Rio Vista Care Home

Type of visit: Required - 1 Year

At approximately 10:30am, Licensing Program Analyst (LPA) Contreras arrived unannounced to conduct a required annual inspection visit. LPA was greeted by Administrator, Maria Laquindanum. Facility is a Residential Care Facility for the Elderly that has a fire clearance approved for a capacity of 6 non-ambulatory, 1 can be bedridden with hospice waiver for 2. There are currently 5 residents in care. LPA reviewed Guardian Roster and found that two staff (S4 & S5) working on shift were not associated to the facility roster (Deficiency cited, see 809D). LPA toured the building and grounds which was found to be clean and at a comfortable temperature. LPA observed all walkways and exits to be unobstructed. All required postings were in a highly visible area. Fire extinguishers were charged and last inspected 5/15/2025. Fire alarms and carbon monoxide detector were tested and operational. Outdoor emergency exit clear from obstruction. Outdoor furniture accessible for resident use. Water temperature measured faucets accessible to residents which is within the allowable range of 105 to 120 degrees F. Disaster drills are conducted quarterly. All bedrooms were equipped with lighting, a night stand and chest of drawers. Resident bathroom observed to have bath mat and grab bar. Facility had an ample supply of linens, towels and extra hygiene products for residents. LPA observed at least a 2 day supply of perishable and 7 day supply of non-perishable foods. Few canned goods were found to be expired and expiration dates were not noted in refrigerated containers(Technical Violation given). Facility kitchen, refrigerators and freezers were clean. Toxins placed under kitchen sink were not locked. In addition, toxins also found under sink not locked in restroom accessible to residents. (Deficiency Cited, see 809D) Sharps and knives were locked in kitchen drawer. LPA observed unlocked drawer with pre poured medications in kitchen(Deficiency Cited, see 809D). Technical violation given for pre-poured medications. Continued onto 809C... continued from 809.... LPA reviewed 4 staff records. S1,S2 lacked LIC503. S3 lacked LIC503 with TB Clearance (Deficiency Cited, See 809D) S1,S4,S5 did not have completed annual training certification (Deficiency Cited, see 809D). LPA reviewed 4 of 4 resident records. All required documentation was present. Physician reports were up to date. Personal Rights LIC613 missing signature for 2 residents (Technical Violation,given) . LIC602 not updated for R5 (Deficiency Cited, See 809D). LPA and Admin conducted a spot check of medication and medication records, all records up to date. Medication is centrally stored and locked. Updated copies of the following documents were requested for facility file and are to be submitted to CCL within 30 days of this visit: LIC500- Personnel Report LIC308- Designation of Responsibility Liability Insurance ***LPA had conversation with Admin recommending TSP. At this time Admin is not interested but will let CCL know if decision changes. Deficiencies cited from the California Code of Regulations, Title 22, Division 6 of California Regulation and the Health and Safety Code. Appeal rights given and discussed with Administrator. Failure to correct the deficiency and/or repeat deficiencies within a 12 month period may result in civil penalties. Exit interview conducted and report read with Administrator.the state’s words, verbatim · CDSS document, Dec 11, 2025

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Jill Nakagawa arrived at the facility unannounced on 1/07/2025 to conduct an Annual Inspection. LPA met with licensee Maria Laquindanum, and explained the purpose of the visit. The facility currently has 6 residents and there were three staff on site at the time of inspection. Each resident was clean and dressed appropriately; 4 of the 6 residents socially engaged in the large family room, listening to music. LPA and licensee toured the interior and exterior of the facility to ensure health and safety of residents in care. Areas toured include but are not limited to:. common areas, resident bedrooms, two bathrooms, kitchen and dining. The facility was a comfortable 72 degrees F. In the areas toured no immediate health, safety, or personal rights violations were observed. All exits were clear of obstructions. The kitchen was clean and well-maintained. There was an ample supply of non-perishable foods. LPA requested more perishables be available, although there were plenty of fresh fruits. LPA reviewed three staff files and found one staff file missing documentation of dementia training. New regulations and the increase in training were discussed. Licensee to forward the documentation of staff training by 1/15/2024. Resident files were missing appraisal forms but information was in Needs and Services Plans. LPA reviewed documentation with Licensee and the regulations regarding dementia care. LIcensee to ensure all pre-appraisal information is included in resident files. LPA requested the following documents be submitted by email to LPA by 1/8/2025: Administrator packet for new administrator, Keanu Guintu, LIC500, LIC308, Resident Roster Areas discussed: Administrator paperwork, new Dementia definition, copy of the new PIN given to Licensee. No citations issued at the time of inspection.the state’s words, verbatim · CDSS document, Jan 7, 2025

The state marks this report as 6 pages; the online copy we transcribed has 1. You can request the full file from the county licensing office.

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Kevin Mknelly arrived at the facility unannounced on 1/11/24 to conduct a Annual Inspection utilizing the CARE inspection tool. LPA met with a licensee and explained the purpose of the visit. LPA and licensee toured the interior and exterior of the facility to ensure health and safety of residents in care. Areas toured include but are not limited to: common areas, resident bedrooms, kitchen and dining. In the areas toured no immediate health, safety, or personal rights violations were observed. LPA advised that the doorways and exits be cleared of obstructions, commonly touched surfaces be cleaned and sanitized regularly, storage areas with locks be maintained and consistently locked, and that hot water be monitored regularly as temperature was measure at 120' F. LPA reviewed resident files. Files were found to be lacking written appraisals and care plans. Staff files were reviewed. S1 does not have proof of 2023 training on file. LPA requested the following documents be submitted by email to LPA: liability insurance certificate; LIC 400- Affidavit regarding Client Cash Resources (updated to reflect no cash managed); Updated Emergency Disaster Plan (LIC 610E); LIC 9020- Register of residents; and current lease agreement As a result of this inspection, the following deficiencies were cited on 809-D, per Title 22 Regulations, Division 6. (A)This poses an immediate Health and Safety risk to clients/residents in care. (B) This poses a potential Health and Safety risk, or personal rights violation, to clients/residents in care. Exit interview conducted. Report copy and appeal rights provided.the state’s words, verbatim · CDSS document, Jan 11, 2024

The state marks this report as 9 pages; the online copy we transcribed has 3. You can request the full file from the county licensing office.