Shiloh Green Manor

Type of visit: Required - 1 Year

At approximately 12:15 PM, Licensing Program Analyst (LPA) Robert Frank arrived unannounced to conduct a Required 1 Year visit and was greeted by Licensee/Administrator Manual Ortega. Shiloh Green Manor is Licensed as a Residential Care Facility for the Elderly (RCFE). The facility is a single story ranch house. The facility has an approved fire clearance for six (6) non-ambulatory residents, four (4) of whom may be bedridden. The facility has a Hospice Waiver for three (3) residents. Upon arrival, LPA was informed that there were six (6) residents in care. At approximately 12:25 PM, LPA reviewed the Facility's Staff Roster and found that all staff on-site were background cleared and associated to the facility per regulation. At approximately 12:30 PM, LPA toured the facility with Licensee/Administrator Ortega. All exits were clear and unobstructed. The facility's one (1) fire extinguisher was last serviced and tagged on 12/19/2025. The fire alarm system was inspected in 1/2026. The facility was sufficiently lighted. LPA inspected four (4) resident bedrooms and found all to have sufficient lighting and furnishings as required per Title 22 Regulations. There was a sufficient supply of both perishable and nonperishable foods as required by Title 22 Regulations. There was an appropriate supply of cleaning products, linens, hygiene products and paper products available for residents. Toxins were observed to be stored inaccessible to residents. The facility has an infection control plan as required. The facility has a required emergency disaster plan. The facility is conducting fire and emergency drills quarterly. The last disaster drill was conducted on 7/1/2026. The facility does have emergency food and supplies to meet the "72 hour shelter in place" requirements. Hot water temperatures for all sinks in facility were found to be within Title 22 regulations of 105 to 120 degrees Fahrenheit. Facility smoke detectors and carbon monoxide detectors were observed to be operational. Continued on 809-C... ...Continued from 809 At approximately 1:05 PM, LPA reviewed five (5) resident files. Five (5) of five (5) resident files were observed to be well organized and thorough with all required documentation. LPA reviewed four (4) staff files. Four (4) of four (4) staff files were observed to be well organized with all required documentation including First Aid and CPR certification and proper training documentation. LPA audited Medication for three (3) residents. LPA observed all medications to be centrally stored, secure and with proper documentation. The facility does not handle resident’s monies for personal and incidental items. Ligaya Ortega’s Administrator Certification 7004360740 is current with an expiration date of 4/7/2028. Manual Ortega's Administrator Certification 7000579740 is current with an expiration date of 6/9/2027. LPA requested the following documents be submitted to Community Care Licensing by 8/10/2026: LIC 500 Personnel Report LIC 610E Emergency Disaster Plan Updated Liability Insurance Updated Property Lease The facility is in compliance. No deficiencies cited during today's visit. Exit interview conducted. Copy of report and discussed and provided to Licensee/Administrator Ortega. Signature on form confirms receipt of documents.the state’s words, verbatim · CDSS document, Jul 20, 2026

