Silver Pines Care Home I

Type of visit: Required - 1 Year

On 10/21/2025, Licensing Program Analyst, Arvin Villanueva (LPA) arrived to the facility unannounced to conduct an annual inspection. LPA initially met with facility staff, Ingrid Meyers, and stated the purpose of today’s visit. Licensee/Administrator, Debbie Loesch, arrived at the facility shortly after. Physical Inspection: Areas inspected include, but not limited to, bedrooms, bathrooms, kitchen/dinning room, garage, and outdoor area. LPA observed the temperature inside the facility was measured at 73 degrees Fahrenheit. The hot water was measured at 113.6 degrees Fahrenheit. Facility maintains at minimum 7-day nonperishable and 2-day perishable food supplies. LPA observed the centrally stored medications area to be locked and inaccessible to residents. Sharp objects, cleaning supplies, and other dangerous items were in locked storage and inaccessible to residents in care. LPA observed fire extinguishers, smoke and carbon monoxide detectors, central heating, and air in the facility. A first aid kit and an emergency supply of food/water was observed. Record Review: Review of 3 resident files include but not limited to Admission Agreement, Medical Assessments, Needs and Services Plan, and Medication Records. LPA reviewed medications for 1 resident. Review of 3 staff files include but not limited to Health Screen, First Aid/CPR certificate, Background Clearance, and Training Records. Facility conducts quarterly fire drills. LPA requested a copy of the following: updated LIC500 and updated LIC308 to be emailed; Administrator submitted their current Liability Insurance prior to this visit. Per the California Code of Regulations, Title 22, Division 6, Chapter 8, no deficiencies were observed or cited. Exit interview held with Administrator Debbie Loesch, and a copy of report was provided.the state’s words, verbatim · CDSS document, Oct 21, 2025

The state marks this report as 4 pages; the online copy we transcribed has 2. You can request the full file from the county licensing office.

Type of visit: Case Management - Annual Continuation

On 11/7/24, Licensing Program Analyst (LPA) Arvin Villanueva conducted an unannounced Case Management - Annual Continuation visit at the facility to continue with the Annual Required Inspection visit initiated on 10/31/24. LPA initially met with a staff on duty (S1) and stated the purpose of the visit. The Administrator Debbie Loesch was notified of this visit and arrived shortly after with Assistant Administrator Ingrid Myers. Present during today's visit were 6 residents in care with 1 staff on duty (S1). The LPA continued with facility visit to ensure there are no health and safety hazards and facility is in compliance with Title 22 Regulations. Facility is fire cleared for 6 non-ambulatory residents. Review of 4 sample resident files (R1, R2, R3, R4) include review of Admission Agreement, Physician Reports, Needs and Services Plan, Centrally Stored Medication Record and Ambulatory Status. No issues were noted at this time. Medication review of 2 sample residents (R3 and R5) include review of physician orders for over-the-counter medications. No issues were noted at this time. Review of 3 sample staff files (S1, S2, and S3) include review of background clearance, First Aid/CPR certificate, Health Screen, Initial and Ongoing Training. Administrator will send updated First Aid/CPR for staff S2, Health Screen for S2 and S3, and associate S2 back to this facility. Facility conducts monthly disaster drill and last drill was on 10/8/24. Facility has a dementia and infection control plan. Administrator will also submit updated LIC500 and LIC308 to the Department. {1 of 2} LPA conducted a case management review of the incident report dated 10/25/24, involving resident R4, in collaboration with the administrator. According to the report, on 10/25/24 at approximately 3:00 AM, R4 fell while attempting to walk to the commode. R4 lost balance and fell backward, resulting in a laceration to the back of the head. The administrator confirmed that the injury was not life-threatening and first aid was promptly administered. Hospice was notified, and a hospice team member arrived the same day to assess the injury and provide additional treatment for R4. The administrator noted that R4 was not initially considered a fall risk at the time of the incident and had been placed on hospice care on 9/12/24. Following the review, the administrator indicated they will submit an updated fall risk assessment for R4, as well as a Fall Prevention Plan for R4 and other residents identified as fall risks. The updated plans will be submitted by 11/30/24. Per the California Code of Regulations, Title 22, Division 6, Chapter 8, no deficiencies were observed during today's visit. Exit interview was conducted and a copy of the report was provided upon exit. {2 of 2}the state’s words, verbatim · CDSS document, Nov 7, 2024

Type of visit: Required - 1 Year

On 10/31/24, Licensing Program Analyst (LPA) Arvin Villanueva arrived to the facility unannounced to conduct an annual required inspection. LPA met with staff on duty (S1) and explained the purpose of the visit. The Licensee/Administrator Debbie Loesch and Assistant Administrator Ingrid Myers arrived shortly after. Upon arrival, there were 6 residents in care with 1 staff on duty (S1). LPA evaluated the physical plant to ensure the health and safety of the residents in care. Areas inspected are including but not limited to the kitchen, resident bedrooms, resident bathrooms, living and dining room and outdoor areas. LPA observed the facility to be free of odor, clean and in good repair at this time. LPA observed 3 bedrooms to be equipped with the required furniture and sufficient lighting throughout the facility. LPA measured the hot water temperature measured at 110 degrees F in the hallway bathroom. LPA observed sufficient seven day non-perishable and two day perishable food supplies. Fire extinguisher observed in the kitchen/dining was last inspected on 1/4/24. Smoke and carbon monoxide detectors were observed, tested and operable at this time. LPA observed centrally stored medications, toxins, and sharp objects were kept locked and inaccessible to residents in care. Swimming pool was observed to be fenced, locked and inaccessible to residents in care. No bodies of water was observed at this time. Fireplace is not being used. Due to insufficient time,this annual visit will require a continuation visit. Exit interview was conducted with the Administrator and a copy of this report was provided.the state’s words, verbatim · CDSS document, Oct 31, 2024

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Christina Valerio and Policy Analyst (PA) Melody Bradley arrived to the facility unannounced to conduct an annual required inspection. LPA met with Licensee/Administrator Debbie Loesch, and explained the purpose of the visit. LPA Valerio, PA Bradley, and Licensee Debbie Loesch toured the physical plant to ensure compliance of Title 22 regulations. LPA Valerio observed resident bedrooms. Resident bedrooms were fully furnished and free from odors. Resident bathrooms were fully stocked with paper towels, toilet paper, handrails, skid mats, soap, and hand sanitizer. Hot water was measured at 106.3*degrees F. The temperature inside the home was 73*F. Common areas were observed to be clean, organized, and free from debris. LPA observed central heating and air, fully charged fire extinguisher, and first aid kit. The facility had a adequate supply of food to meet the requirements of two days of perishables and seven days of non-perishables. An emergency supply of food and water were observed in the garage. Medications, cleaning supplies, and toxins were observed to be locked away and inaccessible to residents in care. The facility has a backyard with a large outdoor sitting areas for visits, has pet goats that are secured behind a locked fence, a place for gardening, and 2 sheds. The sheds were observed to be used for storage. No health or safety concerns observed. LPA reviewed 3 staff files. Staff files were observed to be up to date with current training. LPA review 3 resident files. Resident files were up to date with required documents. Residents were observed in their room, eating breakfast, and watching television. Staff were observed fixing breakfast, assisting residents, and completing chores LPA requested the following documentation: LIC 500, LIC 308, Liability Insurance, and LIC 610D Per California Code of Regulations (CCR) - Title 22, Division 6, Chapter 8, no deficiencies were observed. An exit interview was held, and a copy of the report was provided.the state’s words, verbatim · CDSS document, Sep 28, 2023