Royal Palms Villa

Allegation investigated: Staff did not ensure the facility grounds are kept clean

On 11/04/2025, Licensing Program Analyst (LPA), Wendy Gibbs, conducted an unannounced Complaint Visit to the facility listed above. LPA met with Administrator Bienvenido 'Bien' Cadungog and Caregiver Ja Feliciano, and the purpose of today’s visit was explained. LPA was granted entry into the facility. The investigation consisted of the following: During today’s visit, LPA inspected the inside and outside the facility, interviewed Staff S1-S4, interviewed Residents R1-R4, and received and reviewed the Staff Roster, Resident Roster and guidelines and instructions for Large Item Pick Up. The investigation revealed the following: Unsubstantiated Allegation: Staff did not ensure the facility grounds are kept clean. The allegation alleges that the facility dumps trash around the house, and they pile the garbage five feet over the trash can. When LPA arrived at the facility, staff were observed cleaning the kitchen counters and mopping the floors. During the plant inspection, LPA observed the front yard was clean and maintained. LPA did not observe any unused appliances or furniture in the front. In the backyard, LPA observed the patio with a table and chairs, and all walkways were clean, clear, and free of obstructions, debris, and hazards. LPA observed behind the garage two (2) dressers, four (4) chairs, a washer, and refrigerator that are being stored there from a closed facility. During an interview with the Administrator (S1), stated they are moving the furniture and appliances out of the closed facility and plan on using them at the other facilities. The items stored behind the garage are not visible from the street and do not interfere with the residents’ accessibility to the backyard. LPA received and reviewed Large Item Pick Up, for the city, Guidelines and Instructions that states items cannot be placed on private property, the items should be placed where the recycling is picked up, and items can be placed out 12 hours before pickup is scheduled. During interviews with Staff S1-S4, were asked how often the outside is cleaned and picked up, four (4) out of four (4) stated a gardener comes every other week to cut the grass and staff pick up the yard if they see something while watering the plants. Additionally, Staff S1-S4 were asked if they had furniture or appliances in the front, four (4) out of four (4) stated they had a Large Item Pick Up a few weeks ago. During interviews with Residents R1-R4, were asked if the staff keep the front and back yard clean, four (4) out of four (4) stated yes, it is kept clean. During the course of the investigation, LPA was unable to find evidence to support the allegation. Although the allegation may have happened or is valid, there is no preponderance of evidence to prove the alleged violation(s) did or did not occur, therefore the allegation is unsubstantiated. LPA did not observe or cite any deficiencies. An exit interview was conducted with conducted with Caregiver, Ja Feliciano, and a copy of this report was provided.the state’s words, verbatim · CDSS document, Nov 4, 2025 · control 11-AS-20251028083739