Type of visit: Required - 1 Year

At approximately 11:50 AM, Licensing Program Analyst (LPA) Robert Frank arrived unannounced to conduct a Required 1 Year visit and was greeted by Licensee/Administrator Manual Ortega. Shiloh Green Manor is Licensed as a Residential Care Facility for the Elderly (RCFE). The facility is a single story ranch house. The facility has an approved fire clearance for six (6) non-ambulatory residents, four (4) of whom may be bedridden. The facility has a Hospice Waiver for three (3) residents. Upon arrival, LPA was informed that there were five (5) residents in care and three (3) staff members on-site. At approximately 12:05 PM, LPA reviewed the Facility's Staff Roster and found that all staff on-site were background cleared and associated to the facility per regulation. At approximately 12:10 PM, LPA toured the facility with Licensee/Administrator Ortega. All exits were clear and unobstructed. The facility's one (1) fire extinguisher was last serviced and tagged on 12/20/2024. Fire Department inspected and cleared the fire alarm system in 1/2025. The facility was sufficiently lighted. LPA inspected three (3) resident bedrooms and found all to have sufficient lighting and furnishings as required per Title 22 Regulations. There was a sufficient supply of both perishable and nonperishable foods as required by Title 22 Regulations. There was an appropriate supply of cleaning products, linens, hygiene products and paper products available for residents. Toxins were observed to be stored inaccessible to residents. Facility has an infection control plan as required. The facility has a required emergency disaster plan. The facility is conducting fire and emergency drills quarterly. The last disaster drill was conducted on 7/11/2025. The facility does have emergency food and supplies to meet the "72 hour shelter in place" requirements. Continued on 809-C... ...Continued from 809 Hot water temperatures for all sinks in facility were found to be within Title 22 regulations of 105 to 120 degrees Fahrenheit. Facility smoke detectors and carbon monoxide detectors were tested and observed to be operational. At approximately 12:45 PM, LPA reviewed three (3) resident files. Three (3) of three (3) resident files were observed to be well organized and thorough with all required documentation. LPA reviewed three (3) staff files. All staff files were observed to be well organized with all required documentation including First Aid and CPR certification and proper training documentation. LPA spot checked Medication for three (3) residents. LPA observed all medications to be centrally stored, secure and with proper documentation. The facility does not handle resident’s monies for personal and incidental items. Ligaya Ortega’s Administrator Certification 70043600740 is current with an expiration date of 4/7/2026. LPA requested the following documents be submitted to Community Care Licensing by 9/18/2025: LIC 500 Personnel Report LIC 610E Emergency Disaster Plan Updated Liability Insurance The facility is in compliance. No deficiencies cited during today's visit. Exit interview conducted. Copy of report and discussed and provided to Licensee/Administrator Ortega. Signature on form confirms receipt of documents.the state’s words, verbatim · CDSS document, Aug 18, 2025

Type of visit: Required - 1 Year

Licensing Program Analysts (LPAs), Loera and Alviso, arrived unannounced to conduct a Required-1 Year Inspection, on 8/21/24 at approximately 9:10am. LPAs met with Administrator John Ortega. Facility has a required infection control plan. Facility has a required emergency disaster plan. Facility has an approved dementia plan. The facility has a hospice waiver for three (3) residents. Facility has a fire clearance approved for six (6) non-ambulatory, of which one (1) may be bedridden, in rooms #1,#2, and #5. LPAs toured the facility and made the following observations: Facility was a comfortable temperature and passageways were free from obstructions. Facility outdoor area has several patio furnishings including umbrellas with shade, pathways were cleared. Exit door from kitchen leads onto a ramp to the backyard fire exit gate. The facilities front door leads to a ramp that is a fire exit. Facility has one (1) resident on hospice, which is allowable per their approved hospice waiver. Resident rooms and hallways had sufficient lighting. Facility has smoke alarms and two (2) carbon monoxide detectors. All exits had working auditory alarms. Water temperature in bathroom used by residents measured at 111.5 degrees, which is within regulation (105 to 120 degrees). Resident bathrooms had grab bars and non-slip mats/floors in showers. Extra hygiene products and linens were available. Cabinets containing cleaning supplies were locked and inaccessible to residents in care. Laundry room containing cleaning supplies, soaps, and disinfection's were locked and inaccessible to residents in care. Medications were centrally stored and locked and inaccessible to residents in care. Facility has at least two days of perishable and one week of non-perishable foods which appeared to be of quality and stored per regulation. Emergency food and water supplies are stored in the garage along with Personal Protective Equipment. Last fire/evacuation drill was conducted 07/04/24, per file review. LPAs reviewed five (5) resident files. Continued on LIC809C... LPAs reviewed four (4) staff files. All staff had required training, criminal record clearance, First-Aid, and CPR certification. Updated copies of the following documents were requested for facility file and are to be submitted to CCL within 30 days of this visit: LIC500- Personnel Report LIC308- Designation of Responsibility LIC309- Administrative Organization Liability Insurance Current Lease No Deficiencies Cited Exit interview conducted with Administrator and a copy of this report was provided.the state’s words, verbatim · CDSS document, Aug 21, 2024