the online copy we transcribed has 5. You can request the full file from the county licensing office.

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Vincent Moleski arrived unannounced to conduct an annual inspection. LPA Moleski met with facility administrator Iheoma Nwangburuka and explained the purpose of the visit. LPA Moleski reviewed five resident files (R1-R5) and two staff files (S1-S2). LPA Moleski toured the facility with Nwangburuka and inspected common areas, the kitchen, bedrooms, bathrooms, and backyard areas. Furniture and furnishings were sufficient to meet the needs of residents. The facility temperature was 78 degrees Fahrenheit, which is within the required range of 68 and 85 degrees. The facility's water temperature measured 113 degrees Fahrenheit, which is within the required range of 105 and 120 degrees. LPA Moleski observed first aid supplies and working carbon monoxide/smoke detectors. LPA Moleski observed that the facility's fire extinguisher was not serviced within the last year, as required. The fire extinguisher was last serviced on August 6, 2024, and therefore needed to be serviced by August 6, 2025. LPA Moleski observed a minimum 2-day supply of perishable food and a minimum 7-day supply of nonperishable food. LPA Moleski observed a locked cabinet for the storage of medication. LPA Moleski observed locked cabinets for the storage of cleaning solutions and knives. LPA Moleski interviewed one staff member (S1). This facility is hereby cited per 22 CCR Section 87203. An exit interview was held with Nwangburuka. Appeal rights and a copy of this report was left with Nwangburuka.the state’s words, verbatim · CDSS document, Aug 13, 2025

Allegation investigated: Facility staff are not providing proper notice of rate increases.

Licensing Program Analyst (LPA) Vincent Moleski arrived unannounced to open this complaint investigation. LPA Moleski met with facility administrator Iheoma Nwangburuka and explained the purpose of the visit. LPA Moleski reviewed text message conversations between Nwangburuka and a resident's responsible party (R1's RP). On 3/15/25, Nwangburuka sent a text message to R1's RP raising their rates to $6500 per month, or $250 per day. According to Nwangburuka, prior to this, R1's RP was paying $5000 per month. The notice states that the increase was due to "significant changes in" R1's "health," and because R1 "is now receiving hospice care." Health and Safety Code Section 1569.657(a) requires that "for any rate increase due to a change in the level of care of the resident, the licensee shall provide the resident and the resident’s representative, if any, written notice of the rate increase within two business days after initially providing services at the new level of care. The notice shall include a detailed explanation of the additional services to be provided at the new level of care and an accompanying itemization of the charges." [continued on 9099-C] Substantiated LPA Moleski reviewed R1's file and observed an admission agreement which had been signed by R1's RP, dated 10/15/2017, shortly after a change of ownership took place at this facility. The department has determined the following as it relates to the allegations that facility staff are charging fees without an updated admissions agreement and that facility staff are not providing documents to a resident's attorney-in-fact, as required. Based on interviews and record review, the above allegations are UNSUBSTANTIATED, which means that although the allegations may have happened or are valid, there is not a preponderance of the evidence to prove that the alleged violations occurred. No deficiencies were cited regarding the above allegations. An exit interview was held and a copy of this report was left with Nwangburuka. In an interview, Nwangburuka said that the text message was the only form of written notification sent to R1's RP, although she did have two phone conversations discussing the increase with R1's RP on 3/16/25 and 3/22/25, respectively. The text message sent to R1's RP did not include a detailed explanation of the charges, and did not include an itemized list of charges, as required per Health and Safety Code Section 1569.657(a). Additionally, the notice was not sent within two business days after providing services at the new level of care. LPA Moleski reviewed a hospice notification form, and observed that R1 was placed on hospice as of 2/14/25. LPA Moleski reviewed R1's file and observed an admission agreement which had been signed by R1's RP, dated 10/15/2017. The admission agreement identified R1's initial monthly rate as $3875. LPA Moleski asked Nwangburuka to provide written notices for previous increases from $3875 to the current rate of $5000. Nwangburuka was unable to immediately provide prior notices. LPA Moleski is requesting that Nwangburuka review her records and produce any and all prior written notices for any previous rate increases. Nwangburuka must also produce a formal written notice with all required information if she chooses to move forward with a rate increase due to R1's current level of care. The department has determined the following as it relates to the allegation that facility staff are not providing proper notice of rate increases: Based on interview and record review, the above allegation is SUBSTANTIATED. A finding that the complaint allegation is substantiated means that the allegation is valid because the preponderance of evidence standard has been met. This facility is hereby cited per HSC Section 1569.657(a). An exit interview was held with Nwangburuka. Appeal rights and a copy of this report were left with Nwangburuka.the state’s words, verbatim · CDSS document, Mar 27, 2025 · control 27-AS-20250325131228