Type of visit: Required - 1 Year

On 10/07/25, Licensing Program Analyst (LPA), Wendy Gibbs, conducted an unannounced Annual Visit using the CARE tool. LPA met with Administrator, Bienvenido ‘Bien’ Cadungog, and the purpose of today's visit was explained. LPA was granted entry into the facility. The facility is licensed to serve five (5) non-ambulatory residents aged 60 and over. The facility is approved for one (1) bedridden resident and has an approved hospice waiver for two (2) residents. Currently there are four (4) residents residing at the facility. Structure/Physical Plant The facility is a single-story structure in a residential neighborhood. It consists of five (5) resident bedrooms, 2 bathrooms, living room, dining room, sitting room, kitchen, laundry room, two (2) staff rooms, detached garage, a front yard, and a shaded patio area in the backyard with table and chairs. LPA did not observe any bodies of water on the premises. All outside walkways were observed to be clean, clear, and free of hazards, debris, and obstructions. All railings for ramps and stairs were secured and in good repair. All gates are accessible and open easily from the inside of the yards for an easy exit. Bedrooms LPA inspected all bedrooms and found them to be clean and in good repair. All bedrooms contained the required furniture, including a bed, dresser, nightstand with lamp, chair, storage space for resident’s personal belongings, and ample lighting. All beds had the required linens including a mattress pad, fitted sheets, blanket, comforter, and pillow. LPA observed an additional supply of linens stored in the residents’ closets. Bathrooms LPA inspected both bathrooms and found to be within Tittle 22 regulations. LPA observed the bathroom to be clean and operational. Both bathrooms have secured safety handrails, non-skid mats, and shower chairs available. LPA observed an ample supply of towels and resident toiletries secured in a cabinet in the bathrooms. The water temperature measured 108.5- degrees and 109.2 -degrees Fahrenheit. Kitchen LPA inspected the kitchen and found it to be clean and sanitary. LPA observed an ample supply of dishware, cookware, and cutlery in good repair. All appliances were tested and observed operational and in good working repair. LPA observed a 3-day supply of perishable foods and a 7-day supply of non-perishable foods properly stored, packaged, and labeled. LPA observed all sharps and knives secured in a locked drawer in the kitchen and are inaccessible to residents. All cleaning supplies were observed secured in the locked cabinet under the kitchen sink and are inaccessible to residents. The water temperature measured 110.2-degrees Fahrenheit. Common Rooms LPA inspected all common rooms and found them to be clean and in good repair. The facility was observed to be appropriately furnished during the time of visit. The living room and family room have two couches to accommodate all residents. LPA observed magazines and activities available for residents. The dining room has a large table and chairs and space to accommodate all residents. All walkways and hallways inside the facility were observed clean, clear, and free of obstructions and hazards. All rooms and hallways have ample lighting. The facility was maintained at a comfortable temperature. Safety LPA observed two fully charged fire extinguishers mounted in the facility that were last serviced on 07/25/25. The last Fire Prevention Inspection was on 05/25/24. Smoke detectors and Carbon Monoxide detectors are in compliance and operational. The last Emergency Drill was conducted on 07/10/25. All exits are clearly indicated with an EXIT sign. LPA observed the Emergency Disaster Plan, posted in the kitchen, last updated 03/01/2025. LPA inspected the First Aid kit and found it contained the required items and a manual. LPA observed all required postings, posted throughout the facility. The facility has a working landline telephone. There are no firearms or ammunition stored on the premises. Files LPA reviewed three (3) staff files and the administrators and found they contained the required documents, certification, clearance, and training. LPA observed the administrator’s Administrator Certificate, number 7006800740, is valid till 03/11/2027. LPA reviewed four (4) resident files and observed they had the required documents. LPA reviewed Liability Insurance through Kinsale that is valid till 07/12/2026. During facility file review, LPA observed licensing fees are current. Medications LPA observed centrally stored medications secured in a locked cabinet in the kitchen and are inaccessible to residents. All medications were observed in their original packaging. LPA reviewed medications and medication administration record (MAR) for four (4) residents and found them to be consistent with properly documented records. Infection Control LPA observed the facility’s visitor sign-in procedures and temperature log. LPA observed sanitizing stations throughout the facility. The LPA observed all required infection control signs posted throughout the facility. LPA observed a 90-day supply of PPEs stored in the garage. According to the California Code of Regulations (Title 22, Division 6, Chapter 8), LPA did not observe or cite any deficiencies during today's visit. LPA conducted an exit interview with Administrator, Bienvenido ‘Bien’ Cadungog, and a copy of this report was provided.the state’s words, verbatim · CDSS document, Oct 7, 2025

