Serene Valley Care Home

Type of visit: Required - 1 Year

On March 25, 2026, Licensing Program Analyst (LPA) Garlli Tat conducted an unannounced visit to the facility for the purpose of a required annual inspection. LPA explained the purpose for the visit and was greeted and granted entry by staff on duty. During the visit, facility administrators Prescilla Mariano and Oscar Samson were present and assisted with the inspection. For this visit, there are three staff members on duty, all of which are background cleared and associated. The PUB475 ‘See Something, Say Something’ poster was observed to be located in the hallway. LPA observed that Oscar Samson has a valid Administrator certificate which expires on January 13, 2027. The facility is a Residential Care facility for the Elderly (RCFE) licensed for six residents, six of which may be non-ambulatory, none of which may be bedridden, and a hospice waiver for six. LPA toured the interior and exterior portions of the facility with AD. For this visit, there are a total of three non-ambulatory residents in care, one ambulatory, four of which are on hospice, and one is bedridden. The facility is a single story home. There are a total of five bedrooms, two of which are private resident bedrooms, two are shared resident bedrooms, and one is a staff bedroom. LPA toured each bedroom with the AD and observed that bedrooms were provided with furniture in good repair, clean linens, adequate storage space, and free of any hazards. LPA observed the staff room is kept locked and inaccessible to residents in care. Smoke and carbon monoxide detectors as well as auditory exit alarms were tested and operational. There are a total of three bathrooms, two are for residents and one is for staff. Continued on LIC 809-C. Bathrooms were observed to be in good repair, toilets and faucets were operational and showers were equipped with grab bars and non-skid floor mats. Water temperature in the bathrooms were measured to be between 105.0 and 105.6 degrees Fahrenheit. Facility met the minimum two-day perishable and seven-day non-perishable food supplies. Sharp items and knives were locked in a kitchen drawer and inaccessible to residents in care. Fire extinguisher was charged, mounted and located in the kitchen. Fire extinguisher was dated and tagged on January 23, 2026. LPA observed all the required postings in the kitchen. LPA observed the facility conducted their last emergency disaster drill on March 20, 2026. Facility had back-up emergency food and water supply, located in the garage. LPA observed that the First Aid kit had all the required components. Medications were observed to be locked in a medication cabinet in the kitchen, inaccessible to residents in care. Chemicals were observed to be locked underneath the kitchen sink. LPA observed the door leading to the attached two car garage is kept locked and inaccessible to residents in care. The garage is used for storage. For the exterior portion, LPA observed patio furniture under shading, and the grounds were free of any hazards or obstructions. There are two self-latching gates in the backyard that can be opened in case of an emergency. No bodies of water were observed. During this visit, five resident files and three staff files were reviewed. All staff are background cleared and associated with the facility. LPA reviewed residents’ medication and medication records and three resident interviews, and one interview with family member were conducted. Based on today's observations, there are deficiencies being cited per Title 22 of the California Code of Regulations. An exit interview was conducted with Administrator. This report was reviewed with the administrator and a copy was provided at the end of the visit. Appeal Rights were reviewed.the state’s words, verbatim · CDSS document, Mar 25, 2026