From the deficiency page — Deficiency type: Type B · Section cited: HSC 1569.657(a) · Plan of correction due date: Apr 17, 2025

"(a) For any rate increase due to a change in the level of care of the resident, the licensee shall provide the resident and the resident’s representative, if any, written notice of the rate increase within two business days after initially providing services at the new level of care. The notice shall include a detailed explanation of the additional services to be provided at the new level of care and an accompanying itemization of the charges." This requirement was not met as evidenced by: Based on record review, a written notice was provided regarding an increase in care costs, but which did not contain all required information per the above section, which poses a potential health, safety, and/or personal rights risk.the state’s words, verbatim · CDSS document, Mar 27, 2025

Plan of correction: Licensee agrees to provide LPA Moleski with an updated written notice regarding the rate increase containing all required details by POC due date. After approval, licensee shall provide this notice to R1's RP. Licensee agrees that this notice shall not backcharge R1's RP beyond the date served to R1's RP. Licensee further agrees to provide LPA Moleski with any and all written notices previously provided for any prior rate increases for R1. vincent.moleski@dss.ca.gov R1's RP shall continue paying their standard rate until licensee provides proper written notice.

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Christina Valerio arrived unannounced to conduct an annual inspection. LPA met with facility staff Mila and explained the purpose of the visit. LPA was later met by Administrator Iheoma Nwangburuka. LPA and facility staff toured the facility to ensure compliance with Title 22 regulations. LPA observed the resident bedrooms. The bedrooms were observed to have necessary furniture and furnishings, no odors, and to be organized. The bathrooms were observed to be clean and free from debris. The hot water measured at 106.4*F, which is within the regulatory range. The temperature inside the facility was at a comfortable temperature. The facility is equipped with an emergency supply of food and water, a supply of perishable foods for seven days, and a supply of non-perishable food for a minimum of two days. Fire extinguishers were observed to be in working condition. Medications, sharps, and cleaning supplies were observed to be locked away and inaccessible to residents in care. The backyard was observed to have an area for outside visits. The shed was observed to be empty and utilized for storage. No health or safety concerns observed. Staff was observed cleaning up lunch items, assisting residents with meals, assisting residents with ADLs, and doing exercise with residents. Residents were observed finishing up lunch, watching television, taking a nap, and engaging with staff. LPA Valerio reviewed two (2) staff files and three (3) resident files. Staff files were observed to be complete with required training. Residents files were current with necessary care plans and health documentation. LPA requested the following documentation be sent to the Regional Office: LIC 500, LIC 308, LIC 610, and copy of Liability Insurance Per California Code of Regulations (CCR) Title 22 - No deficiencies were observed during today's visit. An exit interview was held, and a copy of the report was provided.the state’s words, verbatim · CDSS document, Jul 29, 2024

Type of visit: Case Management - Incident

Licensing Program Analyst (LPA) Christina Valerio arrived unannounced to conduct a case management visit to follow up on incidents reports submitted to the Regional Office. LPA Valerio met with Administrator Iheoma Nwangburuka, and explained the purpose of the visit. Two incident reports were submitted, one dated 07/09/2024 and the other dated 07/10/2024. Both incident reports had information that relayed medical emergencies and change of condition; however, the boxes for alleged client abuse were checked. LPA Valerio discussed follow up care for both resident incidents. LPA Valerio advised Administrator Iheoma to review the report prior to submission to ensure the type of incident box is marked correctly. No deficiencies were cited An exit interview was held, and a copy of the report was provided.the state’s words, verbatim · CDSS document, Jul 29, 2024