Type of visit: Required - 1 Year

On 10/30/24, the department conducted an unannounced annual visit using the full CAREs tool. The department met with Administrator, Bien Cadungog, and the purpose of today's visit was explained. The facility is licensed to serve five (5) non-ambulatory residents aged 60 and over. The facility is approved for one (1) bedridden resident and has an approved hospice waiver for two (2) residents. Currently there are four (4) residents residing at the facility. Structure/Physical Plant The facility is a single-story home in a residential neighborhood. It consists of 6 bedrooms, 2 bathrooms, living room, dining room, sitting room, kitchen, laundry room, staff room, detached garage, a front yard, and a shaded patio area in the backyard with table and chairs. The department did not observe any bodies of water on the premises. All outside walkways were observed to be clean, clear, and free of hazards, debris, and obstructions. All railings for ramps and stairs were secured and in good repair. All gates are accessible and open easily from the inside of the yards for an easy exit. Bedrooms The department inspected all bedrooms and found them to be clean and in good repair. All bedrooms contained the required furniture, including a bed, dresser, nightstand with lamp, chair, storage space for resident’s personal belongings, and ample lighting. All beds had the required linens including a mattress pad, fitted sheets, blanket, comforter, and pillow. The department observed an additional supply of linens stored in the residents’ closets. Bathrooms The department inspected both bathrooms and found them to be within Tittle 22 regulations. The department observed the bathrooms to be clean and operational. Both bathrooms have secured safety handrails, non-skid mats, and shower chairs available. The department observed an ample supply of towels and resident toiletries secured in a cabinet in the bathrooms. The water temperature measured 108.2-degrees and 107.6-degrees Fahrenheit. Kitchen The department inspected the kitchen and found it to be clean and sanitary. The department observed an ample supply of cutleries, dishware, and cookware in good repair. All appliances were tested and observed in good working repair. The department observed a 3-day supply of perishable foods and a 7-day supply of non-perishable foods properly stored and labeled. The department observed all sharps secured in a locked drawer in the kitchen and are inaccessible to residents. All cleaning supplies were observed secured in the locked cabinet under the kitchen sink and are inaccessible to residents. The water temperature measured 110.3-degrees Fahrenheit. Common Rooms The department inspected all common rooms and found them to be clean and in good repair. The facility was observed to be appropriately furnished during the time of visit. The living room and sitting room have two couches to accommodate all residents. The department observed magazines and activities available for residents. The dining room has a large table and chairs and space to accommodate all residents. All walkways and hallways inside the facility were observed clean, clear, and free of obstructions and hazards. All rooms and hallways have ample lighting. Safety The department observed two fully charged fire extinguisher mounted in the facility that were last serviced on 07/25/24. The last Fire Prevention Inspection was on 05/24/24. Smoke detectors and Carbon Monoxide detectors are in compliance and operational. The last Emergency Drill was conducted on 10/01/24. All exits are clearly marked with an EXIT sign. The department inspected the First Aid kit and found it contained the required items and a manual. The department observed all required postings, posted throughout the facility. The facility has a working landline telephone. There are no firearms or ammunition stored on the premises. Files The department reviewed three (3) staff files and found they contained the required documents, certification, and training. The department observed the Administrator’s Certificate is valid till 03/11/2025. The department reviewed four (4) resident files and observed they had the required documents. During facility file review, the department observed licensing fees are current. Medications The department observed centrally stored medications secured in a locked cabinet in the kitchen and are inaccessible to residents. All medications were observed in their original packaging. The department reviewed medications and medication administration record (MAR) for four (4) residents and found them to be consistent with properly documented records. Infection Control The department observed the facility’s visitor sign-in procedures and temperature log. The department observed sanitizing stations throughout the facility. The department observed all required infection control sign posted throughout the facility. The department observed a 90-day supply of PPEs stored in the garage. According to the California Code of Regulations (Title 22, Division 6, Chapter 8), the department did not observe or cite any deficiencies during today's visit. The department conducted an exit interview with Caregiver, Ja Feliciano, and a copy of this report was provided.the state’s words, verbatim · CDSS document, Oct 30, 2024

