Skyline Villa

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Magda Malcore made an unannounced visit to the facility to conduct a required comprehensive annual inspection. LPA met Administrator, Martha Ramos and discussed the purpose for the visit. The facility is a Residential Care Facility for Elderly (RCFE) with a license capacity of (8), and a current census of (8). LPA conducted a general inspection of facility, which included, but was not limited to, the following: Operation/Physical Plant: Indoor and outdoor passageways were kept free of obstruction. The facility has no swimming pools or similar bodies of water. The facility has sufficient indoor and outdoor space for resident activities. Outdoor activity space is shaded and enclosed with latching gates. The facility is maintained at a temperature of 71 degrees Fahrenheit. Resident bedrooms were furnished with beds, night stands, chairs, bed linen and lighting. Resident bathrooms were maintained clean and fixtures were operating properly. The hot water temperatures in the bathrooms measured at 105 degrees Fahrenheit. The facility is equipped with operating smoke/carbon monoxide alarms, fully charged fire extinguishers, laundry equipment, Library room with reading material, emergency supplies/water and telephone service. The facility has posted in a common area Community Care Licensing complaint poster, Ombudsman poster, facility license, facility sketch, emergency plan and telephone numbers. The facility has a designated area for resident and staff files. Sharps and chemicals were stored locked. The Administrator was informed that facility's annual licensing fee is due April 13, 2026. Food Service: Kitchen and dining areas were maintained cleaned. Non-perishable and perishable food supply was sufficient for number of residents in care. Cups, plates, and utensils were sufficient for residents in care. **continued on LIC809-C** Health Related Services: The facility maintains a first aid kit with manual and medications were centrally stored in a locked area. LPA audited medications for four (4) residents. LPA observed resident #2 (R2s) pain medication was stored in a plastic bag. The Administrator stated that the family may have brought the medication in the bag. LPA observed in R2's medication box, an expired (November 2025) over the counter medication which was listed on (R2s) medication list as current and being provided to R2. LPA showed the bottle to the Administer and asked if more of the medication was stored at the facility since the medication was expired. The Administrator stated they did not. Record Review: Resident files were reviewed for admissions agreements, physician’s reports, appraisals, needs and services plans. LPA observed resident#1 (R1) did not have a hospice care plan at the facility for review. Staff files were reviewed for First Aid/CPR certifications, criminal record clearances, training, and health screenings. LPA observed that no documentation staff#1 (S1) and staff#2 (S2) Hospice Care training on file for review. The facility currently has residents receiving hospice care. LPA observed (S1) did not have documentation of medication administration training on file for review. The Administrator confirmed that S1 does assist with administering medications. The facility did not maintain current liability insurance and current disaster drill staff training on file for review. During today's visit, deficiencies were cited per Title 22, Division 6, of the California Code of Regulations. An exit interview was conducted where this report was discussed and a copy provided with appeal rights to Administrator Ramosthe state’s words, verbatim · CDSS document, Mar 13, 2026

The state marks this report as 9 pages; the online copy we transcribed has 7. You can request the full file from the county licensing office.

