Roias Home for the Elderly

Type of visit: Required - 1 Year

On 05/27/2026, Licensing Program Analyst (LPA) Jaime Vado conducted an unannounced required 1 year inspection. LPA met with administrator Judy Roias and explained the purpose of today's visit. Currently there are 6 residents in place and 3 staff, one of which is the administrator. The facility is licensed for age range 60 and over. All may be non-ambulatory. The facility has a hospice waiver in place for 4 residents. 2 residents are currently on hospice. This is a single level facility. The facility ambient temperature is comfortable. There are 6 resident rooms. All rooms contain a half bathroom. Water temperature is tested in the common hallway full bathroom measuring as 108F. Cleaning supplies are observed to be locked in the garage. Facility knives are observed to be locked in the medication room. Kitchen food supplies are observed to be in place with 2 day fresh food supply and canned goods fulfilling the 7 day emergency food supply. Majority of the canned goods are stored in the garage. The garage has two additional refrigerators with staff and resident food. Laundry area is observed in the garage as well and is fully operational with new washer and dryer. A tour of the outside of the facility is conducted. Emergency routes are free and clear of any obstructions. At the rear of the facility lot is a separate dwelling that is rented out privately. There is no connecting entrances from the facility to that dwelling. Smoke detectors and carbon monoxide detectors are located through out the facility as well as fire sprinklers. The facility is also equipped with 1 fire alarm pull in the front of the facility. LPA observed 2 fire extinguishers in the facility with inspection tags dated 04/13/2026. Facility conducts emergency drill quarterly. The last drill that was conducted is logged as March 17, 2025. Linens are in place for resident use also stored in the medication room. Continued on next page... Page 2 LPA observed all resident rooms and observed that they contain the required furniture and lighting as outlined in Title 22. Medications, first aid kit, and sharps are stored in locked medication closet near the front of the facility. Toilet and bathing facilities are equipped with grab bars and non-skid mats. Hygiene supplies are in place. Criminal record clearances or exemptions for facility staff or other individuals who have client contact have been reviewed as current. LPA reviewed staff files and resident files on this day which all appear to be current based on the review. Staff training records are observed to be current and in place. Administrator certificate for Judy Roias is observed as current. The following updated items are to be received: • Copy of updated administrator certificate • Copy of facility's liability insurance • LIC308 Designation of responsible staff person • LIC500 Staff Schedule Report is reviewed with Judy. A copy of this report is provided to the facility. No citations issued on this day.the state’s words, verbatim · CDSS document, May 27, 2026

Type of visit: Required - 1 Year

On 04/08/2025, Licensing Program Analyst (LPA) Jaime Vado conducted an unannounced required 1 year inspection. LPA met with administrator Judy Roias and explained the purpose of today's visit. Currently there are 4 residents in place and 3 staff, one of which is the administrator. A new resident is due to move in on this day but is not present during LPAs visit. The facility is licensed for age range 60 and over. All may be non-ambulatory. The facility has a hospice waiver in place for 4 residents. 2 residents are currently on hospice. This is a single level facility. The facility ambient temperature is comfortable. There are 6 resident rooms. All rooms contain a half bathroom. Water temperature is tested in the common hallway full bathroom measuring as 111F. Cleaning supplies are observed to be locked in the garage. Facility knives are observed to be locked in the medication room. Kitchen food supplies are observed to be in place with 2 day fresh food supply and canned goods fulfilling the 7 day emergency food supply. Majority of the canned goods are stored in the garage. The garage has two additional refrigerators with staff and resident food. Laundry area is observed in the garage as well and is fully operational. A tour of the outside of the facility is conducted. Emergency routes are free and clear of any obstructions. At the rear of the facility lot is a separate dwelling that is rented out privately. There is no connecting entrances from the facility to that dwelling. Smoke detectors and carbon monoxide detectors are located through out the facility as well as fire sprinklers. The facility is also equipped with 1 fire alarm pull in the front of the facility. LPA observed 2 fire extinguishers in the facility with inspection tags dated 04/07/2025. Facility conducts emergency drill quarterly. The last drill that was conducted is logged as March 17, 2025. Linens are in place for resident use also stored in the medication room. Continued on next page... Page 2 LPA observed all resident rooms and observed that they contain the required furniture and lighting as outlined in Title 22. Medications, first aid kit, and sharps are stored in locked medication closet near the front of the facility. Toilet and bathing facilities are equipped with grab bars and non-skid mats. Hygiene supplies are in place. Criminal record clearances or exemptions for facility staff or other individuals who have client contact have been reviewed as current. LPA reviewed 4 staff files and 4 resident files on this day which appear to be current based on review. Staff training records are observed to be current and in place. Administrator certificate for Judy Roias is observed as current expiring 05/11/2025 The following updated items are to be received by 04/30/2025: • Copy of updated administrator certificate • Copy of facility's liability insurance • LIC308 Designation of responsible staff person • LIC610E Emergency Disaster Plan • LIC500 Staff Schedule • Copy of control of property or copy of lease Report is reviewed with Michelle Roias. A copy of this report is provided to the facility. No citations issued on this day.the state’s words, verbatim · CDSS document, Apr 23, 2025

Type of visit: Required - 1 Year

LPA Audrey Jeung toured facility and grounds, consisting of 6 client bedrooms and 2 staff bedrooms--all with half bathrooms--full bath/shower room, living/dining area, kitchen, recreation room. There are two beds in each staff room. Washer and dryer are located in attached garage, which also accesses stairs to upper level storage rooms. An accessory dwelling unit (ADU) is being built in backyard. No accessible bodies of water or fire safety hazards observed. PPE supply is adequate. Medications, toxins and sharps are stored appropriately and inaccessible to clients, a comfortable temperature is maintained, and lighting is sufficient for comfort and safety. Toilet and bathing facilities are equipped with grab bars and nonskid flooring material. Liquid soap is available at all sinks. First-aid kit is inspected and complete. A Disaster and Mass Casualty Plan is posted. There are 6 residents present, and 2 staff. Criminal record clearances or exemptions for facility staff or other individuals who have client contact have been reviewed, as well as staff records. Judy Roias, Michelle Roias, and Mercy Moreira are certified RCFE administrators (x 5/25, 5/25, 12/24) that oversee facility operations. Client records are reviewed, including hospice care plans for 3 residents. The following updated forms/information are requested to be submitted to CCLD BY 5/13/24: • LIC 308 Designation of Administrative Responsibility • LIC 500 Personnel Report • LIC 610E Emergency Disaster Plan (page 9 signed and dated) • Building Permit for ADU - Revised sketch of facility grounds (including ADU) Deficiency of the RCFE California Code of Regulations, Title 22, Division 6, Chapter 8 is observed and cited on a following page.the state’s words, verbatim · CDSS document, Apr 29, 2024