Type of visit: Required - 1 Year

On 10/19/23, Licensing Program Analyst (LPA), Wendy Gibbs, conducted an unannounced annual visit using the full CAREs tool. LPA met with Administrator, Marivi Pitts, and the purpose of today's visit was explained. Currently there are three residents residing at the facility, and one is currently receiving Hospice Care. Structure/Physical Plant The facility is a single-story home in a residential neighborhood. It consists of 6 bedrooms, 2 bathrooms, living room, dining room, den, kitchen, laundry room, detached garage, a front yard, and a shaded patio area in the backyard with table and chairs. LPA did not observe any bodies of water on the premises. All outside walkways were observed to be clean, clear, and free of hazards, debris, and obstructions. All railings for ramps and stairs were secured. All gates are accessible and open easily from the inside of the yards for an easy exit. Bedrooms LPA inspected all bedrooms and found them to be clean and in good repair. All bedrooms contained the required furniture, including a bed, dresser, nightstand with lamp, chair, storage space for resident personal belongings, and ample lighting. All beds had the required linens including a mattress pad, fitted sheets, blanket, comforter, and pillow. LPA observed an additional supply of linens stored in the residents’ closets. Bathrooms LPA inspected both bathrooms and found to be within Tittle 22 regulations. LPA observed the bathroom to be clean and operational. Both bathrooms have secured safety handrails, non-skid mats, and shower chair available. LPA observed an ample supply of towels and resident toiletries secured in a cabinet in the bathrooms. The water temperature measured 108.5-degrees Fahrenheit. Kitchen LPA inspected the kitchen and found it to be clean and sanitary. LPA observed an ample supply of cutleries, pots and pans in good repair. All appliances were tested and observed in good working order. LPA observed a 3-day supply of perishable foods and a 7-day supply of non-perishable foods. LPA observed all sharps secured in a locked drawer in the kitchen. All cleaning supplies were observed secured in the locked cupboard under the kitchen sink. The water temperature measured 106.2-degrees Fahrenheit. Continued on LIC-809-C Common Rooms LPA inspected all common rooms and found them to be clean and in good repair. The living room and family room have two couches to accommodate all residents. LPA observed magazines and activities available for residents. The dining room has a large table and chairs and space to accommodate all residents. All walkways and hallways inside the facility were observed clean, clear, and free of obstructions and hazards. All rooms and hallways have ample lighting. Safety LPA observed two fully charged fire extinguisher mounted in the facility that were last serviced on 07/21/23. The last Fire Prevention Inspection was on 09/15/23. Smoke detectors and Carbon Monoxide detectors are in compliance and operational. The last Emergency Drill was conducted on 09/26/23. All exits are clearly marked. LPA inspected the First Aid kit and found it contained the required items and a manual. LPA observed all required postings, posted throughout the facility. The facility has a working landline telephone. There are no firearms or ammunition stored on the premises. Medications LPA observed centrally stored medications secured in a locked cabinet in the kitchen and are inaccessible to residents. LPA reviewed medications for two residents and compared them to the medication distribution chart and found them to be consistent. Infection Control LPA observed the facilities visitor sign-in procedures and temperature log. LPA observed sanitizing stations throughout the facility. LPA observed all required infection control sign posted throughout the facility. LPA observed a 90-day supply of PPEs stored in the garage. LPA observed visitors wearing masks in the facility. Files/Interviews LPA reviewed 2 resident files and found they contained the required documents. LPA interviewed 1 resident who was happy with their care received at the facility and 2 residents were unavailable for interviews during the time of visit. LPA reviewed 4 staff files and found they contained the required documents, certification, and training. LPA conducted interviews with 3 staff, and all staff were able to answer questions regarding resident care, resident rights, policy and procedure. According to the California Code of Regulations (Title 22, Division 6, Chapter 8), LPA did not observe or cite any deficiencies during today's visit. LPA conducted an exit interview with Administrator, Marivi Pitts, and a copy of this report was provided.the state’s words, verbatim · CDSS document, Oct 19, 2023