Sandy's Residential Care Home

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Maria (Mita) Partoza a conducted an unannounced required 1 year inspection visit and met with licensee/administrator (LIC/ADM) Azucena (Sandy) Zipagan and stated the purpose of the visit. The facility is licensed to serve adults 60 years and over, all may be non-ambulatory, 1 bedridden and waiver for 2 hospice care. 2 Out of 2 residents were out attending day program. At 8:30 a.m. LPA toured the facility inside and outside with ADM including but not limited to the kitchen, bathroom, dining room, living room, 5 residents rooms, garage, backyard and exterior walkways. The temperature inside the home was at 70 degrees Fahrenheit. The kitchen was observed to be sanitary and organized, knives and sharps were locked and not accessible to residents. LPA observed 2 days of perishable food and 7 days of non-perishable food. Under the sink cabinet is used to store cleaning supplies and kept locked and not accessible to residents. The kitchen water temperature measured between 115 to 119 degrees Fahrenheit. The facility is maintained, sanitary and organized. The bathroom/s are equipped with grab bars, non-skid mats. The water temperature in the bathroom measured between 117 to 118 degree Fahrenheit. Resident's room have sufficient storage. LPA observed that medications are kept locked and inaccessible to residents. The first aid kit is complete and is accessible to staff. The walkways and ramps are free from debris and obstruction. The facility screen windows were observed to be in good repair. The facility has an additional dwelling unit (ADU) that has a separate entrance and address and not connected to the main building. ADM/LIC stated that the ADU is used by staff. The washer and dryer located in the garage and are in good working condition. Laundry soap and cleaning supplies are locked and not accessible to residents in care. The facility is equipped with a fire, smoke and carbon monoxide alert system that is in good working condition, night lights on the hallway are in good working condition. The hallway are free from obstruction. The last fire and drill training was last done in 09/18/2025, 09/19/2025. Fire extinguisher was last inspected on 6/5/2025. LPA reviewed 2 resident records such as but not limited to the centrally stored medication and destruction record (CSMDR), admission agreement, needs and services plan, health screening and observed records to be complete and updated. LPA reviewed 2 staff records including but not limited to required training, first aid/CPR training, health screening and background clearance. All staff have criminal record clearance/fingerprints. No deficiencies were cited during today's visit. An exit interview was conducted with administrator Azucena Sandy Zipagan. A copy of report was provided.the state’s words, verbatim · CDSS document, Sep 29, 2025

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Maria (Mita) Partoza a conducted an unannounced required 1 year inspection visit and met with licensee/administrator (LIC/ADM) Azucena (Sandy) Zipagan and stated the purpose of the visit. The facility is licensed to serve adults 60 years and over, all may be non-ambulatory, 1 bedridden and waiver for 2 hospice care. 2 Out of 2 residents were out attending day program. At 1:15 p.m. LPA toured the facility inside and outside with ADM including but not limited to the kitchen, bathroom, dining room, living room, 5 residents rooms, garage, backyard and exterior walkways. The temperature inside the home was at 70 degrees Fahrenheit. The kitchen was observed to be sanitary and organized, knives and sharps were locked and not accessible to residents. LPA observed 2 days of perishable food and 7 days of non-perishable food. Under the sink cabinet is used to store cleaning supplies and kept locked and not accessible to residents. The kitchen water temperature measured between 105 to 120 degrees Fahrenheit. The facility is maintained, sanitary and organized. The bathroom/s are equipped with grab bars, non-skid mats. The water temperature in the bathroom measured between 110 to 120 degree Fahrenheit. Resident's room have sufficient storage. LPA observed that medications are kept locked and inaccessible to residents. The first aid kit is complete and is accessible to staff. page 1 of 2 see LIC 809C The walkways and ramps are free from debris and obstruction. The facility screen windows were observed to be in good repair. The facility has an additional dwelling unit (ADU) that has a separate entrance and address and not connected to the main building. ADM stated that the ADU will be used by staff. The washer and dryer located in the garage and are in good working condition. Laundry soap and cleaning supplies are locked and not accessible to residents in care. The facility is equipped with a fire, smoke and carbon monoxide alert system that is in good working condition, night lights on the hallway are in good working condition. The hallway are free from obstruction. The last fire and drill training was last done in 5/5/2024. Fire extinguisher was last inspected on 6/5/2024. LPA reviewed 2 resident records such as but not limited to the centrally stored medication and destruction record (CSMDR), admission agreement, needs and services plan, health screening and observed records to be complete and updated. LPA reviewed 2 staff records including but not limited to required training, first aid/CPR training, health screening and background clearance. All staff have criminal record clearance/fingerprints. No deficiencies were cited during today's visit. An exit interview was conducted with administrator Azucena Sandy Zipagan. A copy of report was provided. page 2 of 2 end of reportthe state’s words, verbatim · CDSS document, Oct 28, 2024

Allegation investigated: Staff are using locks as restraints for the residents while in care

Licensing Program Analyst (LPA) Christine Dolores arrived unannounced to deliver the finding of this complaint investigation. LPA met with Licensee, Azucena “Sandy” Zipagan. On 03/29/2023, the Department received a complaint alleging staff are using locks as restraints for the residents. It was alleged that the resident’s bedroom doors had the ability to be key locked from the outside of the room and the residents does not have capability to unlock the door from the inside. It was also alleged that staff lock the residents’ doors at night to let staff sleep. On 04/05/2023, the initial complaint investigation was conducted. During the initial investigation, LPA Dolores observed all the resident bedroom doorknobs. Based on observation, all the resident bedrooms contained a “panic proof” doorknob with the ability to be locked from the inside. The door can be easily unlocked by turning the doorknob from the inside of the bedroom. The outer part of the doorknob facing the common area requires a key. Facility staff have a key to each bedroom. SEE LIC9099-C. Unsubstantiated Based on interview with the Licensee, the panic proof doorknobs were implemented about two weeks ago from 04/05/2023. A different set of doorknobs were installed after the HCBS final rule was implemented, which was observed by another State agency. The set of doorknobs observed by another State agency were not a “panic lock” and required the residents to unlock the door by turning the button from the inside. The staff had a key to each bedroom. Licensee states there are / were no residents being locked in their bedrooms during the night. The facility does not have a resident who has wandering behaviors. Based on interview with the staff (S2), the facility does not have a resident with wandering behavior during any time of the day. S2 states none of the residents are being locked in their bedrooms but the residents can lock their doors for privacy if they want. S2 states the staff has a key to each bedroom in case of an emergency. The facility has live-in staff on premises and the residents know where the staff resides in case they need anything during the night. Residents are also being checked on during the nighttime. Based on resident interviews, R2 states to have never been locked out of his/her room or locked in his/her room. R1 was able to communicate with LPA but was unable to answer the questions asked. Two residents (R1 – R2) successfully demonstrated how to unlock their bedroom door. The review of resident records shows that R1 – R3 does not have wandering behavior and are able to follow instructions. Correspondence shows the facility was in contact with another State agency regarding guidance on the implementation of locked doorknobs in the resident’s bedrooms. The facility was asked to place the lock doorknobs back to be in HCBS compliance. The Department has investigated the above allegation. Based on interview, record review and observation the above allegation is unsubstantiated. An unsubstantiated finding indicates that although the allegation may have happened and/or is valid there is not a preponderance of evidence to prove the alleged violation did or did not occur. No deficiencies were cited per California Code of Regulations, Title 22. This report was reviewed with Licensee, Azucena “Sandy” Zipagan and a copy of the report was provided.the state’s words, verbatim · CDSS document, Oct 12, 2023 · control 26-AS-20230329161259