Saint Helena Home Care

Type of visit: Required - 1 Year

At approximately 3:15 PM, Licensing Program Analyst (LPA) Julie Florio arrived unannounced to conduct a required 1-year annual inspection and met with Maria Juana Gutierrez, Licensee. Facility is a Residential Care Facility for the Elderly (RCFE) with six (6) residents in care, all of whom were present during today's inspection. Facility has a Dementia Care Plan, a Hospice waiver for three (3), and is approved for all non-ambulatory residents. At approximately 3:45 PM, LPA initiated a tour of the facility with Licensee and observed the following: Facility is a one story home, was a comfortable temperature, and passageways were free from obstructions. LPA observed egress devices activated on all facility doors. Water temperatures in residents' bathrooms measured within the allowable range of 105 to 120 degrees F per Title 22 regulations. LPA observed a supply of clean linens, and hygiene, incontinent care, and paper products available for residents. Residents' bedrooms were inspected and observed to have all the appropriate furnishings as outlined in Title 22 regulations. Cabinets containing cleaning supplies and other items that could pose a risk were locked. Facility has at least two days of perishable food and one week of non-perishable foods, as well as an emergency water supply. Medications were centrally stored and locked. There is a shaded seating area in the backyard with outdoor space for activities. LPA observed residents resting or visiting with loved ones in their rooms or watching TV in the common area. Facility has a supply of games, puzzles, books, magazines, crafts, and instruments for residents in care. Facility has internet service and an internet access device designated for resident use. The telephone was tested and was operational during inspection. Smoke and carbon monoxide detectors were tested and operational during inspection. Fire extinguishers were observed fully charged and were last inspected 03/2026. Continued on LIC809-C... Continued from LIC809C... Emergency Disaster Plan was reviewed and updated 09/2025. Facility conducts quarterly disaster drills with the most recent drill conducted 07/2026. Facility has two generators for emergency preparedness. Facility is quipped with an emergency lighting system and multiple first aid kits. Licensee states they assist residents' families with coordinating medical and dental appointments as well as transportation to and from appointments when residents have the need. Facility does not maintain or manage P&I cash resources for residents. LPA will return at a later date to conduct review of staff, resident, and medication records. Updated copies of the following documents are to be submitted to CCL within 30 days of this visit: LIC610E - Emergency Disaster Plan (updated) Proof of Current Liability Insurance Copy of Administrator Certificate (updated upon receipt) No deficiencies cited during today's inspection. Exit interview conducted with Licensee whose signature on form confirms receipt of documents.the state’s words, verbatim · CDSS document, Aug 25, 2026

Type of visit: Required - 1 Year

At approximately 11:00 AM, Licensing Program Analyst (LPA) Julie Florio arrived unannounced to conduct a required 1-year annual inspection and was greeted by Maria Juana Gutierrez, Licensee. Facility is a Residential Care Facility for the Elderly (RCFE) with six (6) residents in care, all of whom were present during today's inspection. Facility has a Dementia Care Plan, a Hospice waiver for three (3), and is approved for all non-ambulatory residents. At approximately 11:45 AM, LPA initiated a tour of the facility with Licensee and observed the following: Facility is a one story home, was a comfortable temperature, and passageways were free from obstructions. LPA observed egress devices activated on all facility doors. Water temperatures in residents' bathrooms measured within the allowable range of 105 to 120 degrees F per Title 22 regulations. LPA observed a supply of clean linens, and hygiene, incontinent care, and paper products available for residents. Residents' bedrooms were inspected and observed to have all the appropriate furnishings as outlined in Title 22 regulations. Cabinets containing cleaning supplies and other items that could pose a risk were locked. Facility has at least two days of perishable food and one week of non-perishable foods, as well as an emergency water supply. Medications were centrally stored and locked. There is a shaded seating area in the backyard with outdoor space for activities. LPA observed residents resting or visiting with loved ones in their rooms or watching TV in the common area. Facility has a supply of games, puzzles, books, magazines, crafts, and instruments for residents in care. Facility has internet service and an internet access device designated for resident use. The telephone was tested and was operational during inspection. Continued on LIC809-C... Continued from LIC809C... Smoke and carbon monoxide detectors were tested and operational during inspection. Fire extinguishers were observed fully charged and were last inspected 03/2025. Emergency Disaster Plan was reviewed and updated 02/2022. Facility conducts quarterly disaster drills with the most recent drill conducted 07/2025. Facility has two generators for emergency preparedness. Facility is quipped with an emergency lighting system and multiple first aid kits. At approximately 12:45, LPA conducted file review of three (3) staff and three (3) resident files. Three (3) of three (3) staff files reviewed contained all the required documents, proof of training and proof of current First Aid and CPR certification. Three (3) of three (3) resident files reviewed contained all the required documentation. Licensee states they assist residents' families with coordinating medical and dental appointments as well as transportation to and from appointments when residents have the need. Medications and medication records were inspected and the logs were observed maintained in compliance with regulation. Facility does not maintain or manage P&I cash resources for residents. Updated copies of the following documents are to be submitted to CCL within 30 days of this visit: LIC610E - Emergency Disaster Plan (updated) Proof of Current Liability Insurance No deficiencies cited during today's inspection. Exit interview conducted with Licensee whose signature on form confirms receipt of documents.the state’s words, verbatim · CDSS document, Aug 21, 2025

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) J. Macias arrived unannounced to conduct a required Annual inspection and was greeted by Administrator Maria J. Gutierrez. Facility contact information was reviewed. At approximately 09:30am LPA and Administrator toured the building and grounds. The facility was found to be clean and at a comfortable temperature. LPA observed at least a 2 day supply of perishable and 7 day supply of non-perishable food. Food was found to be stored in a safe manner with open items covered and dated. Kitchen drawer with sharp knife was locked. Cleaning supplies were locked and inaccessible to residents in care. All bedrooms were equipped with lighting, night stand, and chest of drawers per regulation. All bedrooms were clean and in good repair. Extra hygiene products and linens were available. Water temperature in sink accessible to residents in care measured at 110.3 and 110.1 degrees F, which is within the allowable range of 105 to 120 degrees F per regulation. Fire extinguishers were last inspected February 22, 2024. Smoke/Carbon Monoxide detectors located throughout the facility were tested and operational. Facility’s last quarterly disaster drill was conducted April 27, 2024. Administrator to conduct next quarterly drill before July 27, 2024. At approximately 10:30am LPA conducted a review of five (5) resident records. All required documentation present. At approximately 11:30am LPA conducted review of four (4) staff records. All required documentation present. At approximately 12:00pm LPA and Administrator conducted a spot check of medication and medication records. Medication is centrally stored in a locked closet. No deficiencies. Continued on 809C... Continued from 809... Administrator Certificate for Administrator, Maria Juana Gutierrez 6021257740 expires 10/6/2024. Updated copies of the following documents were requested for facility file and are to be submitted to CCL within 30 days of this visit: 8/24/2024 LIC500- Personnel Report LIC308- Designation of Responsibility Liability Insurance LIC 610 Emergency Disaster Plan (If changes) Infection Control Plan (If changes) Exit interview conducted with Administrator and a copy of this report was given.the state’s words, verbatim · CDSS document, Jul 24, 2024