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Brandon Lopez made an unannounced visit to conduct the required annual inspection. LPA was greeted and granted entry by care giving staff after explaining the purpose for the visit. Administrator (AD) James Scott was notified via telephone but could not arrive to assist with the inspection. LPA observed that Administrator James Scott has a valid Administrator certificate which expires on February 26, 2027. The facility is a Residential Care Facility for the Elderly (RCFE) licensed for six non-ambulatory residents with a hospice waiver for six. The facility is a single-story home with four resident bedrooms, two of which are shared, one staff bedroom, three shared resident bathrooms, a living room, a family room, a dining room, a kitchen, a laundry room, and an attached two car garage. LPA accompanied by a care giving staff conducted a tour of the interior portion of the facility. On today's visit, LPA observed six residents in care, four of which are on hospice, and two care giving staff present. LPA observed residents relaxing in the living room as well as their respective bedrooms. LPA observed the See Something, Say Something poster (PUB 475) mounted on a wall in the living room. LPA inspected the four resident bedrooms, and they were observed to be free of any hazards. LPA observed the resident bedrooms had the required furnishings of a bed, a chair, a chest of drawers, and a lamp. All resident beds had clean linens and blankets. LPA observed additional linens are stored in hallway closets. LPA inspected the three shared resident bathrooms. Resident bathrooms are clean. Bathrooms are equipped with grab bars and non-skid floor mats. Faucets and toilets were operational. Hot water temperature measured between 108.6 and 110.1 degrees Fahrenheit. LPA observed the staff room is kept locked and inaccessible to residents in care. LPA observed the kitchen has a two day perishable and seven day nonperishable food supply on hand. LPA observed kitchen appliances to be clean and operational. The five top electric stove was operational. LPA observed kitchen knives are stored in a locked kitchen cabinet. LPA observed toxins and chemicals to be stored in a locked kitchen cabinet under the sink. CONTINUED ON LIC809-C Fire extinguishers are located in the resident hallway, in the kitchen, and in the two car garage. Fire extinguishers were observed to be charged and up to date on service. LPA tested the wired smoke detectors which tested operational. LPA tested the carbon monoxide detectors which tested operational. LPA observed the facility conducted their last emergency disaster drill on January 18, 2025. The centrally stored medication is kept in a locked storage cabinet in the family room. A First Aid kit was observed be stored in the family room and it had all the required components. LPA observed an internet device for dedicated resident use in the family room. LPA observed chemicals and toxins to be stored in a locked cabinet in the laundry room. The door leading to the attached two car garage is kept locked and inaccessible to resident. The garage is used for storage. LPA observed the facility has a three day emergency food and water supply stored in the garage. LPA and a care giving staff conducted a tour of the exterior portion of the facility. LPA observed the exterior portion to be clear of obstructions and hazards. LPA observed a shaded outdoor seating area with furniture for resident use. The perimeter gates on the north side and southside of the facility are self-latching and can be opened in an evacuation. There are no bodies of water on the premises. LPA reviewed all six resident files. All the required documentation were present and current in the resident files reviewed. LPA reviewed six residents’ medication and medication records. LPA reviewed two staff files. All staff are background cleared and associated to the facility. Based on today's observations, there are no deficiencies being cited per Title 22 of the California Code of Regulations. An exit interview was conducted with an authorized facility representative and a copy of the report was provided.the state’s words, verbatim · CDSS document, Mar 4, 2025

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Celine De Perio conducted an unannounced visit for the Required 1 Year Inspection. LPA explained the purpose of today’s visit, and was greeted and granted entry by licensee (LE) Irene Wong-Samson. For today’s visit, LPA observed a total of 6 residents in care and 2 staff members on duty. LPA observed the Administrator's Certificate for facility administrator (AD) Oscar Samson which expires on 1/13/2025. LPA De Perio toured the interior and exterior portions of the facility with S1 Granada. The facility is a single level structure and is licensed for 6 residents. For this visit, there are a total of 6 residents in care. There are a total of 5 bedrooms, of which 2 is a private resident room, 2 are shared resident rooms, and 1 room designated for staff. LPA De Perio toured each bedroom in the facility and observed that bedrooms were provided with furniture in good repair, clean linens, adequate storage space, and kept free of tripping hazards. Smoke and carbon monoxide detector and auditory exit alarms were tested and operational. It was observed that there are a total of 3 restrooms in the facility. Restrooms were observed to be in good repair, toilets were operational, and grab bars and non-skid floor mats were provided. Water temperature in restrooms were measured to be at 108.2 degrees Fahrenheit. Facility met the minimum two-day perishable and seven-day non-perishable food supplies. Sharp items and knives were locked and inaccessible to residents in care. Fire extinguisher was charged, mounted and located in the hallway. LPA De Perio observed the emergency disaster and evacuation plan, which is posted in the hallway and in a binder. Facility had back-up emergency food and water supply, located in the garage and in the kitchen. LPA De Perio observed that First Aid Kit had all the required components. LPA De Perio observed that medications and toxins were locked and inaccessible to residents in care. For the exterior portion, LPA De Perio observed patio furniture under shading, and the grounds were free of any hazards. There are 2 gates in the backyard, which both were self-closing and self-latching. No bodies of water were observed. For today's visit no deficiencies were issued per Title 22 Division 6 of the California Code of Regulations. No citations were issued. An exit interview was conducted with LE Wong-Samson. A copy of this report was provided and explained.the state’s words, verbatim · CDSS document, Mar 23, 2024