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Magda Malcore made an unannounced visit to the facility to conduct a comprehensive annual inspection. LPA met with Staff, Hilda Bocanegra, was granted entry and discussed the purpose for the visit. Administrator, Ruben Licea, arrived towards the end of the inspection. The facility is a Residential Care Facility for Elderly (RCFE) with a license capacity of (8), and a current census of (5). LPA conducted a general inspection of facility, which included, but was not limited to, the following: Operation/Physical Plant: Indoor and outdoor passageways were kept free of obstruction. The facility has no swimming pools or similar bodies of water. The facility has sufficient indoor activity space supplies for residents. Outdoor activity space is shaded and enclosed with self-latching gates. The facility is maintained at a temperature of 71 degrees F. Resident bedrooms were furnished with beds, night stands, chairs, bed linen and lighting. Resident bathroom equipment were operating properly and bathrooms were equipped with grab rails and slip mats. The hot water temperatures in the bathrooms measured at 105 degrees F. The facility is equipped with operating smoke detectors and carbon monoxide alarms, fully charged fire extinguishers, laundry equipment, and telephone service. Sharps were kept in a locked cabinet. LPA observed disinfectant wipes left unattended in the front lobby. Medications were kept in a locked cabinet. Current list of resident medications was not provided when requested during LPA's inspection. The administrator stated via telephone that he has the list on computer. The facility has posted in a common area Community Care Licensing complaint poster, Ombudsman poster, facility license, evacuation plan and emergency telephone numbers. The facility has a designated office where resident files are stored. Food Service: Kitchen and dining areas were maintained cleaned. Non-perishable and perishable food supply was sufficient for number of residents in care. Cups and plates were sufficient for number of residents in care. The facility’s refrigerator and freezer were operating properly. Record Review: The facility has a disaster plan for review. Resident files were reviewed for admissions agreements, physician’s reports, appraisals, emergency contact list, and care plans. Resident #1 (R1) did not have a complete physician's report with primary diagnosis, ambulatory status, mental and physical condition, and tuberculosis results in their file for review. Staff files were reviewed for CPR/first aid and job related training, criminal records clearances/exemptions, and health screenings. Staff #1 (S1) did not first aid training and job related training records in their file for review. The Administrator stated via telephone that he has training available to print out on the computer. During today's visit, Deficiencies and advisories were issued per title 22 of the California Code of Regulations. An exit interview was conducted were this report was discussed and copy provided with appeal rights to Administrator Licea at the conclusion of the visit.the state’s words, verbatim · CDSS document, Apr 7, 2025

The state marks this report as 12 pages; the online copy we transcribed has 6. You can request the full file from the county licensing office.

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Anna Bueno conducted an unannounced visit to this facility for a required annual inspection. Entry into the facility is unobstructed and LPA met with care staff Ruben Licea who notified administrator Richard Jerez. The facility is approved for a Hospice Waiver for five (5) residents. LPA and staff Licea toured the interior and exterior of the facility. Physical Plant: The facility is operating within capacity and not beyond the conditions of the license. There are no pools or other bodies of water located on the premises. The facility is being maintained at a comfortable temperature for residents for common areas. All passageways are kept free of obstruction. Hot water temperature was measured in all bedrooms and measured between 105 and 114 degrees Fahrenheit. Grab bars, textured shower floor, and shower aid equipment are utilized by residents. The facility has signal devices for exterior doors. Fire safety installations such as extinguishers, sprinklers, and alarms are present. Fire extinguishers were observed to be charged and last inspected on 06/01/2023. A working interconnected smoke detector system in each bedroom was tested by Administrator. Administrator also tested combination carbon monoxide and smoke detectors in both bedroom hallways. Overall the facility is in good condition; it is clean, sanitary and free of foul odors. Kitchen and Food Service: The total daily diet provided to residents appears to be of the quality and in the quantity necessary to meet resident needs. There is a minimum of one week supply of nonperishable foods and two days of perishable food items, which meets regulatory requirements. All readily perishable food or beverages capable of micro-organism growth are being stored in covered containers at appropriate temperatures. Sharps and cleaning agents are kept secured in the kitchen. Medication, Care, and Supervision: The facility has sufficient and competent staff to provide services needed to meet resident needs. Chemicals and items which can constitute a danger are stored inaccessible to residents. LPA inspected medications and found medications in their original containers. Medications appear to be dispensed according to the physician's orders. LPA did not find a PRN/as needed medication record for residents unable to determine their need for the medication. This poses a potential health and safety risk to residents in care. Resident and Staff Files: LPA reviewed all staff and resident files.Resident files had the required documentation including admission's agreement, consent forms, and appraisal and/or needs and services plan. Staff files had the required documentation including mandated reporting, health screening report and current first aid and/or CPR certification. Staff have training for Dementia care and Activities of Daily Living. LPA Bueno observed that two resident files have Physician's reports from 2022, when a current one is needed. This poses a potential health and safety risk to residents in care. Operations and Administration: Disaster Plan is present and Administrator Jerez will be updating the plan as needed. Administrator is present in the facility a sufficient amount of hours and their administrator certification is up to date. The required licensing and ombudsman posters are posted and in public view. Residents rights are posted and a copy is kept the resident's file. Refer to LIC809D for deficiencies were cited during this visit. Technical advisories and violations were issued in relation to deficiencies observed. An exit interview was conducted where this report, LIC 809D, and appeal rights were discussed and provided to Administrator.the state’s words, verbatim · CDSS document, Mar 15, 2024